Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: lipitor / lovastatin / niaspan attending: chief complaint: chest pain, shortness of breath, hypotension major surgical or invasive procedure: cardiac catheterization pa catheter placement history of present illness: patient is a 84 yo man with h/o of dm, htn, hyperlipidemia, s/p pacer for 3rd degree heart block, non-ischemic cardiomyopathy with ef of 50% who called his cardiologist this am with cp and sob and was found to be hypotensive and in renal failure. of note, patient underwent underwent a colonscopy the day pta with polypectomy x 2 at . per reports for osh he was hypotensive with sbps in the 70 prior to colonoscopy yesterday and therefore it was done without sedation. per patient, his sbp remained low after the procedure, but he was sent home. at 2 am he awoke with cp described as a dull ache located over his left shoulder and to his back associated with sob. nothing made the pain better, but putting a 3rd pillow under his head improved his sob. he was seen in his cardiologist's office today where he was found to have sbp in the 70s, with jvd and crackles on exam and was sent to the ed to evaluate for possible cardiogenic shock. by that time his cp and sob had improved. in the ed at he was found to be hypotensive with sbps 70s-80s and in renal failure with creatinine of 3.7 from a baseline of 1.3, with crackles on exam, bnp 2422 and mild pulmonday edema on cxr. he was seen by cardiology and echo done which revealed ef 20%. he was given 1.4 liters ns, was started on peripheral levophed, and a triple lumen right femoral line was placed. ce's revealed ck 27 and trop 0.016 in the setting of a creatinine of 3.5. per report cxr revealed mild pulmonary edema. he was transferred to for further management. on arrival, sbp 90s/50s on levophed, o2 sats 96 % on 2 l, hr 60. he reports that he breathing feels better. denies cp, palpitations, abdominal pain, dizziness, lightheadedness. on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools. he has occasional brb on the toilet paper. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, ankle edema, palpitations, syncope or presyncope. he has stable 2 pillow orthopnea. he does note that over the past 2 months he has been more sob when walking up stairs when he does the laundry. denies associated cp. he reports that he goes to the 3 times per weeks and lifts weights and does some exercises, which he has continued to do. past medical history: 1. diabetes for the past 5 years. 2. hypertension. 3. hyperlipidemia. 4. he has a pacemaker inserted 3rd degree heart block model number dr 7088. 5. ckd with baseline creatinine 1.3 6. ccy 7. appendectomy 8. shoulder surgery 9. cataract surgery . bph 11. gerd social history: social history is significant for the absence of current tobacco use quite in . drinks 2-3 glases of wine per night. no h/o dts or etoh withdrawal. last drink 2 nights ago. he is married. family history: mother died at the age of 96 of "old age." father had heart problems in his 80s. he has 2 sisters, who are alive and well. he has 7 children, who are alive and well. physical exam: admission physical examination: vs: t 97.9, bp 89/42, hr 61 , rr 18 , o2 % 95 % on 1.5 l gen: elderly male in nad. oriented x3. mood, affect appropriate. lying flat in bed breathing comfortabley. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: on jvd could be appreciates, no carotid bruits. cv: distant heart sounds, rr, normal s1, s2. no s4, no s3. could not appreciate any murmurs chest: resp were unlabored, no accessory muscle use. crackles at the bases bilaterally with diffuse wheezes but good air movement abd: obese, soft, minimally distended, no hsm or tenderness. no abdominial bruits. ext: no c/c/e. no femoral bruits, right femoral line in place. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 1+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp pertinent results: admission labs: 06:04pm blood wbc-10.1 rbc-3.41* hgb-10.8* hct-31.4* mcv-92 mch-31.6 mchc-34.3 rdw-13.1 plt ct-188 06:04pm blood pt-13.3 ptt-27.1 inr(pt)-1.1 06:04pm blood plt ct-188 06:04pm blood glucose-67* urean-56* creat-3.6*# na-136 k-4.4 cl-104 hco3-19* angap-17 06:04pm blood calcium-8.6 phos-5.7* mg-1.7 04:24am blood type-art po2-77* pco2-34* ph-7.36 caltco2-20* base xs--5 cardiac enzymes: 06:04pm blood ck(cpk)-72 03:49am blood ck(cpk)-74 06:04pm blood ck-mb-notdone ctropnt-0.02* 03:49am blood ck-mb-notdone ctropnt-0.02* admission ekg: av paced rhythm, rate 63, with no significant change compared with prior. 2d-echocardiogram performed on : the left atrium is mildly dilated. the estimated right atrial pressure is 10-15mmhg. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is severe global left ventricular hypokinesis (lvef = 20 %). the right ventricular cavity is moderately dilated with moderate global hypokinesis and apical akinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. cardiac catheterization (): 1. coronary angiography in this right-dominant system revealed minimal coronary artery disease. --the lmca had no angiographically apparent disease. --the lad had mild diffuse disease. --the lcx had a 40% stenosis in its mid-portion. --the rca had no angiographically apparent disease. 2. resting hemodynamics revealed normal right- and left-sided filling pressures, with rvedp 8 mmhg and lvedp 16 mmhg. borderline pulmonary arterial systolic pressures with pasp 26 mmhg. normal systemic arterial systolic pressures with sbp 113 mmhg. the cardiac output was depressed with ci 2 l/min/m2. 3. there was no gradient across the aortic valve upon pullback of the angled pigtail catheter from lv to ascending aorta. final diagnosis: 1. nonischemic cardiomyopathy. ef 20% brief hospital course: mr. presented with shortness of breath, chest pain and acute on chronic renal failure. his exam, laboratory values (including elevated bnp) and cxr were consistent with overt volume overload. he was relatively hypotensive with signs of end-organ underperfusion as evidenced by acute on chronic renal failure. he had no ischemic ekg changes and negative cardiac enzymes. tte revealed newly depressed ef to 20%. the patient required levophed for vasopressor support in the setting of hypotension and poor perfusion. he was admitted to the ccu where he had a pa catheter placed and underwent successful diuresis. with symptomatic improvement, successful removal of pressor support and return of renal function toward ckd baseline, the patient underwent cardiac catheterization with appropriate contrast nephropathy prophylaxis. cath revealed no significant cad. his cardiac regimen was targeted to therapy of non-ischemic cardiomyopathy with severely depressed ef: he was initiated on furosemide 20mg once daily, carvedilol 3.125mg twice daily, aspirin 81mg once daily and digoxin 0.125mg once every other day. his acei dose was reduced to lisinopril 2.5mg once daily (down from 5mg once daily prior to admission) due to relative hypotension. upon discharge, his home spironolactone, doxazosin and finasteride were held and he was instructed to discuss restarting these medications with his outpatient cardiologist, dr. . his home bisoprolol was discontinued. the inciting etiology for his decompensation is not known though appears temporally related to his recent colonoscopy prep. the patient will follow-up with dr. - his outpatient cardiologist - within 1 week (and the plan was discussed over the phone with dr. . he will also undergo repeat echo in approximately 2 months time with follow-up with dr. of ep. if his ef is persistently depressed at that time he may benefit from upgrade of his pacer to biv icd. at the time of discharge the patient's symptoms were markedly improved with near complete return to pre-admission baseline. medications on admission: spironolactone 25 mg every evening lisinopril 5 mg every evening bisoprolol fumirate 7.5 mg every evening pravastatin 40 mg every evening gemfibrozil 600 mg po bid doxazosin 4 mg every evening levothyroxine 50 mcg every morning glipizide 2.5 mg each morning prilosec 20 mg every morning fenesteride 5 mg every morning calcium d super complex and a-z vitamins discharge medications: 1. pantoprazole 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 2. pravastatin 20 mg tablet sig: two (2) tablet po daily (daily). 3. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 4. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 5. glipizide 2.5 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po once a day. 6. hexavitamin tablet sig: one (1) cap po daily (daily). 7. calcium 500+d 500 (1,250)-200 mg-unit tablet sig: one (1) tablet po once a day. 8. aspirin 81 mg tablet sig: one (1) tablet po once a day: three month supply. disp:*90 tablet(s)* refills:*4* 9. aspirin 81 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 10. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day): three month supply. disp:*180 tablet(s)* refills:*4* 11. carvedilol 3.125 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 12. furosemide 20 mg tablet sig: one (1) tablet po daily (daily): three month supply. disp:*90 tablet(s)* refills:*4* 13. furosemide 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 14. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day): three month supply. disp:*45 tablet(s)* refills:*4* 15. digoxin 125 mcg tablet sig: one (1) tablet po every other day. disp:*15 tablet(s)* refills:*2* 16. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: primary: non-ischemic cardiomyopathy acute on chronic renal failure secondary: diabetes mellitus ii hypertension hypercholesterolemia chronic kidney disease benign prostatic hypertrophy gerd discharge condition: stable discharge instructions: you were admitted with chest pain, shortness of breath and kidney failure. the cause of this is newly decreased cardiac function with fluid overload. you were treated with fluid removal and medical therapy intended to improve your cardiac function. the cause of this problem is currently unknown, however, it is not due to coronary artery disease. please call dr. office within the next week for follow-up. in addition you must have a repeat echocardiogram on to evaluate for interval change in your cardiac function. after this echocardiogram you must follow-up with dr. (an electrical heart specialist) for consideration of a change in your pacemaker type. take all medications as prescribed. new medications include furosemide 20mg once daily, carvedilol 3.125mg twice daily, aspirin 81mg once daily and digoxin 0.125mg once every other day. please reduce your dose of lisinopril at home to 2.5mg once daily (down from 5mg once daily prior to admission). discontinue your home spironolactone (also called aldactone) and bisoprolol. please do not take your home doxazosin and finasteride (medications for enlarged prostate which can cause low blood pressure) until you are seen by dr. and discuss restarting these medications with him. weigh yourself daily and call your doctor for any increase in weight greater than 3lbs. adhere to a low salt diet less than 2g salt daily. call your doctor or return to the hospital for any new or worsening chest pain, shortness of breath, difficulty breathing when lying flat in bed, nausea, vomiting or any other concerning symptom. followup instructions: call dr. office () to follow-up within the next week. echocardiogram , 8:00am in of the building. dr. 11:20am in of the building. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of right heart structures pulmonary artery wedge monitoring diagnoses: other primary cardiomyopathies esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified atrioventricular block, complete cardiogenic shock cardiac pacemaker in situ acute on chronic systolic heart failure 

Answer: The patient is high likely exposed to