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: patient recorded as having no known allergies to drugs attending: chief complaint: chest pain major surgical or invasive procedure: pci with 3 sequential stents widely patent, first two to lad, third to amend lmca dissection, all with good angiographic result. history of present illness: 67 year old blind, deaf man with esrd, htn, cad s/p nstemi, cardiomyopathy with ef 35%, initially admitted to hospital with burning chest pain radiating to shoulders. ruled out for mi. yesterday, patient returned to with burning chest pain radiating to his shoulder. no ekg changes, but known lbbb. initial negative troponin negative, but afternoon trop elevated to 0.97. overnight episodes of cp responded to 2 sl ntg +/- morphine. continued to have episodes of cp responsive to ntg. patient was transferred directly to cath lab on . . coronary angiography on revealed a right dominant system with diffuse coronary artery disease. the lmca was without angiographically apparent stenosis. the lad had 3 sequencial stents that were widely patent. there was a 50% stenosis at the d1 level proximal to the stents. there was diffuse disease between the 2nd and 3rd stents with approximately 60% stenosis, and there was a 90% focal lesion just distal to the 3rd stent that was new since the prior catheterization in . the d1 had 90% proximal disease that was not apparently changed since prior. the lcx had a widely patent stent and no significant disease. the rca had chronic subtotal occlusion in the mid-portion, with collaterals from the lad distally. he had a successful pci of the distal lad with a des which was post-dilated to 2.5mm. at this point the patient could not tolerate further intervention due to marked agitation, so it was elected not to intervene on the d1 lesion. . after this intervention the patient was transferred to 3 and continued to have chest pain on the floor. he continued to ask for nitroglycerin for chest pain overnight. ekgs were consistently unchanged. the pain was not relieved with a gi cocktail. trop was 0.63, ck=53 on am of and previously was trop=0.97 at osh on . due to his continued symptoms, he was taken to cath again on the afternoon of after his regularly scheduled hd session. the d1 lesion was successfully angioplastied and a successful pci of prox/mid lad with des was performed, but the procedure was complicated by lmca artery dissection. on the last final angiography injection, the lmca was dissected, at which point the patient arrested. cpr was immmediately initiated and atropine was given. the prowater wire was still in place in the lad and a 3.5x28mm xience des was able to be delivered to the lmca/prox lad. this stent was post-dilated to 4.0 nc balloon with sealing of the dissection and restoration of timi 3 flow into the lad and lcx. the patient left the lab intubated and on 5mcg/kg/min of dopamine to maintain a sbp of 100-110mmhg. reportedly, his home sbp runs in the 90s-100s. . upon transfer to the ccu the patient was sedated, intubated, and on dopamine to maintain his pressures. he had a peripheral line and femoral sheath for access. initial blood gas was ph 7.53, pco2 36, po2 237, hco3 31, basexs 7. past medical history: as above, and: 1) hypertension. 2) speech and hearing deficit. 3) peptic ulcer disease, dyspepsia 4) gout 5) osteoarthritis. 6) chronic renal insufficiency, thought nephrosclerosis 7) retinitis pigmentosa 8) a fib on amio 9) h/o nstemi social history: he denies tobacco or alcohol use. he is currently unemployed on disability and lives with girlfriend. family history: mother died of mi after age 80. father died at 20's of an unspecified brain "problem". other family history is not known by patient. physical exam: vs: t=99.7 bp=126/68 hr=103 rr=18 o2 sat=100% intubated general: caucasian male, sedated, intubated. heent: ncat. sclera anicteric. perrl. neck: supple with no jvd cardiac: rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: ctab, no crackles, wheezes, or rhonchi. right chest wall with temporary hd cath site clean, intact. abdomen: soft, nd. no hsm. abd aorta not enlarged by palpation. no abdominial bruits. has bowel sounds in all four quadrants. extremities: no c/c/e. no femoral bruits. skin: no rashes pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ exam at discharge: t 98.1 bp 104/61 hr 85 rr 20 99% ra general: caucasian male, sedated, intubated. heent: ncat. sclera anicteric. perrl. neck: supple with no jvd cardiac: rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: rare rales left base, otherwise ctab abdomen: soft, nd. no hsm. abd aorta not enlarged by palpation. no abdominial bruits. has bowel sounds in all four quadrants. extremities: no c/c/e. no femoral bruits. skin: no rashes pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ pertinent results: cxr : findings: in comparison with study of , the nasogastric tube has been pushed forward slightly so that the side hole appears to extend beyond the esophagogastric junction. endotracheal tube has been removed. progressive improvement in pulmonary vascular status. . tte : the left atrium is mildly dilated. the right atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. no masses or thrombi are seen in the left ventricle. overall left ventricular systolic function is moderately depressed (lvef= 35 %) with global hypokinesis and akinesis of the infero-lateral and apical segments. tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). there is no ventricular septal defect. with mild global free wall hypokinesis. the aortic root is moderately dilated at the sinus level. the ascending aorta is moderately dilated. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. coompared to the prior study dated , no major change. . cardiac cath : final diagnosis: 1. two vessel coronary artery disease. 2. successful ptca of d1 branch. 3. successful pci of prox/mid lad with des. 4. lmca dissection successfully treated with des. . cardiac cath : comments: 1. coronary angiography in this right dominant system revealed diffuse coronary artery disease. the lmca was without angiographically apparent stenosis. the lad had 3 sequencial stents that were widely patent. there was a 50% stenosis at the d1 level proximal to the stents. there was diffuse disease between the 2nd and 3rd stents with approximately 60% stenosis, and there was a 90% focal lesion just distal to the 3rd stent that was new since the prior catheterization in . the d1 had 90% proximal disease that was not apparently changed since prior. the lcx had a widely patent stent and no significant disease. the rca had chronic subtotal occlusion in the mid-portion, with collaterals from the lad distally. 2. resting hemodynamics demonstrated low to normal systemic blood pressures with sbp 101 mmhg and dbp 51 mmhg. 3. successful pci of the distal lad with a 2.25x12mm taxus des, post-dilated to 2.5mm. 4. successful closure of the right femoral arteriotomy site with a 8f angioseal device. final diagnosis: 1. diffuse coronary artery disease with new distal lad stenosis. 2. successful pci of the distal lad with des. labs at discharge: wbc rbc hgb hct mcv mch mchc rdw plt ct 7.8 3.45* 9.6* 30.6* 89 27.7 31.3 19.6* 171 glucose urean creat na k cl hco3 angap 101 35* 6.1*# 143 4.0 99 32 16 calcium phos mg 8.3* 3.7# 2.5 brief hospital course: 67 y/o blind, deaf male w/esrd, cardiomyopathy with ef 35%, transferred to with nstemi, s/p cath here on with stenting of distal lad stenosis with continued chest pain, whose repeat cath on was complicated by lmca dissection. . # coronaries: cath : lad w/ 3 sequential stents widely patient. 50% lesion at d1 proximal to stents. 60% diffuse disease between 2nd and 3rd stents; 90% focal lesion just distal to 3rd stent (new since ). d1 with prximal 90% disease (unchanged). new stent placed over distal lad lesion. procedure stopped prematurely secondary to agitation. patient returned to the floor and continued with chest pain. went back to the cath lab on where he received a des to mid lad. this second cath was complicated by lad dissection, the patient became asystolic, coded for 20 minutes and received des to lmca. on return to the ccu, patient did well. he was continued on his aspirin, plavix, metoprolol, lipitor. imdur was discontinued. lisinopril was started, and he was sent home on this regimen on . he is to take aspirin and plavix for life given his stent to the lmca. he was discharged on in improved and stable condition. . # pump: has known cardiomyopathy with ef 35% on echo. no overt clinical signs of heart failure at this time. no peripheral edema, crackles, or jvd. . # rhythm: h/o paroxysmal atrial fibrillation, but was in nsr for most of admission. patient was continued on amiodarone, started on metoprolol as bp could tolerate. . # hypotension: initially on dopamine, but weaned off. goal sbp maintained near 90s-100s. patient continued on metoprolol, and eventually tolerated introduction of lisinopril, as indicated post-myocardial infarction. . # anemia: hct dropped from 30.9 pre-procedure to 24.8 post-procedure. hct on discharge was 30.6, at baseline. . # esrd w/ hd on mwf: underwent normal session of hd friday morning prior to cath. patient continued on nephrocaps, renagel. patient will continue regular monday, wednesday, friday schedule for hemodialysis. . # gout: allopurinol continued on discharge. . # congenital deafness: can read lips effectively at baseline. involved asl interpreters as needed following extubation. . # peptic ulcer disease, dyspepsia: continued on famotidine. pt remained a full code throughout hospitalization. medications on admission: lopressor 100 po bid asa 325 mg po daily zocor 40 mg po daily colace 100 mg po daily esomeprazole 40 mg po daily sevelamer 1600 mg po with meals mvi po daily allopurinol 100 mg po daily cholecalciferol 400 units po daily amiodarone 200 mg po daily isosorbide mononitrate 120 mg po daily metoprolol tartrate 100 mg po bid lorazepam 0.5 mg po q6 hrs prn oxazepam 10 po qhs prn maalox 30 cc po q8 prn morphine sulfate 2 mg iv q4 hrs prn nitroglycerin 1 tab sl prn discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 2. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 3. sevelamer hcl 400 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). :*180 tablet(s)* refills:*2* 4. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 5. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 6. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 7. multivitamin tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 8. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 9. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). :*90 cap(s)* refills:*2* 10. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). :*90 tablet(s)* refills:*2* 11. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). :*90 tablet(s)* refills:*2* 12. nitroglycerin 0.3 mg tablet, sublingual sig: tablet, sublinguals sublingual prn (as needed) as needed for angina: take one tablet every 5 minuties for chest pain, if pain continues after three doses, call your doctor. :*30 tablet, sublingual(s)* refills:*0* 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). :*60 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary diagosis: nstemi, s/p stent x 2 to lad, with subsequent lad dissection, s/p stent to lmca with good angiographic result secondary diagnoses: (prior to this hospitalization) 1. cardiac risk factors: dyslipidemia, hypertension 2. cardiac history: dilated cardiomyopathy (ef 35%); nstemi , lad stent in , cypher to om3 with poba to distal lcx in ; unsuccessful ptca of rca chronic total occlusion ; paroxysmal atrial fibrillation 3. other past medical history: esrd w/ hd on mwf gout congenital deafness retinitis pigmentosa hypertension speech deficit peptic ulcer disease, dyspepsia gout osteoarthritis. discharge condition: stable and improved discharge instructions: you were admitted to the hospital for chest pain. after initially being evaluated at hospital, you were transferred to for further care. your chest pain was coming from your heart, and you required 3 stent placements during your hospital course. your heart stopped for a short period of time, and you were resuscitated. you needed assistance breathing, and had a breathing tube for a short period of time. after the heart procedure, you were cared for in the icu. you continued to improve, and had the breathing tube removed. other medications used to support your heart were also no longer needed. you resumed your regularly scheduled hemodialysis, which you tolerated well. you were discharged on in good condition. the following changes were made to your medications: you will continue taking aspirin 325 mg daily and plavix 75 mg daily for the rest of your life unless you are told to stop by your cardiologist you have been started on lisinopril 2.5 mg daily for your heart you will stop taking imdur for your blood pressure. please see below for follow up appointments. you will need to have repeat catheterizations in the next 12 months to ensure that the stents are working well. please call your doctor or 911 if you develop chest pain/pressure, shortness of breath, fevers/chills, lightheadedness, or any other concerning medical symptoms. followup instructions: you have a follow up appointment with dr. at . they will contact you. please discuss a repeat cardiac catheterization with him during this visit. . please follow up with your primary care doctor within one week of discharge. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours coronary arteriography using two catheters left heart cardiac catheterization other and unspecified coronary arteriography insertion of endotracheal tube hemodialysis laryngoscopy and other tracheoscopy cardiopulmonary resuscitation, not otherwise specified insertion of drug-eluting coronary artery stent(s) insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel procedure on single vessel diagnoses: other primary cardiomyopathies end stage renal disease renal dialysis status subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery cardiac complications, not elsewhere classified gout, unspecified atrial fibrillation percutaneous transluminal coronary angioplasty status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cardiac arrest old myocardial infarction other left bundle branch block cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure osteoarthrosis, unspecified whether generalized or localized, site unspecified other and unspecified special symptoms or syndromes, not elsewhere classified peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction pigmentary retinal dystrophy dissection of coronary artery deaf, nonspeaking, not elsewhere classifiable 

Answer: The patient is high likely exposed to