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: history of present illness: the patient is a 76-year-old male who presented to with chest pain on and was transferred to the for management of an acute myocardial infarction. he has a history of atrial fibrillation since , deep venous thrombosis, and colon cancer. his cardiac risk factors include a remote smoking history, hypercholesterolemia, and a family history of myocardial infarctions. he was in his usual state of health until the morning of when he developed acute chest pain when getting up at 4 a.m. the pain appeared localized mostly to his back without any radiation. he did not have symptoms of dyspnea. no nausea, and no diaphoresis. he was able to go back to sleep and woke up again at 5 a.m. with severe squeezing chest pain localized to the anterior chest. he rated the pain ; again no radiation, no dyspnea, no nausea, and no diaphoresis were noted. he had never had this type of chest pain before. he also had not experienced any recent changes in exercise tolerance of being able to walk about one flight of stairs (limited by dyspnea and not limited by pain). he did not give any history of orthopnea or paroxysmal nocturnal dyspnea. he does have chronic leg edema which has not changed recently. he was brought to where he received four doses of sublingual nitroglycerin which relieved the chest pain temporarily. an electrocardiogram at showed st elevations in v2 to v6. his cardiologist is dr. at , but due to an unavailability of beds he was transferred to for cardiac catheterization. the initial electrocardiogram at showed marked st elevations in leads i, avl, and v2 to v6, with reciprocal depressions over the inferior leads, as well as a right bundle-branch block pattern, and left axis deviation. cardiac catheterization at showed total occlusion of the left anterior descending artery after first heart sound, diffuse irregularities in the right coronary artery, but no significant disease in the left main coronary artery and left circumflex. the left anterior descending artery occlusion was successfully stented; however, no reflow resulted. he was admitted to the coronary care unit for management of his acute myocardial infarction. past medical history: 1. atrial fibrillation since . 2. congestive heart failure in the setting of atrial fibrillation. 3. deep venous thrombosis in and (the latter in the setting of colectomy). 4. colon cancer, status post colectomy with colostomy in . 5. arthritis. 6. hypercholesterolemia. 7. one past episode of hematuria of unclear etiology. 8. depression. 9. benign prostatic hyperplasia with transurethral resection of prostate a little more than five years ago. allergies: no known drug allergies. medications on admission: medications at home included digoxin 0.25 mg p.o. q.d., zestril 20 mg p.o. b.i.d., furosemide 40 mg p.o. q.d., celexa 20 mg p.o. q.d., lipitor 10 mg p.o. q.d., metoprolol 50 mg p.o. b.i.d., verapamil 240 mg p.o. q.d., naproxen 500 mg p.o. q.d. social history: he is a retired police officer. he lives with his wife in . he smoked four packs per day for over 10 years, but he quit 40 years ago. he occasionally drinks alcohol. family history: his brother died from a myocardial infarction at the age of 56. his father died from "heart disease" at the age of 40. physical examination on presentation: physical examination on admission to the coronary care unit revealed vital signs with a temperature of 97, blood pressure of 110/60, heart rate of 77, respiratory rate of 16, pulse oximetry 90% on 3 liters nasal cannula. general appearance revealed the patient was tired-appearing but in no acute distress. head, eyes, ears, nose, and throat revealed pupils were equal, round, and reactive to light. extraocular movements were intact. his sclerae were anicteric. he had moist mucous membranes, and no appreciable oral lesions. neck revealed jugular venous pressure was difficult to assess due to the supine position. no carotid bruits were appreciated. cardiovascular examination revealed an irregularly irregular rhythm with a holosystolic murmur at the apex, radiating to the axilla. the lungs had mild diffuse wheezes throughout. the abdomen was soft, nontender, and nondistended, with active bowel sounds. a well-healed midline scar, and a colostomy bag in place on the left side. extremities revealed 1 to 2+ pitting edema on both legs and chronic venous stasis changes. good distal pulses. the catheterization site in the right groin were remarkable for dressing soaked with blood. no hematoma or bruits were evident. neurologic examination revealed the patient was alert and oriented. cranial nerves ii through xii were intact. no drift. full grip strength. plantar flexion strength was . his reflexes were symmetric. his toes were equivocal. pertinent laboratory data on presentation: laboratory data at the time of admission to the coronary care unit, his hematocrit was 43.4, white blood cell count was 7.9, platelet count was 161. his pt was 16.9, inr of 2, ptt of 23.2. sodium of 140, potassium of 4.9, chloride of 106, bicarbonate of 22, blood urea nitrogen of 29, creatinine of 0.9, blood glucose of 203. the initial creatine kinase was 114, and the ck/mb was 7, troponin i was less than 0.3. radiology/imaging: electrocardiogram performed status post catheterization showed atrial fibrillation with an average ventricular response of 69, marked st elevations were noted in leads i, avl, and v2 through v6; suggesting an acute myocardial infarction. there was also a right bundle-branch block pattern and left axis deviation. a chest x-ray from showed evidence of congestive heart failure as well as small right-sided pleural effusion. hospital course by system: 1. cardiovascular: following catheterization, he was admitted to the coronary care unit with a diagnosis of acute myocardial infarction. he was started on aspirin, plavix, and an 18-hour course integrilin following catheterization, and metoprolol and nitroglycerin drip for management of chest pain and blood pressure. his coumadin had been held for catheterization, and he was started on heparin for anticoagulation in the setting of atrial fibrillation. his digoxin, verapamil, lasix, and zestril were initially held. he was initially not given an intravenous fluids as his physical examination and outside chest x-ray suggested possible mild fluid overload. an echocardiogram was planned for the next day. over the course of the first night he had three short episodes of chest pain and nausea which were relieved by nitroglycerin. one of them required 1 mg of morphine. electrocardiograms at that time with chest pain showed developing q waves, but no new st elevations. serial creatine kinases were drawn which peaked at the second creatine kinase at 5856, the ck/mb was 482, and the mb index was 8.3. the third creatine kinase was 3586, ck/mb of 258, mb index of 7.2. in the morning of , he became hypotensive to a blood pressure of 80/40. he had not yet given consent for a central line. he was given two fluid boluses of 250 cc of normal saline which stabilized his blood pressure. however, over the next few hours he developed considerable respiratory distress requiring increasing concentrations of oxygen and a brief course of bipap. a chest x-ray showed evidence of congestive heart failure. he now gave consent for central line, and a right internal jugular line was put in place. he was given a total of 160 mg of intravenous lasix with great improvement in his respiratory status, and he was able to breathe comfortably on nasal cannula again. his blood pressure remained stable except for one further episode of hypotension in the evening of , for which he was briefly placed on a levophed drip which was discontinued after two hours. he did not require management with intravenous pressors. an echocardiogram done on showed extensive left ventricular systolic dysfunction including akinesis of the distal third of the inferior, lateral, and anterior walls as well as the apex, and additional areas of hypokinesis. there was evidence of torn mitral cordis with moderate (2+) eccentric jet of mitral regurgitation directed inferolaterally. moderate tricuspid regurgitation was also seen. his ejection fraction was 20% to 25%. note: based on the american heart association recommendations, these findings recommend endocarditis prophylaxis in the future. his blood pressure remained stable, but he still was repeatedly tachycardia into the 100 to 120 range. over the next two days his metoprolol dose was increased. captopril and eventually digoxin were added to the regimen for improved blood pressure and rate control. please see addendum to this discharge summary for further cardiovascular course and details on the medications on discharge. 2. pulmonary: as noted above, the patient developed respiratory distress on , likely secondary to congestive heart failure. he initially required bipap but was quickly able to switch back to nasal cannula with improved oxygenation following 160 mg of intravenous lasix. his respiratory status continued to improve over the next two days. he was given daily intravenous lasix for continued diuresis and will likely be switched back to his home oral regimen of daily lasix prior to discharge. please see addendum for details of his pulmonary course. 3. genitourinary: as noted above, the patient has a history of hematuria even though a full workup has never been initiated. during the initial night of , he developed significant hematuria with clotting in the foley catheter bag as well as leakage of blood and urine around the foley catheter. his urine output dropped to 0 secondary to clotting. an attempt was made with a larger foley which was only briefly successful. due to the hematuria, the post catheterization integrilin was stopped after a total of 15 hours instead of the normal 18 hours. the urology service was consulted and were able irrigate copious clots with a larger foley catheter. he was started on continuous bladder irrigation which was stopped after 24 hours, as he had no further hematuria. the urology service recommended outpatient workup of the hematuria when he was stable including outpatient cystoscopy. for this, the patient should follow up with dr. (telephone number ). 4. endocrinology: the patient's initial blood glucose on admission was 203. he did not have a known diagnosis of diabetes, but was placed on fingerstick checks and an insulin sliding-scale. he did require an average of 2 units of regular insulin per day. most of his blood sugars were in the 150 to 170 range. his hemoglobin a1c was checked which was 6.7. this suggested he does potentially recent onset diabetes. given his cardiac history, he would benefit from glucose control and should probably be started on an oral hypoglycemic such as metformin on discharge. please see details in the addendum. note: please see addendum to this discharge summary for the hospital course beginning on until the time of discharge for further events of hospital stay; including discharge diagnosis, medications, and followup instructions. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization catheter based invasive electrophysiologic testing implantation or replacement of automatic cardioverter/defibrillator, total system [aicd] diagnoses: pure hypercholesterolemia congestive heart failure, unspecified acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation paroxysmal ventricular tachycardia 

Answer: The patient is high likely exposed to