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: mrs. is a 58 year old woman with a complicated prolonged hospital course who was transferred to the service on . originally, she was admitted on , to the vascular left below the knee amputation on . her postoperative course was complicated by suicidal ideations requiring a one-to-one sitter. for a more detailed review of the patient's stay on the vascular service, please refer to the discharge summary from . the patient was subsequently transferred to medical intensive thought to be a combination of uremia secondary to acute on chronic renal failure and necrotic infection. in the medical intensive care unit, the ekg showed new inferior st elevations and the patient subsequently ruled in for an acute myocardial infarction with peak ck of 369, mb of 23 and troponin of 38.5. preoperative stress mibi on , had shown moderate defects anteriorly, inferiorly, laterally and apically, with marked diffuse hypokinesis and ejection fraction of 20%. dialysis was initiated on with continued improvement in mental status. the patient was initially treated conservatively for an myocardial infarction with heparin, beta blocker, aspirin, ace inhibitor. the patient was taken to the catheterization laboratory on . in the catheterization, the patient was discovered to have three-vessel disease and underwent percutaneous transluminal coronary angioplasty of obtuse marginal 1 lesion with good results. for more details, please refer to the catheterization report from . post-catheterization, the patient did not have any chest pain, shortness of breath, dizziness, nausea, vomiting or other complaints. past medical history: 1. coronary artery disease status post myocardial infarction on ; catheterization on with percutaneous transluminal coronary angioplasty to obtuse marginal. congestive heart failure with an ejection fraction of 20%. 2. insulin dependent diabetes mellitus for four years. 3. peripheral vascular disease. 4. chronic renal insufficiency which is now acute renal insufficiency on hemodialysis. 5. hypertension. 6. history of anti-phospholipid antibody. 7. anemia. 8. tracheal stenosis, status post tracheostomy in . 9. right hemiarthroplasty. allergies: benadryl and morphine. medications on transfer: 1. aspirin 325 mg p.o. q. day. 2. nph 5 units q. a.m.; 1 unit q. p.m. 3. regular insulin sliding scale. 4. protonix 40 mg p.o. q. day. 5. calcium bicarbonate 500 mg p.o. three times a day. 6. rocaltrol 0.25 micrograms p.o. q. day. 7. nephrocaps. 8. captopril 6.25 mg p.o. three times a day. 9. imdur 30 mg p.o. q. day. 10. iron sulfate 325 mg p.o. three times a day. 11. colace 100 mg p.o. twice a day p.r.n. 12. lopressor 50 mg p.o. twice a day. 13. zoloft 50 mg p.o. q. day. 14. integrilin drip. physical examination: physical examination revealed a pleasant 51 year old woman in no acute distress. temperature was 98.0 f.; blood pressure 131/71; heart rate 77; respiratory rate 16; oxygen saturation 97% on room air. the patient was comfortable. examination of the head: oropharynx was clear. mucous membranes were moist. there was no jugular venous distention. heart was regular rate and rhythm, no murmurs, rubs or gallops. lungs: there were bilateral inspiratory and expiratory mild wheezes centrally more than peripherally consistent with tracheal stenosis. abdomen was soft, nontender, nondistended. good normal bowel sounds. groin: sheath sore in place. extremities: status post left below the knee amputation. right foot ulcer is not necrosed and not cellulitic. neurologic examination: alert and oriented times three, grossly nonfocal. laboratory: on admission, white blood cell count 8.4, hematocrit 28.5, platelets 328. sodium 131, potassium 3.2, chloride 102, bicarbonate 26, bun 22, creatinine 2.0, glucose 63. ekg post-ptca shows normal sinus rhythm, inferior qs consistent with inferior myocardial infarction, normal intervals, borderline left anterior descending, t wave inversions in leads i and avl. also in leads v4 and v6. there were 0.5 to 1. depressions. ekg was not significantly changed from . hospital course: the patient underwent cardiac catheterization on . per catheterization report, the patient has a severe three-vessel coronary artery disease, moderate to severe pulmonary hypertension, and successful percutaneous transluminal coronary angioplasty of the obtuse marginal 1. left anterior descending was diffusely diseased throughout its course to a 30% in proximal segment with serious lesions of up to 80% in the mid segment and 90% in the distal vessel. cardiac output was severely reduced with mildly elevated right sided and moderate to severe pulmonary hypertension. the patient did not have any complications post catheterization. there is no groin hematoma. the patient did not have any chest pain, shortness of breath, nausea or vomiting. disposition: the patient will be discharged to a rehabilitation today in stable condition. condition at discharge: all her other medical issues remained stable. the patient had hemodialysis today on . per renal consultation, av fistula was most likely needed. therefore, the patient was evaluated by a transplant consultation for the placement of an av fistula. they recommended performing this procedure at a later date after the patient fully recovers from catheterization. the patient's glycemic control has been stable. the patient's renal issues: the patient continued to have acute on chronic renal failure and will require hemodialysis at the rehabilitation facility. hematologically, the patient's anemia has been stable and hematocrit post-catheterization was unchanged. in the rehabilitation, the patient will need pet and conair bed for her sacral and decubitus ulcers. discharge medications: 1. aspirin 325 mg p.o. q. day. 2. nph 5 units q. a.m. and 1 unit q. p.m. 3. protonix 40 mg p.o. q. day. 4. tums 500 mg p.o. three times a day. 5. imdur 30 mg p.o. q. day. 6. nephrocaps. 7. iron sulfate 225 mg p.o. three times a day. 8. lopressor 50 mg p.o. twice a day. 9. colace 100 mg p.o. twice a day p.r.n. 10. zoloft 50 mg p.o. q. day. 11. atorvastatin 20 mg p.o. q. day. 12. heparin 1000 units subcutaneously twice a day. 13. rocaltrol 0.25 micrograms p.o. q. day. the patient is not on an ace inhibitor secondary to her renal failure. discharge instructions: 1. the patient will require hemodialysis as an outpatient. , m.d. dictated by: medquist36 procedure: coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization hemodialysis transfusion of packed cells other amputation below knee diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute myocardial infarction of unspecified site, initial episode of care gangrene ulcer of other part of lower limb diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled secondary cardiomyopathy, unspecified 

Answer: The patient is high likely exposed to