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: shortness of breath major surgical or invasive procedure: placement of pa catheter history of present illness: this is a 65m who was diagnosed with pulmonary hypertension in who was electively admitted for initiation on flolan therapy. his pulmonary hypertension is thought to be due to copd and obstructive sleep apnea. pt reports that his activity is limited to walking from bed to his bathroom at home secondary to his shortness of breath. . mr. was originally diagnosed with pulmonary hypertension in when he was hospitalized in for dyspnea. at the time, he was diagnosed with obstructive sleep apnea and treated with cpap. his workup included a cardiac catheterization that revealed one-vessel coronary artery disease and severe pulmonary hypertension. he was started on tracleer, sildenafil and warfarin but continued to be symptomatic and was referred to for a second opinion in . he had a right heart catheterization with nitric oxide reactivity series on , which demonstrated severe pulmonary hypertension with baseline pa pressures of 70/29 mmhg, pcwp of 14 mmhg, cardiac index 2.1 liters/min/m2 and pulmonary vascular resistance of 532 dynes/s/cm5. with 100% fio2, the pa pressure reduced to 51/25 mmhg and pvr reduced to 370 dynes/s/cm5. there was no evidence of significant left-to-right shunting. . in addition to cardiac catheterization, he had a dobutamine stress echocardiogram on that demonstrated normal left ventricular ejection fraction without inducible ischemia, no significant valvular disease but with a moderately dilated right ventricle and evidence of impaired lv relaxation. . ros: significant for runny nose, occasional cough and diarrhea and left shoulder pain. otherwise negative. past medical history: 1. pulmonary hypertension, diagnosed in , on tracleer, ravatio, and warfarin. 2. hypertension. 3. obesity. 4. obstructive sleep apnea on cpap. 5. non-insulin dependant diabetes. 6. mild lv diastolic dysfunction 7. moderate one-vessel coronary artery disease and lad. 8. emphysema 9. home o2 requirement, 3l at rest, 4l with exertion 10. s/p appendectomy 11. s/p hernia repair x2 . s/p left ankle surgery . s/p left wrist surgery . gerd social history: he is a former auto mechanic. he previously smoked 80 pack years and was a heavy drinker. he quit both almost 20 years ago. he is a widower. he has 4 children and 11 grandchildren and one great grandchild. history of asbestos exposure from brake pads. family history: mother - deceased complications of emphysema father - deceased heart failure and chronic kidney failure diabetes. physical exam: general appearance: well nourished, no acute distress, overweight / obese, no(t) anxious, no(t) diaphoretic eyes / conjunctiva: perrl, no(t) sclera edema head, ears, nose, throat: normocephalic, no(t) endotracheal tube, no(t) ng tube, no(t) og tube cardiovascular: (s1: normal), (s2: normal), no(t) s3, no(t) s4, distant heart sounds peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: clear : ) abdominal: soft, non-tender, bowel sounds present, no(t) distended, obese extremities: right: absent, left: absent skin: warm, no(t) rash: , no(t) jaundice neurologic: attentive, follows simple commands, responds to: not assessed, movement: not assessed, tone: not assessed pertinent results: admission labs: 05:53pm blood wbc-10.2 rbc-4.22* hgb-13.0* hct-38.1* mcv-90 mch-30.8 mchc-34.1 rdw-14.6 plt ct-297 05:53pm blood neuts-72.9* lymphs-18.2 monos-4.4 eos-3.7 baso-0.7 05:53pm blood pt-14.8* ptt-29.6 inr(pt)-1.3* 05:53pm blood glucose-99 urean-31* creat-1.4* na-139 k-3.8 cl-103 hco3-24 angap-16 05:53pm blood calcium-10.1 phos-3.7 mg-1.8 . chest x-ray ()- in comparison with the study of , there has been placement of a right ij swan-ganz catheter that extends well into the right pulmonary artery system beyond the confines of the mediastinum. no evidence of pneumothorax. no acute focal pneumonia. . chest x-ray () - as compared to the previous radiograph, the swan-ganz catheter has been removed. the introduction sheath is still in place in the right internal jugular vein. there is no evidence of pneumothorax. unchanged normal size of the cardiac silhouette, absence of pneumonia or of overhydration. no pleural effusions. . discharge labs: 06:08am blood wbc-12.0* rbc-3.80* hgb-12.3* hct-35.4* mcv-93 mch-32.5* mchc-34.8 rdw-14.2 plt ct-229 05:20am blood pt-14.0* ptt-29.4 inr(pt)-1.2* 06:08am blood glucose-124* urean-38* creat-1.6* na-139 k-4.2 cl-103 hco3-26 angap-14 06:08am blood calcium-9.7 phos-3.4 mg-2.1 brief hospital course: a&p: 65m with severe pulmonary hypertension electively admitted to initiate flolan therapy. . # pulmonary hypertension - patient with symptomatic, functionally limiting pulmonary hypertension was admitted for trial of flolan infusion. a pa catheter was palced on arrival with pcwp of 12, pa pressures of 50-60/20's. he was continued on home doses of tracleer and sildenafil. flolan infusion was intiiated at a starting dose of flolan 2ng/kg/min, then uptitrates by 2ng/kg/min every hour. he initially tolerated the medication well with mild flushing, headache and lightheadedness, but then at 6ng/kg/min he developed flash pulmonary edema with development of respiratory distress and increased oxygen requirement. flolan was downtitrated, symptoms were managed and patient stabilized with eventual reinitiation of flolan at a slower rate of titration. he did not tolerate the medication however developing recurrent respiratory distress several times therefore not reaching even the target dose of 8ng/kg/min. his primary pulmonary team determined that he was not a good candidate for flolan therapy and the medication was stopped. he was stable on home dose of oxygen at discharge and at baselne in terms of respiratory status. . # hypertension - he was continued on home regimen of lisinopril with systolic blood pressures in 90-110's. . # chronic diastolic heart failure - he was continued on his home dose of lasix. . # coronary artery disease - known 75% mid lad stenosis, mild diagonal disease 40% proximal circumflex stenosis and a 40-50% pda stenosis. he was continued on aspirin, ace inhibitor . # cri : patient received several extra doses of iv lasix for episodes of flash pulmonary edema with subsequent increase in creatinine to 1.6 at discharge. he was instructed to liberalize fluid intake and follow-up for repeat creatinine several days after discharge . # diabetes mellitus - he was initially kept on insulin sliding scale, but then transitiuoned back to home dose of metformin with good overall blood sugar control. . # obstructive sleep apnea - continued on home cpap . # copd - stable, continued on home oxygen . # gerd - continued on ppi. medications on admission: bosentan 62.5 mg b.i.d. budesonide 32 mcg inhaler lexapro 20 mg daily fenofibrate 145 mg daily furosemide 80 mg daily prevacid 30 mg daily lisinopril 10 mg daily metformin 850 mg t.i.d. potassium chloride 20 meq daily sildenafil 40 mg t.i.d. warfarin 2-3mg qhs aspirin 81 mg daily pyridoxine 100mg daily vitamin c and multivitamins budeprion xl 150mg daily discharge medications: 1. bosentan 62.5 mg tablet sig: one (1) tablet po twice a day. 2. budesonide 0.25 mg/2 ml suspension for nebulization sig: one (1) inhalation once a day. 3. lexapro 20 mg tablet sig: one (1) tablet po once a day. 4. fenofibrate 150 mg capsule sig: one (1) capsule po once a day. 5. lasix 80 mg tablet sig: one (1) tablet po once a day. 6. prevacid 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 7. lisinopril 10 mg tablet sig: one (1) tablet po once a day. 8. metformin 850 mg tablet sig: one (1) tablet po bid (2 times a day). 9. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 10. sildenafil 25 mg tablet sig: two (2) tablet po tid (3 times a day). 11. coumadin 3 mg tablet sig: one (1) tablet po once a day. 12. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 13. pyridoxine 50 mg tablet sig: two (2) tablet po daily (daily). 14. bupropion hcl 150 mg tablet sustained release sig: one (1) tablet sustained release po qam (once a day (in the morning)). 15. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 16. outpatient lab work chem 7. please fax results to dr. at ( discharge disposition: home discharge diagnosis: primary: pulmonary hypertension secondary: hypertension obstructive sleep apnea on cpap non-insulin dependent diabetes chronic diastolic heart failure coronary artery disease gerd discharge condition: good. hemodynamically stable and afebrile. stable oxygen requirement discharge instructions: you were admitted to the hospital for initiation of flolan therapy for treatment of your pulmonary hypertension. you did not tolerate the medication and therefore it was stopped. there were no medication changes while you were in the hospital your creatinine had increased slightly on the last day of your hospital stay probably due to dehydration. please drink plenty of fluids at home and get followup instructions: please follow-up with your pulmonologist as directed. you were given a lab slip to be completed on wednesday, and followed up by dr. . provider: ,interpret w/lab no check-in intepretation billing date/time: 1:30 provider: function lab phone: date/time: 1:30 procedure: pulmonary artery wedge monitoring diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified acute on chronic diastolic heart failure other chronic pulmonary heart diseases chronic kidney disease, unspecified other emphysema 

Answer: The patient is high likely exposed to