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: integrilin attending: chief complaint: here for elective cath of l iliac artery for poss stenting. major surgical or invasive procedure: catheterization of l iliac from r side. history of present illness: : pt is a 52 yo male with history of diabetes, htn, depression, anxiety disorder,cad s/p mi in ptca to rpl, cypher stenting rca (repeat cath in with no flow limiting disease), and pvd complaining of worsening lle pain. reported that he could only walk block without severe pain. he was seen in dr. office found to have abi of 0.5 on the left with blunted waveforms and was cheduled for le angiography. on arrival to the hospital he was found to be hypotensive to the 60s but was asymptomatic. it was decided to proceed with the procedure and he was given 5 liters of ns during the procedure with bps in high 70's to 90's but asymptomatic. cath showed 100% occlusion of l external iliacstress echo on showed ef 50 % which is unchanged from previous. of note patient was seen in the ed on with chest pain at which time he had a cta chest was negative and troponins were flat. he said that the chest pain lasted only a few seconds, was sharp and was in center to left chest. denied sob, n/v or diaphoresis at this time. it was also noticed that his hct on was 46.2 and on admission 36.3. he was transferred to the ccu as he was hypotensive and had decreased hct. denies melana, brbpr, hematemesis, hemoptysis, recent illness, cp on exertion, sob, change in bowel habits. has had some decreased po intake as he has not been thirsty but has had good uop. currently has no symptoms. past medical history: 1. coronary artery disease, status post mi in , status post stent in to the right coronary artery. cardiac catheterization: lm and cx free of disease. lad with an 80% ostial stenosis of the d1. rca with diffuse disease of the proximal and mid segment with a maximal stenosis of 50%. the distal rca stent was widely patent. ffr of mid rca was 0.88. echo: ef 50%, trivial mr, 1+ tr cardiolite stress test: negative for ischemia. . 2. hypertension. 3. anxiety disorder. 4. pvd with claudication. 5. major depressive disorder. 6. diabetes. 7. appendectomy 8. asthma social history: social history: has history of smokingpatient is separated and lives with his 12 year- old son and his mother. currently does not work. he was born in and grew up in south . he came to the us in . family history: family history: (+ ) fhx cad: mother had mi at the age of 81. his 60 year-old brother has "problems with his heart". physical exam: vitals: bp 98/70 hr 79 r 15 o2 sats 95% ra general: middle aged male lying in bed in nad heent: mmm, no jvd, no lad cv:nl s1 s2, 2/6 systolic murmur heard best at the apex pulm: cta anteriorly abd: normal bs, soft, nt/nd guaiac: negative ext: warm, 1+ dp pulse on right, no palpable dp pulse on left, no edema groin: cath site c/d/i with neuro: aaox 3, 5/5 strength in upper and lower extremities, senastion to light touch intact labs: see end of note ekg: nsr, rate 75, normal intervals, q wave in iii, no st changes, poor r wave progression . pertinent results: 10:01pm glucose-128* urea n-16 creat-0.9 sodium-144 potassium-4.0 chloride-114* total co2-21* anion gap-13 10:01pm ck(cpk)-47 tot bili-0.2 10:01pm ck-mb-notdone ctropnt-<0.01 10:01pm calcium-9.0 phosphate-2.6*# magnesium-1.7 iron-56 10:01pm caltibc-268 haptoglob-229* ferritin-171 trf-206 10:01pm osmolal-302 10:01pm wbc-5.7 rbc-3.99* hgb-13.5* hct-37.3* mcv-93 mch-33.9* mchc-36.3* rdw-15.8* 10:01pm neuts-55.4 lymphs-37.2 monos-6.4 eos-0.9 basos-0.2 10:01pm macrocyt-1+ 10:01pm plt count-148* 10:01pm pt-12.9 ptt-34.1 inr(pt)-1.1 03:05pm glucose-94 urea n-20 creat-0.9 sodium-139 potassium-3.9 chloride-113* total co2-19* anion gap-11 03:05pm alt(sgpt)-17 ast(sgot)-13 ck(cpk)-36* alk phos-34* amylase-60 03:05pm albumin-3.1* 03:05pm plt count-137* 03:05pm wbc-7.4 rbc-3.83* hgb-12.6*# hct-36.3* mcv-95 mch-32.9* mchc-34.7 rdw-15.9* 03:05pm pt-13.6* ptt-36.8* inr(pt)-1.2 05:47am blood cortsol-6.6 10:01pm blood osmolal-302 10:01pm blood caltibc-268 hapto-229* ferritn-171 trf-206 05:47am blood ck-mb-notdone ctropnt-<0.01 10:01pm blood ck-mb-notdone ctropnt-<0.01 05:47am blood ck(cpk)-47 10:01pm blood ck(cpk)-47 totbili-0.2 03:05pm blood alt-17 ast-13 ck(cpk)-36* alkphos-34* amylase-60 . . cath : comments: 1. access was obtained via the right cfa in a retrograde fashion. 2. resting hemodynamics showed normal central aortic pressures. 3. the abdominal aorta had minimal disease. 4. right lower extremity: patent cia/eia as well as the proximal sfa and profunda artery. 5. left lower extremity: the cia was patent. the eia had a long occlusion into the cfa, which reconstituted via collaterals. the proximal sfa and profunda were patent. 6. unsuccessful pta of the left eia (see pta comments). final diagnosis: 1. occluded left eia. . . cxr on admit:impression: no evidence of acute cardiopulmonary process. brief hospital course: brief overview: 52 yo male with h/o diabetes, htn, depression, anxiety disorder,cad s/p mi in ptca to rpl, cypher stenting rca (repeat cath in with no flow limiting disease), and pvd complaining of worsening lle pain. pt was admitted for cath for possible stenting of the l iliac artery. he was found to have a sbp in the 60's on presentation to the cath . the catheterization was conducted, and the l iliac was totally occluded. no intervention was performed. s/p le cath he was tx'd to the ccu for monitoring. his bp returned to the low 100's and he was tx'd to the floor. he was stable overnight on the floor and was restarted on a small dose of his home bb and discharged in good condition. . hospital course by system: 1. hypotension: the pt was hypotensive in the cath presenting from home. it was thought that this was most likely dehydration as patient said he has been taking decreased po and had been npo after mn for the procedure. however, after vigorous hydration in the with 5l of saline, he remained hypotensive. blood cultures, u/a, urine culture were negative. cortisol in am was 6.6, which is not diagnostic, so a cortisol stim test was conducted, which revealed a normal response. hct remained stable. iron studies and hemolysis labs revealed no abnormalities. ce's remained flat. in the ccu, all antihypertensives were held. seroquel was also held as it has been implicated in orthostatic hypotension. no definitive determination of the cause of the hypotension was revealed, but the bp was stable and was tx'd to the floor overnight. his bp remained stable and his metoprolol was restarted at 12.5 , a much lower dose. it was thought that he was likely dehydrated when he presented, as well as having taken all of his bp meds just prior to presentation. f/u was arranged for close monitoring of his bp and the pt was discharged in good condition. . 2. pvd - the pt was brought in for cath of the l iliac via the r iliac. he was tx'd to the ccu s/p cath with total occlusion of l ext iliac, no intervention. the pt was continued on asa, plavix. at the time of this hospitalization, there was no plan for or. . 3. dm: hypoglycemics were held post-cath to prevent hypoglycemia and/or lactic acidosis. the pt was continued on a riss and fingersticks were followed. . 4. psych: there were no issues at this hospitalization. seroquel was held initially and restarted after the first night in the hospital. he tolerated his home dose well from a bp point of view. of note, the pt was noted to have a bilateral ue/le tremor throughout his body. this was thought to represent an eps. it has been constant and unchanged for years per the pt. . 5. seizure disorder: anti-epileptics were continued and there were no issues at this hospitalization. . 6.anemia: there was a significant acute decrease in hct after the cath , recheck and get hemolysis labs and iron studies. there were no obvious sites of acute blood loss, and the patient was guaiac negative. he did not require any transfusions. it was later thought that this drop in hct represented a significant dilutional anemia due to the 5l of fluid the pt received in the cath . . 7. ppx: the patient received mucomyst after his procedure for kidney protection. 9. codae status: the patient remained full code during the course of this hospitalization. medications on admission: metformin 500mg glipizide 10mg . actos 30mg daily. aspirin 325mg daily. cardizem cd 240mg daily. plavix 75mg daily. zestril 10mg daily. lorazepam 1mg tid. metoprolol 100mg . isosorbide 20mg . pletal 100mg . depakote 1000mg qam, 1500mg qpm. niaspan 1000mg daily. folic acid 1mg . crestor 10mg daily. seroquel 200mg qhs. oxycodone 5mg qid. zonegran 200mg daily. advair diskus 1 puff . albuterol 1 puff tid. discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. divalproex sodium 500 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po qam (once a day (in the morning)). 4. divalproex sodium 500 mg tablet, delayed release (e.c.) sig: three (3) tablet, delayed release (e.c.) po qpm (once a day (in the evening)). 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. rosuvastatin calcium 5 mg tablet sig: two (2) tablet po daily (daily). 7. zonisamide 100 mg capsule sig: two (2) capsule po daily (daily). 8. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 9. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 10. glipizide 10 mg tablet sig: one (1) tablet po bid (2 times a day). 11. pioglitazone 30 mg tablet sig: one (1) tablet po daily (daily). 12. quetiapine fumarate 200 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 13. cilostazol 100 mg tablet sig: one (1) tablet po bid (2 times a day). 14. oxycodone 5 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. 15. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 16. metformin 500 mg tablet sig: one (1) tablet po twice a day. 17. lorazepam 1 mg tablet sig: one (1) tablet po three times a day. 18. niacin 500 mg capsule, sustained release sig: one (1) capsule, sustained release po twice a day. capsule, sustained release(s) discharge disposition: home discharge diagnosis: hypotension l internal iliac occlusion dm bipolar discharge condition: good discharge instructions: your blood pressure was low, likely because you were dehydrated. your blood pressure medications may be too high, as well. we have reduced the number and amount of bp medications at this hospitalization. . you should call dr. early next week for an appointment. ( . you should call dr. for an appointment, as well. they will need to measure your blood pressure and check your basic labs. . be sure to drink plenty of fluids. . if you develop lightheadedness, lose consciousness, have chest pain or shortness of breath, please seek medical attention immediately. followup instructions: dr. - pt to call for appt. dr. - pt to call for appt. procedure: arteriography of femoral and other lower extremity arteries aortography diagnoses: other iatrogenic hypotension anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled coronary atherosclerosis of unspecified type of vessel, native or graft other convulsions percutaneous transluminal coronary angioplasty status stricture of artery bipolar i disorder, most recent episode (or current) unspecified 

Answer: The patient is high likely exposed to