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: heart failure exacerbation major surgical or invasive procedure: swan ganz catheter placement and removal coronary catheterization right popliteal stent placement history of present illness: 72 yo aremian speaking male w/ post-infarction cardiomyopathy (ef 20%) s/p biv icd, cad, dm, pvd, af who was admitted to ccu after elective rhc showed depressed cardiac index of 1.4. history is obtained with the help of his niece who acts as an interpreter. he was seen by dr. in clinic on w/ complaints of le claudication. it was felt that he had critical limb ischemia but there was also concern for volume overload and decompensated chf. at that visit, his bumex dose was increased and he was brought to cath lab for rhc this am. in the cath lab, he was found to have elevated filling pressures and a ci of 1.4. a pa catheter was placed and he was admitted to the ccu for further management. . of note, patient notes worsening in his baseline sob over the last 2 months. prior to 2 months ago, he was able to do very little w/o sob, but over the last 2 months has been sob with minimal exertion including going to bathroom and getting up from a seated position. his niece notes he complains of sob w/ walking 20 ft and cannot do stairs. also notes orthopnea but no pnd. over the last 2 months, patient also notes lightheadedness and vision changes with change in position from sitting/laying to standing. he has fallen due to these symptoms recently but denies any loc. ros is also notable for > 1 year of le pain and sensation of cold les. he notes burning as well as pain at rest and with exertion w/o significant difference. he also developed a small ulcer on his r medial malleolus ~ 1 month ago for which he recently completed a course of antibiotics given by his pcp. past medical history: # cad s/p mi - h/o pcis in (anatomy unknown) # post-infarction cardiomyopathy (ef 20%) s/p biv icd - model 7277 biventricular icd # mr, tr # dm # pvd w/ nonhealing ulcers - s/p balloon angioplasty of right lower extremity in many years ago # afib/aflutter # h/o cva in , no residual symptoms # pulmonary hypertension # cri, bl cr 1.7-1.9 # dvt lle 1.5 yrs ago? social history: pt lives with his daughter in . he is separated from his wife. denies etoh use. tobacco now ~ 5 cigs/day w/ 35 pack-yr hx. family history: no hx of sudden cardiac death in family. physical exam: vs: t 97.1, bp 122/63 , hr 60, rr 16, o2 99% on 2lnc gen: chronically ill appearing elderly male, laying at 30 degrees in bed in nad, resp or otherwise. oriented x3. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp to angle of manible and bilat. jvd. cv: icd pocket over l chest nontender without erythema. pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. holosys murmurs at llsb and apex. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. diffuse course rales in bilateral lung fields 3/4 up. abd: obese, soft, ntnd. + hepatomegaly w/ pulsatile liver. no abdominial bruits. ext: 1+ le edema bilaterally. ulcer over r medial malleolus pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 1+ dp, 1+ pt : carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp, 1+ pt pertinent results: pac placement the tip of a new right transjugular pulmonary artery catheter projects over the right portion of the central mediastinum probably in a large intrapericardial right pulmonary artery. transvenous right atrial and left ventricular transvenous pacer leads and the right ventricular pacer defibrillator lead are in standard placements. some of the central hazy opacification on both sides of the chest at the level of the hila could be due to overlying soft tissue, but i suspect there is mild pulmonary edema. large heart is stable and there is no pleural effusion or pneumothorax. widening of the superior mediastinum is longstanding feature probably a combination of mediastinal fat and large head and neck vessels. no pneumothorax. if there is any concern about malpositionning of the pulmonary artery catheter standard views, including a lateral should be obtained ------------- cardiac cath comments: 1. hemodynamic assessment revealed elevated right-sided filling pressures with rvedp 27 mmhg. there was significant pulmonary arterial systolic hypertension with pasp 80 mmhg. the pcwp was elevated with mean pcwp 21 mmhg. cardiac output was significantly depressed, with ci 1.4 l/min/m2. final diagnosis: 1. depressed cardiac output with elevated pcwp and elevated rvedp. 2. pulmonary arterial hypertension. --------------- cxr findings: in comparison with study of , the patient has taken a much better inspiration. the cardiac silhouette is essentially within normal limits, and there is no evidence of vascular congestion, pleural effusion, or acute pneumonia. pacemaker device remains in place. ct head without contrast (, done for headache s/p eye surgery): there is no evidence hemorrhage, shift of normally midline structures, or infarction. encephalomalacia extending from the left temporal subcortical white matter to the centrum semiovale is likely a consequence of old infaction. atherosclerotic calcification of the cavernous carotids and vertebral arteries are noted bilaterally. surrounding osseous structures are unremarkable. a large mucus retention cyst is identified within the right maxillary sinus. the mastoid air cells are well aerated. the orbits appear unremarkable bilaterally. impression: no intracranial hemorrhage or edema. renal u/s (): 1. normal renal size, without evidence of hydronephrosis. 2. slightly irregular renal contours, particularly on the left, although much less apparent than on prior ct. this could relate to scarring from prior infection or infarction. 3. new trace ascites around the liver, and in the morison's pouch. brief hospital course: 72 y/o armenian male with post infarction ischemic cm, ef 20% s/p biventricular icd, h/o atrial fibrillation, dm, pvd non healing le ulcers admitted with volume overload secondary to florid heart failure on right heart cath, cardiac index 1.4 admitted for optimization of heart failure therapy prior to vascular intervention . # heart failure exacerbation post-infarction cardiomyopathy with ef 20%n s/p biv icd. elevated filling pressures ci in cath lab 1.4. pa catheter left in place. no obvious events in recent past leading to current decompensation. no significant change in wall motion on recent echo. ? chronic progression of severe cmpy. started lasix gtt after 80mg iv bolus. lasix gtt at 7mg/hr. on second hospital day increased coreg to 12.5 mg and increased to 10mg lisinopril . by hd#3 patient had diuresed 5 liters with creatinine holding steady, cardiac index rose to 2.08 and cvp decreased, co 4. patient developed renal failure likely secondary to contrast, diuresis, and increase in lisinopril. renal function improved, did not require hd. gradually patient became volume overloaded and was placed back on lasix gtt with transition to oral budesonide 4mg . at discharge he was at his baseline weight and was given strict instructions on taking medications, low sodium diet, daily weights. patient to follow up with dr. in clinic on . . # acute kidney injury on chronic kidney disease baseline creatinine around 1.7-1.9, creatinine initially improved with diuresis. patient was diuresed about 5 liters, initially it was thought patient would undergo revascularization after discharge, therefore he was not given nac. patient underwent revascularization after undergoing substantial diuresis and having lisinopril dose increased. subsequently developed secondary to combination of above. creatinine peaked at 5.1, nephrology was consulted, placed on renagel while kidney function improved. creatinine improved and was in mid 3's at discharge. lisinopril was held, he was scheduled nephrology follow up. . # cad h/o mis in the past w/ severely depressed ef. unknown anatomy but may have had pcis in past in . increased coreg to 12.5mg , held ace given , continued statin and asa. . # rhythm h/o af s/p biv icd for cardiomyopathy. av paced currently. continued amiodarone. held coumadin given potential repeat intervention during hospitalization. inr subtherapeutic at discharge, patient was continued at dose of 2.5mg qod, no bridging therapy was deemed necessary given only indication of atrial fibrillation. patient to have inr checked on at dr. office in . . # pvd severe pvd w/ prior interventions in past. current nonhealing ulcer on rle w/ claudication symptoms at rest. recently evaluated by dr. who felt pt had critical limb ischemia requiring le cath and intervention. however, need to optimize chf prior to intervention. patient underwent pvd intervention on given improved cardiac status with placement of right popliteal stent. he is to continue plavix for at least 1 month's duration. would discuss with cardiology stopping plavix at that time. patient had significantly improved pain in lower extremity after the procedure. . # dm recent hba1c 13.0. on insulin, discharged on home dose of 70/30 insulin. . # recent cataract surgery patient was off eye drops upon initial admission and developed severe headache and eye pain. given he was on heparin a ct head was obtained which showed no evidence of bleed. opthalmology was consulted and recommended continuing only prednisolone eye drops. headache and eye pain were completely resolved prior to discharge. medications on admission: amiodarone 200 mg p.o. daily warfarin 2.5 mg p.o. qod aspirin 325 mg daily lisinopril 5 mg p.o. daily carvedilol 3.125 mg qam, 6.25 qhs bumex 3 mg lipitor 40 mg p.o. daily insulin 70/30 30 units qam, 20 units qhs ketorolac tromethamine 0.5 % 1 drop tid * pt states only using 1 eye drop. unclear which still using gatifloxacin 0.3 % one drop ophthalmic tid * prednisolone acetate 1 % drops,one drop tid * discharge medications: 1. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 4. warfarin 2.5 mg tablet sig: one (1) tablet po every other day (every other day). 5. insulin nph & regular human 100 unit/ml (70-30) cartridge sig: as directed units subcutaneous as dir: 30 units qam, 20 units qhs . 6. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 7. carvedilol 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 8. bumetanide 2 mg tablet sig: two (2) tablet po twice a day. disp:*120 tablet(s)* refills:*0* 9. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic qid (4 times a day). discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: # acute systolic heart failure (post-infarction cardiomyopathy) with ef 20%, s/p biv icd # acute kidney injury # chronic kidney disease . secondary diagnosis: # cad s/p mi - h/o pcis in (anatomy unknown) # post-infarction cardiomyopathy (ef 20%) s/p biv icd - model 7277 biventricular icd # mr, tr # dm # pvd w/ nonhealing ulcers - s/p balloon angioplasty of right lower extremity in many years ago # afib/aflutter # h/o cva in , no residual symptoms # pulmonary hypertension # cri, bl cr 1.7-1.9 # dvt lle 1.5 yrs ago? discharge condition: stable discharge instructions: you were admitted and treated for acute systolic heart failure. you underwent a right popliteal stent to treat your peripheral vascular disease. you developed acute kidney injury secondary to diuretics and contrast, your kidneys are slowly recovering. it is important for you to take your medications as prescribed and weigh yourself daily. if you develop an increase in weight of 2lbs it is imperative you call dr. office for further instructions. your lisinopril (acei) was held due to your resolving kidney function. you will have your kidney function, inr level as well as glucose checked on monday at dr. office. . if you develop fever greater than 101f, chest pain, shortness of breath, severe back pain or lightheadedness, or if you at any time become concerned about your health please contact your pcp, at or present to the nearest ed. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet. . the following changes to your medications were done: - bumex was increased to 4mg - lisinopril is being held secondary to resolving acute kidney injury - plavix 75mg daily . please go to your scheduled appointments listed below. followup instructions: provider: . phone: date/time: 10:30 provider: , md phone: date/time: 10:30 provider: , : date/time: 9:00 provider: clinic phone: date/time: 10:00 renal appointment with dr. 3pm in 7 procedure: coronary arteriography using two catheters angioplasty of other non-coronary vessel(s) aortography pulmonary artery wedge monitoring monitoring of cardiac output by other technique right heart cardiac catheterization arteriography of renal arteries procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery tobacco use disorder mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation other chronic pulmonary heart diseases atrial flutter chronic kidney disease, stage iii (moderate) automatic implantable cardiac defibrillator in situ personal history of venous thrombosis and embolism personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits acute systolic heart failure accidents occurring in residential institution superficial injury of cornea diseases of tricuspid valve diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy atherosclerosis of native arteries of the extremities with ulceration other drugs and medicinal substances causing adverse effects in therapeutic use ulcer of lower limb, unspecified 

Answer: The patient is high likely exposed to