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: iodine-iodine containing attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization aortic balloon pump placement mechanical ventilation history of present illness: patient is 80 yo man presenting with chest pain and st elevations on ekg. he was in usual state of health until 6 pm on day of admission after eating dinner. he started to have chest pressure and reflux and was noted to be diapheretic. pt was brought to the ed by ems who administered heparin and sl nitro. in the ed hr ranged in 60s and sbp initially 140 then in 110s. o2 sat upper 90% on 5l --> nrb. his initial ecg suggested 1 mm ste in iii, avf and avr as well as depression in i, avl v4-6. in cath lab he also had 1 mm ste in v1. on presentation to the icu, patient was intubated and unresponsive with a aortic balloon pump in place. review of systems unable to obtain secondary to intubation, however, patient's family reports he was fine prior to onset at symptoms at 6pm. past medical history: - intracranial hemorrhage 2/96 l frontoparietal r occipital - amyloid angiopathy - focal seizure disorder: right lip and right hand paresthesias. - osa - dementia - bph - s/p appendectomy - hypertension social history: patient is married with children. unable to obtain smoking/alcohol/drug history. family history: unable to obtain. physical exam: vs: t= bp=99/24 hr=67 o2 sat= 100 general: intubated and sedated, not following commands heent: ncat. pin point pupils neck: supple with jvp of 5 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: course ventalator sounds through out. abdomen: soft, non distended extremities: cool extremities with delayed but present capillary refill bilaterally, 2+ dp, pt pulses on r but no dopplerable pulses on left. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: admission labs: 08:30pm blood wbc-12.3* rbc-5.37 hgb-16.6 hct-46.2 mcv-86 mch-30.9 mchc-35.9* rdw-13.6 plt ct-72* 08:30pm blood pt-16.5* ptt-75.0* inr(pt)-1.5* 08:30pm blood fibrino-53* 08:30pm blood urean-24* creat-1.4* 08:30pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 08:34pm blood glucose-121* lactate-5.1* na-145 k-3.8 cl-103 calhco3-24 abg trends: 09:36pm blood type-art o2 flow-10 po2-152* pco2-38 ph-7.33* caltco2-21 base xs--5 comment-non-rebrea 01:57am blood type-art po2-251* pco2-32* ph-7.28* caltco2-16* base xs--10 03:52am blood type-art po2-143* pco2-28* ph-7.31* caltco2-15* base xs--10 08:06am blood type-art po2-101 pco2-26* ph-7.26* caltco2-12* base xs--13 intubat-intubated 02:32pm blood type-art po2-65* pco2-33* ph-7.24* caltco2-15* base xs--12 intubat-intubated lactates: 08:34pm blood glucose-121* lactate-5.1* na-145 k-3.8 cl-103 calhco3-24 09:36pm blood lactate-3.0* k-3.6 01:57am blood lactate-5.7* 02:30am blood glucose-158* lactate-5.6* k-4.7 03:52am blood glucose-168* lactate-6.5* k-5.3* 05:29am blood lactate-6.6* 08:10am blood lactate-6.3* 12:10pm blood lactate-8.5* 02:32pm blood lactate-8.2* k-5.4* microbiology: blood cultures pending c diff toxin negative mrsa screen negative imaging: cardiac cath (preliminary) 1) selective coronary angiography of this right-dominant system demonstrated two-vessel coronary disease. the lmca, lcx, and ramus had no angiographically-significant cad. the lad had a smooth tubular 70% lesion in the proximal segment of the vessel. the rca had 65% proximal-to-mid vessel stenosis. these latter two lesions did not appear flow-limiting. 2) resting hemodynamics revealed moderately-elevated left-sided filling pressures with a pa diastolic pressure of 26 mmhg and a mean wedge pressure of 26 mmhg. the mixed venous oxygen saturation was low at 40%, which, with a systemic arterial oxygen saturation of 99%, correlated with a fick cardiac output of approximately 1 l/min/m2. 3) because of relative hypotension and a low cardiac index, a 40cc iabp was placed. the mixed venous oxygen saturation was rechecked after placement of the iabp, and was noted to be 49% (increased from 40% prior to iabp placement). this also correlated with an improvement in the patient's lactate from 5.1 initially to 3 after iabp placement. the patient was then given 1 liter of iv fluids, after which time a third mixed venous oxygen saturation was checked and was noted to be 54%. 4) a bilateral pulmonary arteriogram was performed to exclude significant pe, and showed no intraluminal defects. 5) urgent transthoracic echocardiogram performed in the cath lab to evaluate potential causes of cardiogenic shock revealed trace-to-mild aortic regurgitation with relatively preserved ejection fraction and no wall motion abnormalities. 6) a shunt run showed no significant oxygen saturation step-up. final diagnosis: 1. two vessel coronary artery disease. 2. trace-to-mild aortic regurgitation. 3. mild systolic ventricular dysfunction. 4. altered mental status. echo: due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). the sinuses of valsalva are dilated. moderate (2+) aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. ct head: 1. no intracranial hemorrhage. 2. old right occipital infarct and chronic small vessel ischemic disease. 3. prominent ventricles without mass lesion; considerations include atrophic change versus normal pressure hydrocephalus. cxr: findings: as compared to the previous radiograph, the patient has been intubated. the tip of the endotracheal tube projects 5 cm above the carina. the aortic balloon pump is in correct position. the swan-ganz catheter has been inserted over an inferior access. the tip projects over the left pulmonary artery. moderate cardiomegaly with relatively extensive retrocardiac atelectasis and blunting of the left costophrenic sinus, so that small pleural effusion cannot be excluded. mild pulmonary edema. no evidence of pneumonia. cxr: as compared to the previous radiograph, the endotracheal tube and the intra-aortic balloon pump are in unchanged position. swan-ganz catheter over inferior access, the tip of the catheter projects over the left pulmonary artery. unchanged moderate cardiomegaly. slightly improving areas of left basal atelectasis. no overt pulmonary edema. no pneumonia. cta torso: 1. type a aortic dissection with dissection extending to the ostia of the coronary arteries, and findings consistent with rupture of the false lumen in the aortic root and small mediastinal hematoma. the coronary arteries remain perfused by the true lumen at the time of this scan. 2. additional extension of aortic dissection to the branch vessels of the aorta including right subclavian, right common carotid, left subclavian, celiac, sma, left renal artery. the left kidney is hypoperfused with developing infarcts. 3. extension of dissection to the splenic artery with splenic infarcts. 4. heterogeneous perfusion of the liver. the hepatic artery appears to be supplied by the true lumen. 5. no specific evidence of bowel ischemia at the present time although dissection extends into the superior mesenteric artery. mild stranding about the cecum and ascending colon is nonspecific at the present time though continued observation for bowel ischemia would be warranted depending on the clinical status given the elevated lactate. 6. small right inguinal hematoma at the site of central venous access catheter placement. 7. additional nonurgent findings including diverticulosis, marked bph, and tiny hypodense lesions in the kidneys too small to characterize. brief hospital course: mr. is an 80yo m with history of htn, amyloid angiopathy, previous intracranial hemorrhage and dementia who presented with acute onset of chest pain and was found to have ekg showing 1 mm ste in iii, avf and avr as well as depression in i, avl v4-6. code stemi was called in the er, and patient was taken emergently to cardiac catheterization. prior to transport, he received sublingual nitroglycerin, heparin drip and aspirin. in the cath lab, he also had 1 mm ste in v1. while in the cath lab, he had non-flow limiting lesions in his lad and rca. patient became more obtunded requiring intubation. rhc was done and showed pad 28 mmhg. initially difficult to wedge but later wedge correlated with pad. also lvedp done and was 29 mmhg. the ci came back at 0.95 l/min/m2. lactate came back at 5.1. pa gram performed using peg tail catheter and did not show intraluminal defects suggestive of pe. there was also concern for infection and sepsis rather than cardiogenic shock given that the patient was having copious diarrhea in the cath lab. an echo was performed to see if there was a large wall motion abnormality to explain the profound cardiac dysfunction and to guide whether pci was necessary. this showed preserved lvef, minimal mitral regurgitation and 2+ai on preliminary review. at this point, concerned about the low cardiac index and elevated filling pressure, indicative of cardiogenic shock, a 40 cc iabp was placed via rcfa. due to initial lack nof augmentation, balloon was exchanged for a new 40 cc balloon and similarly, unsatisfactory wave form. (note: despite removal of the iabp/sheath combination, the rcfa angiogram via 9f sheath showed no evidence of extravasation). a shunt run post iabp shwoed svc 40%, ra 45%, rv 47% and pa 49% which indicated improvement in pa sat from 40% pre-iabp. this also correlated with improvement in lactate from 5.1 --> 3.0. 1 l ns bolus was administered and repeat pa numbers obtained: pa sat 54% and a sat 99%. this is further improvement in pa sat following iabp. following the interventions in the cath lab, cardiogenic shock remained high on the differential but his hemodynamic studies in the cath lab and continued declining clincal condition did not fully support this diagnosis. given his history of head bleed, he was taken to the ct on his way to the icu and had a head scan negative for new acute bleed. he was started on broad spectrum antibiotics and given fluids for possible septic shock. patient developed large volume, guaiac positive stools. his lactates continued to rise despite these interventions with metabolic acidosis. patient's blood pressure slowly declined over the morning of requiring use of a single pressor. given lack of improvement in hemodynamics with aortic balloon pump, this was removed, and patient underwent cta of his torso to evaluate for source of his elevated lactate such as ischemic bowel. his cta showed a type a aortic dissection involving aortic root with suggestion of coronary involvement also extending to bifurcation with contained rupture of posterior arch, involvement of sma, splenic, l renal with resultant end organ ischemia. general, vascular and cardiac surgery were all consulted. the patient's poor prognosis was discussed with his family who elected to focus on comfort and withdraw supportive care. he expired the afternoon of . medications on admission: - donepezil (aricept) 10 mg daily - hctz 25 mg daily - oxcarbazepine (trileptal) 600 mg - tamsulosin 0.4 mg daily discharge medications: expired discharge disposition: expired discharge diagnosis: type a aortic dissection shock discharge condition: expired discharge instructions: expired followup instructions: expired md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours combined right and left heart cardiac catheterization coronary arteriography using two catheters implant of pulsation balloon diagnoses: acidosis obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified essential hypertension hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) defibrination syndrome other shock without mention of trauma acute myocardial infarction of other inferior wall, initial episode of care chronic systolic heart failure epilepsy, unspecified, without mention of intractable epilepsy encounter for palliative care do not resuscitate status dissection of aorta, thoracoabdominal acute vascular insufficiency of intestine systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction vascular dementia, uncomplicated cerebral atherosclerosis other diseases of spleen other amyloidosis 

Answer: The patient is high likely exposed to