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: indomethacin / ace inhibitors attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization echocardiogram ct scan history of present illness: 86 year old man with hx. cad, mi's, cabg times 2 (, ), and hx. 16 separate cath's in our system, htn, dm, hyperchol, who presents to the ed after having several days of intermittant upper back pain with ratiation to the bilateral shoulders (in the past this has been described as an anginal equivalent for him). initially, he did not take any sl ntg for these episodes, but last night, had pain as above, but also involving the chest. he took ntg with relief, but had to repeat this three times through the night, and at 5 am this morning, due to recurrent pain at rest, he came to the ed. on arrival, history and nature of pain were concerning for a pe, ct neg for ao dissection. in the scanner, chest pain worsened, so put on nitro and hep gtt, and pain gone. no ecg changes, markers flat. became asymptomatic shortly after. past medical history: * cad * dm * hyperlipdemia * chf * htn * tias * gerd * upper gi bleed (no nsaids aside from asa) * dvd * iron deficiency anemia * glaucoma * hyperkalemia with ace inhibitors * mi (most recent ) * cabg , cabg times 2, multiple pci's as follows: . no records of cabg in our system (cabg's done , ) last pci here on (16 in record) - totally occluded native lcx. svg to lplb with serial lesions, 40%, 80%, 60%. 3 des placed in the 3 svg lesions. mult attemts made to cross the native lt. cx. lesion w/o success. at end, 20% residual stenosis of the svg with timi 3 flow and no dissection. . stress - treadmill protocol. rpp , 53% max hr, stopped at 6 min for fatigue, sinus with frequent pvc. no pain or ecg changes. mibi: mod, partially rev. , mod, fixed inf, calc. ef 56%. . echo: ef 50%. impaired relaxation. lv wall 15 mm thick. lad, symmetric lvh, no as, no ar, no ms, no mr. . social history: lives with his wife. 3 children. no tbx or ethanol. was in the navy for some years family history: no cad physical exam: pe: . af 56 195/76 16 98% on 2l nad jvp flat bibasilar fine crackles, otw cta rrr, hsm, , no s3 s/nt/nd/bs+ guaiac neg. 1+ le edema, good distal pulses, no rash pertinent results: electrolytes 10:00am calcium-9.1 phosphate-4.0 magnesium-1.9 07:10am blood calcium-8.4 phos-4.5 mg-2.7* . urine 09:55am urine color-straw appear-clear sp -1.009 09:55am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg general urine information type color appear sp 11:00am straw clear 1.010 09:55am straw clear 1.009 dipstick urinalysis blood nitrite protein glucose ketone bilirub urobiln ph leuks 11:00am lge neg neg neg neg neg neg 5.0 neg 09:55am neg neg neg neg neg neg neg 5.0 neg microscopic urine examination rbc wbc bacteri yeast epi transe renalep 11:00am 149* 9* none none 0 other urine findings mucous 11:00am rare miscellaneous urine eos 11:00am positive 1 1 positive rare eos urine culture (final ): no growth. . blood counts 10:00am wbc-5.5 rbc-3.24* hgb-9.9* hct-30.2* mcv-93 mch-30.7 mchc-32.9 rdw-15.3 10:00am neuts-66.8 lymphs-25.4 monos-4.2 eos-3.0 basos-0.6 06:35am blood wbc-7.1 rbc-3.16* hgb-9.6* hct-28.7* mcv-91 mch-30.5 mchc-33.5 rdw-15.5 plt ct-207 06:15am blood wbc-5.7 rbc-2.69* hgb-8.5* hct-25.0* mcv-93 mch-31.7 mchc-34.1 rdw-15.6* plt ct-178 01:25pm blood hct-26.2* 06:20am blood wbc-7.0 rbc-3.36* hgb-10.8*# hct-30.2* mcv-90 mch-32.1* mchc-35.7* rdw-16.3* plt ct-165 06:15am blood wbc-6.3 rbc-3.30* hgb-10.5* hct-29.8* mcv-90 mch-31.7 mchc-35.1* rdw-16.2* plt ct-156 07:10am blood wbc-6.3 rbc-3.72* hgb-11.3* hct-33.2* mcv-89 mch-30.3 mchc-34.0 rdw-15.9* plt ct-196 07:10am blood pt-12.0 ptt-23.5 inr(pt)-1.0 06:35am blood glucose-183* urean-33* creat-1.4* na-141 k-3.6 cl-104 hco3-26 angap-15 06:15am blood glucose-169* urean-30* creat-1.4* na-141 k-3.7 cl-101 hco3-31 angap-13 06:20am blood glucose-104 urean-41* creat-2.2* na-138 k-3.9 cl-99 hco3-27 angap-16 06:15am blood glucose-108* urean-54* creat-2.6* na-140 k-3.8 cl-102 hco3-28 angap-14 07:10am blood glucose-123* urean-45* creat-1.9* na-142 k-4.2 cl-105 hco3-27 angap-14 . cardiac enzymes 02:45pm ck(cpk)-101 02:45pm ck-mb-2 ctropnt-<0.01 10:00am ck(cpk)-113 10:00am ctropnt-<0.01 10:00am ck-mb-3 02:45pm blood ck(cpk)-101 01:15am blood ck(cpk)-93 09:00am blood ck(cpk)-90 08:59pm blood ck(cpk)-116 09:55am blood ck(cpk)-84 11:40pm blood ck(cpk)-76 06:15am blood ck(cpk)-84 02:45pm blood ck-mb-2 ctropnt-<0.01 01:15am blood ck-mb-notdone ctropnt-0.01 09:00am blood ck-mb-notdone ctropnt-0.01 08:59pm blood ck-mb-3 ctropnt-<0.01 09:55am blood ck-mb-notdone ctropnt-0.02* . chemistries 10:00am blood glucose-189* urean-31* creat-1.2 na-142 k-4.5 cl-106 hco3-27 angap-14 06:35am blood glucose-183* urean-33* creat-1.4* na-141 k-3.6 cl-104 hco3-26 angap-15 11:40pm blood k-3.6 06:15am blood glucose-169* urean-30* creat-1.4* na-141 k-3.7 cl-101 hco3-31 angap-13 06:20am blood glucose-104 urean-41* creat-2.2* na-138 k-3.9 cl-99 hco3-27 angap-16 06:15am blood glucose-108* urean-54* creat-2.6* na-140 k-3.8 cl-102 hco3-28 angap-14 07:10am blood glucose-123* urean-45* creat-1.9* na-142 k-4.2 cl-105 hco3-27 angap-14 . studies cta impression: 1. no evidence of pulmonary embolism or aortic dissection. the aorta is normal in caliber. 2. lung findings consistent in appearance with hypersensitivity pneumonitis. 3. hiatal hernia . cxr : findings most consistent with moderate congestive heart failure. . cardiac cath 1. selective coronary angiography of this right dominant system revealed severe native three vessel coronary artery disease. the left main coronary artery had a proximal 40% in-stent restenosis. the left anterior descending artery is heavily calcified. there is diffuse plaquing proximally. there is a 80% stenosis of the lad before s1 and d2; the lad is then totally occluded thereafter. the septal branches supply collaterals to rpl. the left circumflex artery is heavily calcified. there is an ostial occlusion of the lcx. the av groove circumflex and several om branches are supplied by antegrade collaterals. the right coronary artery is the dominant vessel. the rca has proximal and mid total occlusions. 2. vein graft angiography revealed svg --> lpl with an 60% ostial svg stenosis, a 40% mid-svg stenosis, and a 90% mid-svg stenosis with timi i-ii flow beyond the stenoses. these stenoses were all in previously placed stents. 3. arterial conduit angiography revealed a patent lima --> lad. the lad supplied collaterals to the distal acute marginal branches and om branches. 4. successful predilation using 4.0 x 20mm minirail balloon, stenting using 3.5 x 24mm taxus stent and post dilation using 4.0 x 09mm nc ranger balloon of the mid svg (to lpl) with lesion reduction from 90% to 0% with plaque shift distally successfully treated with primary stenting using 3.5 x12mm taxus stent. 5. successful direct stenting of the proximal svg (to lpl) using 3.5 x 12mm taxus stent and post dilation using 4.0 x 9mm nc ranger balloon with lesion reduction from 60% to 0%. 6. successful direct stenting of the ostial svg (to lpl) stenosis using 3.5 x 20mm and 3.5 x 08mm taxus stents and post dilation using 4.0 x 9mm nc ranger and 4.5 x 12 maverick balloons with lesion reduction from 60% to 5%. the final angiogram showed timi iii flow with no dissection or embolisation. (see ptca comments) final diagnosis: 1. severe native three vessel coronary artery disease. 2. multiple svg --> lpl stenoses. 3. patent lima --> lad. 4. successful stenting of the mid, proximal and ostial svg (to lpl) lesions. . tte the left atrium is mildly dilated. there is moderate symmetric left ventricular hypertrophy. resting regional wall motion abnormalities include inferior and inferolateral hypokinesis. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are moderately thickened. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. shadowing, the severity of mitral regurgitation may be significantly underestimated.] the left ventricular inflow pattern suggests impaired relaxation. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (tape reviewed) of , estimated pulmonary artery systolic pressure is now higher. left ventricular systolic function appears similar (although views are technically suboptimal for comparison). brief hospital course: a/p: 86 year old man with mmp, lengthy cardiac history incl cabg times 2, mult pci, who presents with cp at rest, initially cp alleviated by ntg gtt, markers flat. . 1. cp: patient initially thought to have possible pe or aortic dissection. had a chest cta performed that was negative for both. went to cath , had 5 serial taxus stents to the svg to om1. patient chest pain free during rest of admission. continued asa, statin, b-blocker, plavix. . 2. chf: patient initially thought to have some volume overload and was diuresed. held off on further diurese once patient developed arf. patient was self-diuresing prior to discharge. continued to hold lasix but should be restarted as outpatient. patient appeared euvolemic prior to discharge. patient instructed to weigh himself daily and to contact his pcp if he gains weight. he was also instructed to follow a low sodium diet. . 3. htn: continued outpatient meds including b-blocker, nitrate and nifedipine. increased imdur and nifedipine for better bp control as pressures occasionally elevated to 160's-170's. . 4. dm: patient maintained on lantus and riss. held oral agents while inpatient initially because of catheterization and dye load and then because of arf. patient will resume prior regimen upon discharge. . 5. arf: cr bumped to maximum of 2.6 during admission in post-cath period. likely to dye load during cath on and overdiuresis. diuretics held. obtained urine studies which were significant for rare eos suggesting ain. allopurinol was held. renal function improved prior to discharge with cr 1.5. he will have labs checked in two days to ensure that cr continues to trend downward. patient will resume allopurinol as outpatient. . 6. anemia: patient w/ baseline hct in low 30's. dropped lower this admission (patient reports that hct always drops after cath) but improved after 2u prbc and remained stable for remainder of hospitalization. patient will have labs checked two days after discharge to ensure that hct remains stable. . 7. gerd: ppi . 8. ppx: ppi. . 9. fen: cardiac/diabetic diet. repleted lytes prn. medications on admission: 1. atorvastatin 2. aspirin 325 3. clopidogrel 4. docusate 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs 6. allopurinol 300 mg tablet sig: one (1) tablet po daily 7. folic acid 8. insulin - 12 u lantus hs 9. carvedilol 12.5 mg tablet sig: four (4) tablet po bid 10. nifedipine 60 mg tablet sustained release 11. furosemide 20 mg tablet sig: one (1) tablet po daily 12. aciphex 20 hs 13. glucophage 750 am 1000 pm 14. spironolactone 25 mg 15. imdur 30 discharge medications: 1. atorvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. multivitamin capsule sig: one (1) cap po daily (daily). 8. aciphex 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po at bedtime. 9. carvedilol 12.5 mg tablet sig: four (4) tablet po bid (2 times a day). 10. isosorbide mononitrate 60 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 11. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po once a day. disp:*30 tablet sustained release(s)* refills:*2* 12. allopurinol 300 mg tablet sig: one (1) tablet po once a day. 13. lantus 100 unit/ml cartridge sig: one (1) 12 units subcutaneous at bedtime. 14. glucophage oral 15. outpatient lab work please check chem 7, magnesium, cbc, uric acid. please send results to patient's pcp . phone number . discharge disposition: home with service facility: discharge diagnosis: s/p cardiac catheterization and stent placement discharge condition: stable discharge instructions: please come to the emergency department if you develop chest pain, shortness of breath, dizziness or other concerning symptoms. . please take all medications as prescribed. . please make follow up appointments to see your primary care physician and your cardiologist as noted below. . there have been a few changes to your medications. do not take your spironolactone/aldactone until instructed otherwise. your dose of imdur is now 60mg daily. your dose of nifedipine is now 90mg daily. you should wait until you see dr. this week to resume your lasix (furosemide). do not take your lasix for now. . weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet . please limit your intake of salt in your diet. you should also follow a low fat and diabetic diet. . please follow your diabetes regimen as you had been prior to admission. followup instructions: 1. call dr. for a follow up appointment within one week. his phone number is . 2. you should make a follow up appointment in one to two weeks with dr. at . 3. you should have lab work checked on tuesday to make sure that your blood counts and kidney function are stable. procedure: other lysis of peritoneal adhesions open and other right hemicolectomy other small-to-large intestinal anastomosis diagnoses: subendocardial infarction, initial episode of care unspecified essential hypertension intestinal bypass or anastomosis status diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified aortocoronary bypass status percutaneous transluminal coronary angioplasty status peritoneal adhesions (postoperative) (postinfection) long-term (current) use of insulin old myocardial infarction acute vascular insufficiency of intestine diastolic heart failure, unspecified peritonitis (acute) generalized 

Answer: The patient is high likely exposed to