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: history of present illness: mr. is an 84 year-old gentleman with an unknown past medical history as he has never seen a physician in the past who, on the day of admission, developed sudden onset of chest pain at rest. he described the pain as substernal chest pain radiating across his chest and between his shoulder blades. the patient denied associated shortness of breath, nausea, vomiting, lightheadedness, or dizziness. he states he has been in his usual state of health prior to the onset of chest pain. he denied fevers or chills, congestion, cough, no gi symptoms. he denies prior history of chest pain as well. the patient also denied paroxysmal nocturnal dyspnea, orthopnea, dyspnea on exertion, or lower extremity edema. he states he walks three to four miles every day without symptoms. the patient arrived at an outside hospital emergency department approximately forty minutes after his chest pain began. the chest pain continued to radiate across his chest to his back. his pulse on admission was 92 with a blood pressure of 106/80. a cta was done at the outside hospital that was negative for aortic injury, but the electrocardiogram showed anterior st elevations, qs in v1 and v2, right bundle branch block and left anterior vesicular block. the patient was given nitro drip, heparin intravenous, intravenous beta blocker and transferred to for cardiac catheterization. electrocardiograms at the outside hospital involved to include st elevation and both the anterior and lateral leads with peak st elevations of 6 mm in leads v2 and v3. initial cardiac enzymes were negative at the outside hospital. of note, the patient's glucose is in the 400s when he was admitted. in the cardiac catheterization laboratory the patient was shown to have the following results on angiography. he had a right dominant system and left anterior descending coronary artery with a 95% thrombotic proximal and mid lesion involving the first diagonal and first septal branch. his left circumflex had an 80% mid lesion and his right coronary artery had a 40% mid and 60% posterolateral lesions. for intervention the patient had angioject and stent to the left anterior descending coronary artery without complications. hemodynamics in the cardiac laboratory showed a cardiac output suppressed at 3.10, a low index of 1.67, pa pressure of 31/18 with a wedge pressure of 22, the a wave being 23 and the v wave being 28, and a right ventricular pressure of 32/8. past medical history: as previously stated the patient denies. medications: the patient states he only takes one multivitamin every day at home. allergies: no known drug allergies. past surgical history: the patient denies. social history: the patient lives by himself. his wife suffers from dementia and lives in a nursing home. he visits her every day. the patient has remote smoking history describing that he smoked during world war ii basically a pack per month. he denies etoh use. physical examination: on admission the patient's temperature was 97.4. his heart rate was 92 and sinus. his blood pressure was 150/90. sat 98% on a nonrebreather and then subsequently 93% on 8 liters nasal cannula. respiratory rate 17. in general, he was anxious. he was alert, but not oriented. per report the patient had been very anxious in the catheterization laboratory requiring heavy sedation with morphine and haldol. heart regular rate and rhythm. s1 and s2. difficulty to hear over diffuse lung, rhonchi and crackles. lungs diffuse crackles bilaterally. abdomen soft, nontender, nondistended. positive bowel sounds. no hepatosplenomegaly. extremities no clubbing, cyanosis or edema. good distal pulses with 2+ dorsalis pedis pulses bilaterally and 2+ posterior tibial pulses bilaterally. neurological examination not oriented to time or place. cranial nerves ii through xii grossly intact. strength grossly normal bilaterally, although examination limited as the patient has sheath in place. laboratory data: the patient's data from the outside hospital included a hematocrit of 47.4, white blood cell count 15.6, platelets 249. the cks at the outside hospital included a ck of 143 with an mb of 3.8, mb index of 2.7 and an troponin i of 0.22. at the patient's second ck came back at 6433 with an mb of 465 and mb index of 7.2 and a troponin greater then 50. the patient's chem 7 included sodium 134, k 4.8, chloride 98, bicarb 20, bun 21, creatinine 1.1 and glucose of 412. hospital course: 1. cardiovascular: the patient had a very large anterior st elevation myocardial infarction. he is status post stenting of his left anterior descending coronary artery. for management of his coronary artery disease he was started on aspirin, plavix and he was placed on integrilin for a total of 18 hours. he was empirically started on a statin. he was also started on a beta blocker and an ace inhibitor and his cardiac enzymes were cycled. the patient was started on captopril 12.5 t.i.d. this was titrated up to 25 t.i.d., however, the patient had problems with hypotension and orthostasis, therefore this was decreased to 12.5 t.i.d. the patient tolerated lopressor 25 b.i.d. he is also placed on atorvastatin 20 q.h.s., plavix 75 q.h.s. and aspirin 325 q.d. post cardiac catheterization the patient's anterior and lateral st elevations did resolve with flattening of the st segment. after the ck peak of 6433 the patient's ck decreased to 2963 with an mb of 214. the next ck on was down to 1269. pump function: the patient was noted on bed side echocardiogram after his cardiac catheterization to have severe increase in his ejection fraction with a estimated ef of 20% the patient had a formal echocardiogram on the that showed an ejection fraction between 20 and 30%. the left ventricular wall thickness was seen to be normal. left ventricular cavity size normal, overall left ventricular systolic function was said to be severely depressed. right ventricular free wall is hypertrophied. right ventricular chamber size normal. focal hypokinesis of the apical free wall. left ventricular cavity size was said to be normal with severely depressed severe hypokinesis of the anterior septum and anterior free wall, moderate hypokinesis of the inferior septum and lateral wall and akinesis of the apex. based on these results the patient was started on intravenous heparin for the risk of left ventricular thrombus with such an akinetic ventricle including the apex. however, as it was discovered that the patient had baseline dementia per family report and he subsequently suffered from an episode of delirium it was felt that the atrial fibrillation did not outweigh the risk the patient had of falling. therefore the intravenous heparin was stopped and the patient was placed on prophylactic subq heparin. the patient was diuresed with 20 intravenous lasix prn and responded nicely within the first 24 hours. his chest x-ray, which had initially showed failure cleared after diuresis and the patient required no further dosing of lasix. rhythm: with the patient's low ef and guard ventricular ep consult was considered for risk stratification. however, it was felt that with the patient's underlying medical conditions including delirium on top of dementia an ep consult would not benefit the patient at this time. cardiac follow up: the patient was to be set up with a cardiologist in his area prior to discharge and to be set up with cardiac rehabilitation. 2. diabetes: the patient presented with blood sugars in the 400s. his urine and serum were negative for ketones. the hemoglobin a1c was checked that came back at 12.7 indicating the patient had diabetes undiagnosed for quite some time. the patient was initially controlled with an intravenous insulin drip according to the protocol and was then converted over to a sliding scale of regular insulin along with glucophage 500 b.i.d. and nph fixed doses. 3. neurological: as stated previously the patient was noted to be severely agitated during cardiac catheterization and subsequently in the coronary care unit and on the floor. he was initially managed with haldol, which seemed to help with the patient's agitation and was therefore discontinued. a geriatric consult was obtained and they recommended that the patient be given risperidone .5 mg b.i.d. on a prn basis only and this was done with control of the patient's agitation. to rule out causes of delirium the patient had blood cultures times two, urine cultures and analysis and a chest x-ray. all infectious workup was negative. the patient also had a tsh checked, which was within normal limits and a b-12 level checked. b-12 was within normal limits at 773. his tsh was within normal limits at 0.32. the patient's mental status cleared during his hospital course and was significantly cleared on at which time the patient was alert and oriented times three and was appropriate and cooperative. the patient had required a one to one sitter from the 9th until the 12th. the sitter was then discontinued on the . it was concluded that the most likely cause of the patient's delirium on top of his baseline dementia were hypotension and hyperglycemia. therefore as stated under cardiovascular the patient's captopril dose was decreased to prevent orthostasis and he was put on a tight glucose control regimen including glucophage, nph and regular insulin sliding scale. this is the end of the hospital course as of . the rest of the dictation will be completed by the intern taking over this service. , m.d. dictated by: medquist36 procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization combined right and left heart cardiac catheterization coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor injection or infusion of platelet inhibitor insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization combined right and left heart cardiac catheterization coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor injection or infusion of platelet inhibitor diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation hypotension, unspecified other complications due to other cardiac device, implant, and graft delirium due to conditions classified elsewhere 

Answer: The patient is high likely exposed to