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: acute shortness of breath major surgical or invasive procedure: cardiac catheterization percutaneous coronary angioplasty with drug eluting stent placement history of present illness: mr. is a 60 year-old male active smoker who has not seen a doctor , with no known past medical history, who presented to hospital following acute onset of shortness of breath last night. he notes that he was laying in bed when he became acutely short of breath during the night prior to admission. his breathing became progressively more labored, and he called 911. he reports associated stomach upset and diaphoresis with the shortness of breath, but denies n/v. he was taken to hospital, where a cxr was consistent with chf. his ekg revealed peaked t waves anteriorly and st depressions anterolaterally. bnp 1190. he was administered asa, plavix, ntg, heparin iv and integrillin and was transferred to for further care. of note, per report, mr. blood pressure dropped precipitously at the osh following administration of metoprolol. it is unclear what his hr was at that time. by the sister's account, mr. has had several episodes of shortness of breath over the past few weeks. he seems to be tachypneic at baseline. past medical history: no known past medical history. social history: he lives with his sister. is an active smoker, with a 60 pack-year smoking history. remote history of alcohol abuse. family history: no known family history of cad. physical exam: physical examination on admission to the ccu: vitals: bp 131/97, hr 117, regular. rr 20, sat 96% on 4l nc. gen: in nad. pleasant. heent: anicteric. mmm. poor dentition. neck: jvp up to the jaw. no carotid bruit. resp: good air entry bilaterally. rhonchi at rll. cvs: normal s1, s2. no s3, s4. no murmur or rub. gi: bs normoactive. abdomen soft and non-tender. ext: no pedal edema. good peripheral pulses. neuro: alert and oriented x 3. pertinent results: relevant laboratory data on admission: pre catheterization: hgb-13.3* calchct-40 o2 sat-96 glucose-138* k+-3.6 abg: po2-169* pco2-54* ph-7.36 total co2-32* base xs-3 post-catheterization: chemistry: glucose-100 urea n-13 creat-0.8 sodium-141 potassium-3.1* chloride-98 total co2-34* anion gap-12 calcium-7.9* phosphate-3.2 magnesium-1.4* cardiac enzymes: ck(cpk)-839* ck-mb-74* mb indx-8.8* ctropnt-3.08* miscellaneous: %hba1c-6.2* tsh-0.23* relevant studies in admission: cxr: note is made of mild cardiomegaly. mediastinal contours are within normal limits. note is made of patchy opacities in the right lower lobe, which can represent early pneumonia. opacity overlying the right apex is noted, which can be due to projection, however, please follow in repeated chest x-ray. note is made of mild edema, more prominently on the right. impression: 1) patchy opacity in the right lower lobe, which probably representing pneumonia. 2) cardiomegaly, edema more prominently on the right. 3) opacity overlying the right apex, which can be due to projection, however, please repeat the study with better positioning. cardiac catheterization: 1. selective coronary angiography revealed a right dominant system with three vessel coronary artery disease. the lmca had no angiographically apparent flow limiting lesions. the lad had 50% and 70% mid vessel stenoses as well as an occluded major diagonal branch. the lcx had a 95% hazy om1 lesion. the rca had a well collaterized mid vessel occlusion. 2. resting hemodynamics demonstrated moderately elevated right sided pressures (mean ra 13 mmhg), moderately elevated pulmonary pressures (pad 33 mmhg), and moderately elevated left sided pressures (mean pcwp 31 mmhg) with a moderately depressed cardiac index (1.9 l/min/m2). 3. left ventriculography was deferred. 4. successful stenting of the om1 with a 2.5x24mm taxus with a 2.75mm highsail baloon at 18 atms (see ptca comments). 5. unsuccessful attempt at angioplasty of the totally occluded d1 and proximal rca due to inability to cross the lesions with the wire (see ptca comments). final diagnosis: 1. three vessel coronary artery disease. 2. moderate ventricular dysfunction. 3. successful stenting of the om with a drug eluting stent. 4. unsuccessful attempt at ptca of the totally occluded d1 and the totally occluded proximal rca. echo: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. the left ventricular cavity is moderately dilated. there is severe global left ventricular hypokinesis. lvef 15-20%. no masses or thrombi are seen in the left ventricle. right ventricular chamber size is normal. there is mild global right ventricular free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. moderate (2+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: dilated cardiomyopathy with severely depressed lvef (? multivessel cad?). moderate mitral regurgitation. brief hospital course: 60 year-old male smoker with no significant past medical history, transferred from outside hospital with chf and lateral ekg changes. his hospital course will be reviewed by problems. 1) cad: mr. was taken directly to the cath lab on arrival. coronary angiography revealed serial lad lesions, totally occluded rca with collaterals and occluded diagonal felt to be old, as well as what appeared to be an acute total occlusion of the om1. intervention was performed on the latter with a drug eluting stent. hemodynamics revealed ra 11, pa 42/27/35, pcwp 24 and co/ci 3.01/1.86. ekg showed sinus tachycardia, laa, lvh, lateral st depressions. his cardiac enzymes were elevated (peak ck 74, trop 3.08 on admission), consistent with a nstemi felt related to acute om occlusion. he was admitted to the ccu for post-mi management and diuresis. in the ccu, he was started on asa, plavix, high-dose lipitor for secondary prevention, and ace. he was also placed on a ntg drip for a short period of time for tight bp control, quickly weaned off. an echo was performed on and revealed severe lv dysfunction with ef 15-20%, with global hypokinesis, felt likely mixed cardiomyopathy. beta-blockade therapy was initiated on , and ace therapy was titrated in hospital. the importance of medication compliance and smoking cessation was also emphasized, but continued emphasis and close follow-up will be required as an out-patient. follow-up with dr. (cardiology) and dr. () was arranged prior to discharge. he was discharged on asa, plavix, lisinopril 10, coreg 3.125 and lipitor 80. consideration should be given to titration of beta-blockade as an out-patient. 2) chf: as mentioned above, cxr on admission was consistent with chf, and pcwp in cath lab was elevated at 24. an echo performed on revealed ef 15-20% with global hypokinesis. while in hospital, he was diuresed with lasix with parallel improvements in his cxrs and decreased oxygen requirements. ace inhibitor therapy was initiated, and he was discharged on lisinopril 10 mg po qd and a standing dose of lasix 20 mg po daily. 3) rhythm: mr. was noted to have sinus tachycardia on admission. thyroid function studies revealed low tsh at 0.23, but normal free t4 and t3, felt most likely consistent with sick euthyroid. repeat thyroid function studies are advised as an out-patient. mr. current alcohol use. his sinus tachycardia was ultimately felt to be most likely in the setting of his cardiomyopathy. beta-blockade therapy was initiated with caution while in hospital. consideration should be given to up-titration as an out-patient. change to a more selective beta-blocker may be required if worsening copd is noted. 4) r/o pneumonia: multiple cxrs in hospital were suspicious for a rll infiltrate. although he remained afebrile, levofloxacin was started on in the setting of increased leukocytosis for coverage of cap. he will complete a 7-day course (last dose on ) as an out-patient. 5) copd: mr. is an active smoker. physical examination on admission was remarkable for diffuse wheezes. bronchodilatory therapy via nebulizers was given, and he was started on advair diskus and inhalers. he was discharged on advair and atrovent qid. please consider out-patient pft's. 6) social: case management was involved and free care application was initiated in hospital. medications on admission: none discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. atorvastatin calcium 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 4. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). disp:*60 disk with device(s)* refills:*0* 5. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). disp:*1 inhaler* refills:*2* 6. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days: last dose on . . disp:*4 tablet(s)* refills:*0* 8. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: 1. coronary artery disease status post coronary stent placement 2. congestive heart failure 3. probable pneumonia 4. probable chronic obstructive lung disease discharge condition: patient discharged home in stable condition. discharge instructions: please take all your medications as prescribed. most importantly, you need to take plavix and aspirin daily to prevent blockage of the stent that was placed into your heart vessel. you have a scheduled appointment with dr. next week on at 14:30. it is important that you come to this appointment. you also have an appointment with dr. in the department of cardiology on at 13:00. please call your doctor or return to the hospital if you experience chest pain or worsening shortness of breath. followup instructions: 1) provider: , md where: phone: date/time: 2:30 2) provider: , m.d. where: cardiac services phone: date/time: 1:00 it is crucial that you go to both these appointments. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor insertion of drug-eluting coronary artery stent(s) diagnoses: pneumonia, organism unspecified other primary cardiomyopathies subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery tobacco use disorder mitral valve disorders congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified other specified cardiac dysrhythmias euthyroid sick syndrome 

Answer: The patient is high likely exposed to