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: this is a 69 year old female with a history of coronary artery disease status post coronary artery bypass graft, complete heart block with a ddd pacer, diabetes mellitus, renal failure on hemodialysis, hypertension, aortic stenosis and mitral regurgitation, who presented today from hemodialysis for her anginal equivalent shortness of breath and bilateral arm pain/pressure. the patient states that the pain / pressure was in her forearms and went from 2 out of 10 to zero out of 10 with one sublingual nitroglycerin. she denies chest pain, nausea, vomiting, orthopnea or radiating pain. she has always slept with two pillows. she denies additional orthopnea. she has no recent paroxysmal nocturnal dyspnea, no jaw or neck pain, no fever or chills, diarrhea, constipation, abdominal pain. no increased lower extremity edema and no recent weight gain. past medical history: 1. renal failure on hemodialysis. 2. coronary artery disease status post coronary artery bypass graft; status post ddd pacer for complete heart block. 3. diabetes mellitus on insulin. 4. history of gastrointestinal bleed. 5. history of gastric varices. 6. glaucoma. 7. asthma. 8. aortic stenosis. 9. mitral regurgitation. 10. hypertension. 11. history of recent catheterization in with a stent placed in the saphenous vein graft to the patent ductus arteriosus graft. 12. history of thrombocytopenia secondary to heparin. 13. hit antibody negative. 14. history of alcohol abuse. 15. peripheral vascular disease. 16. ejection fraction of 20 to 30%. allergies: aspirin causing gastrointestinal bleed; penicillin causing hives. intravenous contrast dye; cardizem. medications on admission: 1. amitriptyline 25 mg q. h.s. 2. nph insulin 34 units q. a.m. and 20 units q. p.m. 3. regular insulin sliding scale. 4. nephrocaps two daily. 5. phos-lo two three times a day. 6. lopressor 100 mg p.o. twice a day. 7. lipitor 20 mg daily. 8. protonix 40 mg daily. 9. imdur 30 mg daily. 10. plavix 75 mg daily. 11. aspirin 81 mg daily. social history: married. she has three daughters; no tobacco. quit alcohol years ago and has history of alcohol abuse. family history: father died of a myocardial infarction at age 59. mother had a cerebrovascular accident at age 68. physical examination: temperature 97.6 f.; heart rate 83; blood pressure 136/72; respiratory rate 24; oxygen saturation 93% on room air. in general, alert and oriented in no acute distress. heent: supple neck, dry mucosal membranes. right pupil defect. clear oropharynx. jugular venous distention four to six centimeters. cardiovascular is regular rate and rhythm with a iii/vi systolic murmur at the base radiating to the carotids and to the apex. harsh blowing murmur. respiratory: crackles were heard bilaterally one third of the way up. abdomen soft with positive bowel sounds, nontender, nondistended. positive umbilical hernia. extremities with no lower extremity edema. neurologic examination is alert and oriented, non-focal. cranial nerves ii through xii intact bilaterally. laboratory on admission: white blood cell count 10.0, hematocrit 35.5, platelets 189, mcv 100, inr 1.2. sodium 140, potassium 4.9, bun 15, creatinine 2.2, glucose 251. chest x-ray showed congestive heart failure with interstitial edema. ekg showed ventricular pacing, no change compared to previous electrocardiograms. hospital course: 1. angina: the patient was admitted to telemetry and serial ck and troponin were followed. the patient was on aspirin, plavix, beta blocker, statin, and initially remained chest pain free, however, her troponin continued to rise. the patient eventually ruled in with a troponin that rose as high as 2.43. she also developed persistent angina that required initiation of a heparin drip and a nitroglycerin drip and scheduled cardiac catheterization. shortly before cardiac catheterization, the patient became acutely hypotensive and developed flash pulmonary edema requiring emergent intubation and urgent cardiac catheterization. the catheterization revealed diffuse native disease and no new lesions in her three grafts, however, she had elevated pulmonary pressures in the mid 60s systolic. she was started an intra-aortic balloon pump and dobutamine for after load reduction and transfer to the cardiac care unit. she remained on cardiac pressors for a short time and her intra-aortic balloon pump was removed within 24 hours; however, she continued to have elevated pulmonary capillary wedge pressures despite hemodialysis and despite being at her baseline dry weight. she had a repeat echocardiogram which revealed systolic congestive heart failure with an ejection fraction of approximately 20%, severe global left ventricular hypokinesis. in addition, it revealed four plus mitral regurgitation, three plus tricuspid regurgitation, and moderate to severe aortic stenosis. the patient remained angina free in the intensive care unit and was transferred out to the medicine floor. the patient was seen by cardiothoracic surgery to evaluate for potential surgical repair of her aortic valve and mitral valve; however, it was felt that at this time the patient would not be a surgical candidate and would most likely be an extremely poor surgical candidate at any time in the future. it was determined that medical management of her congestive failure and valvular disease would be the appropriate course of therapy. the patient was started on low dose ace inhibitor and beta blocker and was continued on her aspirin, plavix and statin. 2. atrial tachycardia: the patient was noted to have episodes of atrial tachycardia during her stay in the intensive care unit. these episodes were broken by carotid sinus massage. the patient remained asymptomatic throughout the entire duration of the arrhythmia. it was felt that the addition of beta blocker would help control the patient's multiple pacs and atrial tachycardia. 3. renal failure: the patient was continued on hemodialysis throughout her admission. 4. asthma / chronic obstructive pulmonary disease: the patient was continued on her advair discus and albuterol p.r.n. 5. diabetes mellitus: the patient was continued on an insulin sliding scale and scheduled nph. 6. urinary tract infection: the patient was treated for a urinary tract infection with levofloxacin. 7. anemia: the patient was felt to have anemia of chronic disease secondary to her renal disease. the patient's hematocrit should be followed as an outpatient and she may need transfusions and / or epogen injections. 8. anxiety: after being told that she was going to be a very poor surgical candidate, the patient became very anxious and restless and complained of lower back and shoulder pain. the patient's pain and anxiety was relieved with morphine, ativan, and reassurance. the remainder of the discharge summary to be dictated by the covering house officer. condition on discharge: stable. , m.d. dictated by: medquist36 d: 17:33 t: 18:42 job#: procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures insertion of endotracheal tube hemodialysis implant of pulsation balloon diagnoses: thrombocytopenia, unspecified subendocardial infarction, initial episode of care urinary tract infection, site not specified chronic airway obstruction, not elsewhere classified rheumatic heart failure (congestive) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure mitral valve insufficiency and aortic valve stenosis diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to