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: the patient, mr. , is a 61-year-old white male with a history of anxiety, coronary artery disease status post coronary artery bypass graft x2, end stage renal disease on dialysis, type ii diabetes, ischemic cardiomyopathy with one patent vessel and ejection fraction of 15%, was presented to after complaint of shortness of breath and chest pain. the patient reported shortness of breath for about a month in which sitting around the house would cause breathing difficulties. the patient reported that his breathing is relieved by breathing from a paper bag, as recommended by her friend. it initially occurred in less frequency, but now patient reported symptoms approximately eight times daily. furthermore, the patient reported episodic nonradiating, sharp, chest pain lasting a few seconds. on the day of admission, the patient called his primary care physician and was advised to come to the emergency department for evaluation/treatment. while in the emergency department, the patient's symptoms of chest pain and shortness of breath were improved with oxygen supplement. at interview, the patient denied chest pain, shortness of breath, fever, chills, nausea, vomiting, diaphoresis. the patient reported similar episodes in with the same symptoms of shortness of breath and chest pain. the patient was admitted for two days that subsequently ruled myocardial infarction. a persantine mibi stress test was performed which showed superior and inferior wall fixed defect/moderate lateral wall defect and ejection fraction of 15%. there was no acute electrocardiogram change at that time. the working diagnosis at that time was that the patient was under dialyzed as a result of lower dry weight. the patient was dialyzed again during admission and the symptoms improved. the patient reported increased anxiety, in which he thinks that he is about to die because of all these medical problems. the patient lives alone with only one friend that he can really talk to and has been separated from his wife and . the patient has been out of work since the age of 46 due to renal and cardiac problems. past medical history: 1. diabetes 2. end stage renal disease 3. coronary artery disease, status post coronary artery bypass graft x2 in and 4. gastritis 5. anemia 6. high cholesterol status post right cerebrovascular accident 7. cardiomyopathy 8. hypertension 9. anxiety allergies: the patient has no known drug allergies. initial medications: 1. zestril 25 qd 2. imdur 60 mg 1 tablet qd 3. nitroglycerin prn 4. neurontin 100 mg 1 tablet qd 5. nephrocaps 1 tablet qd 6. prilosec 40 mg qd 7. lopressor 50 mg 8. pravachol 40 mg qd 9. xanax 0.25 mg 10. reglan 10 mg tid 11. glyburide 2.5 mg qd 12. asa 325 mg qd social history: the patient admits to smoking half pack a day for the past 20 years. denies use of alcohol and intravenous drugs. the patient is separated from his wife, lives alone, has a . family history: both the father and the brother have type ii diabetes and also coronary artery disease. admission vitals: blood pressure 97/60, pulse 89, respiration 20, o2 saturation 100% on 2 liters. physical examination: general: the patient is a 61-year-old male who appeared older than stated age, no apparent distress, awake, alert and oriented to time, place and person, was unhappy that he has returned to the hospital for his symptoms. head, ears, eyes, nose and throat: normocephalic, atraumatic. pupils equal, round and reactive to light. extraocular eye movements intact bilaterally. mucous membranes moist. oropharynx benign. no lymphadenopathy bilaterally. cardiovascular: the patient has regular rate and rhythm with 3/6 holosystolic ejection murmur appearing loudest at the left upper sternal border. jugular venous distention was normal at 8 cm. pulmonary: the patient's lung fields are clear to auscultation bilaterally without wheezing or crackles. abdomen: soft and nontender with active bowel sounds in all quadrants. there was no mass, no bruit, no rebound tenderness or guarding. extremities: there is 1+ bilateral lower extremity edema. there was no upper extremity edema. overall, there is no clubbing or cyanosis. there is an av shunt on the left arm. neurologic: cranial nerves ii through xii are intact bilaterally. the motor exam was for all muscle groups and deep tendon reflex was 2+ at all points. mini mental exam: the patient feels lonely from living by himself and has been agitated and very unhappy with the fact that he has to come to the hospital quite often. the patient has no suicidal or homicidal ideation. admission labs: cbc: white count 8.0, hematocrit 41.6, hemoglobin 13.9, platelets 140. chemistries: sodium 136, potassium 4.1, chloride 92, bicarbonate 27, bun 41, creatinine 7.1 with glucose of 188. pt 15.1, ptt 29.4, inr 1.6. electrocardiogram showed no acute changes, has the evidence of old left bundle branch block. imaging studies: the patient had a chest x-ray which showed mild chronic failure and bilateral basilar atelectasis. hospital course: in summary, this is a 61-year-old white male with a history of coronary artery disease, status post coronary artery bypass graft x2, diabetes, end stage renal failure on hemodialysis, severe ischemic cardiomyopathy with one patent vessel and an ejection fraction of 10% who was admitted with shortness of breath and chest pain. the pertinent issues are as follows: 1. cardiovascular: the patient ruled out for myocardial infarction with the cycled enzyme of ck and also troponin, all of which are within normal limits. the patient was also initially placed on telemetry but was subsequently discontinued since there were no events recorded. the patient's cardiac medication of zestril, imdur and nitroglycerin were held because the blood pressure was in the 80s and the patient was asymptomatic. on hospital day #3, the patient was seen by the congestive heart failure service for evaluation in hopes to provide better treatment plan for his cardiac status. the patient was found to be an ideal candidate for the placement of a ventricular pacemaker and on , the patient was brought to the operating room and the pacemaker was successfully placed. the patient's blood pressure has been in the 80s to 90s during the earlier part of the admission and after the cardiac medications were discontinued, the pressure was hovering in the 70s on the day before pacemaker placement. after the pacemaker was placed on , the blood pressure remained low in the 60s and 70s and four boluses of 250 cc normal saline were given to boost up the blood pressure. on the next hospital day, the patient did not tolerate the increase in fluid well and had obtunded and complained of discomfort. a stat echocardiogram was ordered which showed ejection fraction to be less than 10%. however, there was no pleural effusion. at this point, the patient was given dopamine to increase his blood pressure, but was subsequently discontinued after about 10 minutes or so because the patient was complaining of chest pain with radiation to the left arm. the patient was brought to the coronary cardiac care unit for monitoring of these episodes of hypertension and the patient did well in the unit with no improvement in the blood pressure, but asymptomatic with the patient able to function both physically and mentally. after the patient was returned to the floor, the patient was given cardiac rehabilitation by ambulating with nurse 3x a day. the patient was also given a trial of midodrine which increased his blood pressure and at the same time caused no symptoms. the ep service and the congestive heart failure service has followed the patient throughout. 2. pulmonary: the patient has been doing well after the initial complaint of shortness of breath in the emergency room. the patient's oxygen saturation has been between 97% and 100% on room air and lung auscultation has been essentially clear without evidence of crackles or wheezing. the patient will be discharged with instructions that if he gets short of breath again, do not exhale into the paper bag like he did before. the patient's symptoms of shortness of breath is most likely contributed by his anxiety of his medical conditions and this can be hopefully alleviated by placing the patient on celexa. 3. renal: the patient has been getting hemodialysis on a monday, wednesday, schedule and has been doing well with that. it was found that if more fluids were taken out, the patient's blood pressure actually responds better and the patient's subjectively feels better. the amount of fluid that has been taken out during this admission has been between 2 kg to 3 kg. 4. diabetes: during this admission, the patient was given glyburide 2.5 mg qd as well as the regular insulin sliding scale. the patient's fingerstick glucose check 4x a day has been fairly stable. 5. gastrointestinal: the patient with history of gastritis was placed on reglan and also on protonix on admission. the patient's reglan was discontinued because it was suspected that it was one of the causes for hypotension. the patient has been doing well just on protonix without gastrointestinal complaints. 6. psychiatry: the patient has been emotionally up and down throughout admission, but more stable towards the end. the patient was very distressed about having to go to dialysis 3x a day and that is essentially his whole life and he really cannot do anything else. after hospital day 10, the patient has been emotionally more stable. the patient has not had any episodes of crying. this is unclear as to whether this is from the effect of celexa or because the patient has become accustomed to the medical team and has built trust in the care. a psychiatric hospital was obtained initially in the beginning of the admission. the recommendation was that the patient is baseline and could obtain help from ssri. discharge condition: stable discharge diagnoses: 1. diabetes 2. end stage renal disease on dialysis 3. coronary artery disease 4. gastritis 5. anemia 6. high cholesterol 7. status post right cerebrovascular accident 8. cardiomyopathy 9. hypertension 10. anxiety 11. ischemic cardiomyopathy discharge medications: 1. midodrine 10 mg po tid while awake, with the last dose given before 6 p.m. to prevent hypertension 2. glyburide 2.5 mg 1 tablet po qd 3. nephrocaps 1 tablet po qd 4. asa 325 mg qd 5. pravachol 40 mg qd 6. protonix 40 mg 1 tablet po qd 7. tylenol 650 mg 1 tablet po q 4 to 6 hours prn pain/fever 8. celexa 20 mg 1 tablet po qd follow up appointments: the patient is to follow up with: 1. the electrophysiology team which right now, he has an appointment on , at 11 a.m. this is a six week follow up with dr. who has already done a follow up 10 days after the placement of the pacemaker. 2. the patient is also to follow up with the congestive heart failure service with dr. at the hospital cardiology department. 3. the patient should also follow up with his primary care doctor. dr., 12-766 dictated by: medquist36 procedure: catheter based invasive electrophysiologic testing initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle pulmonary artery wedge monitoring cardiac mapping diagnoses: other primary cardiomyopathies anemia in chronic kidney disease coronary atherosclerosis of native coronary artery congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease anxiety state, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled other sedatives and hypnotics causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to