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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with drug eluting stent to the right coronary artery history of present illness: 72-year-old male history of prior mi () and h/o esophagectomy for ?esophageal ca (not confirmed on path) presents with midline chest squeezing and pressure with diaphoresis and nausea since :00 am yesterday. the pain was more severe yesterday and has gradually diminished, but did not resolve until he was take for cath this am. the patient had an mi in . he has hypertension but denies hypercholesterolemia or diabetes. . initial vs at were t 97.9 hr 60 rr 12 bp 115/68 pox 98 ra. labs at were significant for wbc 9.2, hgb 13.7, hct 38.6, mcv 92.9, plt 202 with normal differential. ecg was significant for hr 55 bpm, nsr, st changes 1-1. elevations in ii,iii and avf with subtle st depressions in v5,v6 concerning for acute inferior wall mi. the patient was given asa 325, plavix 600mg, heparin 4000 u bolus then started on 1000u /hr gtt. patient was transferred to for acs and emergent coronary revascularization. . at , patient was taken to c. cath lab immediately for late presentation/cto proximal rca with export and des to proximal rca with 6f rfa angioseal. he was transferred to the ccu on an eptifibatide gtt. . . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: - cad - hypertension - esophagectomy (patient unsure of the pathology) social history: tobacco: quit 35 years ago. smoke between 0/5-4 packs per day x 25 years. alcohol: averagesglass of wine daily recreational drugs: cocaine and pot in his 20's family history: - no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory except a maternal uncle that had mi in 40's - mother: alive, s/p cva, dementia - father: died at 93, dementia physical exam: physical examination on admission: general: nad. oriented x3. heent: ncat. sclera anicteric. perrl, eomi. neck: supple with no jvp. cardiac: rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. midline epigastric hernia extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ physical examination on discharge: general: nad, aaox3 heent: ncat, sclera anicteric, wearing glasses, mucus membranes moist neck: supple with no jvp visualized with pt. in 90 degree upright position cardiac: rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities. unlabored work of breathing, no accessory muscle use or retractions, no cough. ctab, good aeration, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. active bowel sounds heard in chest and neck d/t esophagectomy. no hsm or tenderness. midline epigastric hernia extremities: warm, no edema skin: no sores or lesions, right cath site with mild echymosis and small knot underneath the skin, no tenderness. pulses: bilaterally, carotid, radial, femoral, dp, and pt 2+ access/devices: right ac piv without erythema or edema pertinent results: labs on admit: 01:12pm blood wbc-7.7 rbc-4.08* hgb-12.9* hct-38.3* mcv-94 mch-31.5 mchc-33.6 rdw-13.4 plt ct-217 01:12pm blood glucose-117* urean-17 creat-0.9 na-137 k-3.7 cl-100 hco3-30 angap-11 05:59pm blood ck-mb-145* mb indx-11.7* ctropnt-4.72* 05:49am blood ck-mb-45* mb indx-7.3* ctropnt-3.26* 01:12pm blood calcium-8.6 phos-2.6* mg-1.8 cholest-187 02:36pm blood %hba1c-6.0* eag-126* 01:12pm blood triglyc-127 hdl-66 chol/hd-2.8 ldlcalc-96 ldlmeas-109 labs on dc: 07:55am blood wbc-4.8 rbc-3.79* hgb-11.8* hct-35.5* mcv-94 mch-31.2 mchc-33.3 rdw-13.5 plt ct-166 07:55am blood glucose-111* urean-19 creat-1.0 na-139 k-4.1 cl-104 hco3-31 angap-8 07:55am blood calcium-8.7 phos-2.9 mg-2.0 ecg : sinus rhythm. st segment elevation in leads iii and avf up to two millimeters with q waves in the inferior leads consistent with inferior wall myocardial infarction in evolution. st segment depressions in leads i and avl consistent with reciprocal changes. cath : 1. selective coronary angiography in this right dominant system demonstrated single vessel coronary artery disease. the lmca was free of angiographically significant coronary artery disease. the lad had a 50% lesion in its mid segment. the lcx had mild, diffuse non-obstructive coronary artery disease. the rca was totally occluded proximally and filled distally with left to right collaterals. 2. limited resting hemodynamics revealed normal systemic arterial blood pressure with a central aortic blood pressure of 117/61. 3. successful aspiration thrombectomy and pci of the proximal and mid rca with 3.5x28mm -dilated to 4.0mm (see ptca comments). 4. successful right groin closure with 6f angioseal device. final diagnosis: 1. single vessel coronary artery disease. 2. acute stemi due to thrombotic occlusion of the rca 3. normal systemic arterial blood pressure. 4. successful pci of the proximal rca with des. 5. continue aspirin and plavix. 6. admit to ccu for post-stemi care including statins, beta-blocers, and ace inhibitors. echo : the left atrium and right atrium are normal in cavity size. the estimated right atrial pressure is 5-10 mmhg. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with near akinesis of the basal 2/3rds of the inferior wall. the remaining segments contract normally (lvef = 45 %). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. impression: normal left ventricular cavity size with regional systolic dysfunction c/w cad (pda distribution). dilated ascending aorta. brief hospital course: hospital course: this is a 72 y/o male with h/o cad, prior mi (), htn, and esophagectomy for ? esophageal ca (not confirmed on path) admitted with stemi of ii, iii, avf and std of v5-6 s/p des to rca. #. stemi/cad: the patient presented with stemi of ii, iii, avf and std of v5-6, with q-waves in ii,iii, and avf already present. he was taken to the cath and was found to have a complete thrombotic occlusion to the rca, now s/p des. the patient was not taking asa or a statin even though he had a prior mi in 's. the patient received asa, plavix, heparin gtt prior to osh transfer and was started on intergralin prior to cath. post-cath echo with ef 45%. pt. was stable without cp or sob, vss on d/c. we started asa 325 mg po daily, clopidogrel 75 mg po daily, lisinopril 2.5 mg po daily and metoprolol tartrate 6.25mg po bid. #. htn- patient reports baseline bp is 120-140 at home. current bp 90-110's/50-70's and mentating well. we held home amlodipine and started lisinopril and metoprolol tartrate. #. hld- not on a statin at home, does take a number of supplements, including vitamin e and niacin. we started atorvastatin 80mg and suggested pt. stop taking his niacin and vitamin e d/t interactions. suggested the pt. consider d/cing the other supplements, with the exception of vitamin d and any others that were prescribed by his pcp #. esophagectomy for ? esophageal ca. performed in 3/. the path report did not confirm a cancer, but pt. wanted the operation just in case contact: wife, code: full (confirmed with pt/family) dispo: home. lives with his wife at home, is retired, but active with projects around the home. has 5 grown children, some in the area. medications on admission: - folate 800mg - amlodipine 5mg - vitamin d 2,000 units 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. folic acid 800 mcg tablet sig: one (1) tablet po once a day. tablet(s) 3. cholecalciferol (vitamin d3) 2,000 unit tablet sig: one (1) tablet po once a day. 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 6. metoprolol succinate 25 mg tablet extended release 24 hr sig: 0.5 tablet extended release 24 hr po once a day. disp:*15 tablet extended release 24 hr(s)* refills:*2* 7. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet sublingual as directed as needed for chest pain: take 1 tablet under tongue for chest pain, wait 5 mins, then take 1 more tab. if you still have chest pain after two tabs, call 911. . disp:*25 tab* refills:*0* discharge disposition: home discharge diagnosis: acute inferior st elevation myocardial infarction hypertension coronary artery disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it has been a pleasure caring for you at . after about 24 hours of chest pain, you went to an on , where you were diagnosed with an inferior heart attack with st wave elevations. you were transferred to , where you had a cardiac catheterization, which diagnosed that your right coronary artery was blocked. you were given medication to thin your blood and a drug-eluding stent was placed to keep the vessel open. you spent the night in the intensive care unit for monitoring and you were transferred to the cardiac step down unit the next day (), as you were doing very well. your stay has been without fevers or other complications and you are ready to return home today. a number of medications have been added to your list, and you should continue to take these once you return home to protect your heart and prevent further cardiovascular complications. we have stopped your amlopidine and instead started you on lisinopril and metoprolol extended release for blood pressure control, as these medications are recommended after a heart attack. we have also started you on aspirin 325 mg daily following your stent placement, your cardiologist will decide how long you need this dose and when you may take aspirin 81 mg. clopidogrel (plavix) is another blood-thinning medication and should be taken for one year to protect your stent. please do not stop taking the aspirin or plavix for any reason unless directed to by your cardiologist. these medications are absolutely necessary to protect you from another heart attack. for cholesterol control, you have been started on atorvastatin (lipitor). regarding your multiple supplements, we recommend that you stop the niacin and vitamin e, as they can interact with the atorvastatin. please speak with your pcp regarding the need/benefit of the other vitamins. you have a prescription for nitroglycerin to use for chest pain. please call 911 if you still have chest pain after 2 tablets. call dr. if you use any nitroglycerin at all. followup instructions: name: , p. location: healthcare - crown colony address: , , , phone: appointment: tuesday 11:00am department: cardiac services when: thursday at 2:20 pm with: , md building: sc clinical ctr campus: east best parking: garage procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension other and unspecified hyperlipidemia acute myocardial infarction of other inferior wall, initial episode of care old myocardial infarction chronic total occlusion of coronary artery 

Answer: The patient is high likely exposed to