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: des to proximal lad () history of present illness: 83m with htn presents with acute onset of chest pain that awoke patient from sleep at 2 am. the pt reported pain in l chest, non-radiating left sided chest pain/pressure/constant x2 hours. he reported this to his son who subsequently brought him to the ed. he took his atenolol 50mg in the evening. in the ed initial vials 96.6 56 130/62 16 100%ra. ecg notable for ekg with anterolat st elevations and reciprocal depressions. trop <0.01. the pt was given asa 325mg, plavix 600mg and started on a heparin gtt. the pt was brought directly to the cath lab. while in the cath labe the pt was noted to have a lad thrombus which was removed. the pt received a prox lad des. on arrival to the ccu (was boarding in the cvicu) the pt is chest pain free. on review of systems, 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. he denies recent fevers, chills or rigors. 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: 1. cardiac risk factors: -diabetes, -dyslipidemia, +hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: none prior to -pacing/icd: none social history: -tobacco history: none -etoh: none -illicit drugs: none family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission: vs: aferbile 61 102/62 general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 5cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: clear anteriorly. no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no anterior crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominal bruits. extremities: right groin c/d/i. no bruit. no edema. good distal pulses and cap refill. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ left: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ discharge exam: nsr sbps 110/70s. general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. neck: supple, no jvd. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: clear anteriorly. no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. crackles heard bilaterally lower of lung bases, l>r. no wheezing abdomen: soft, ntnd. +bs. extremities: right groin c/d/i. no bruit. no edema. good distal pulses and cap refill. skin: intact pulses: right: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ left: carotid 2+ femoral 2+ popliteal 1+ dp 1+ pt 1+ pertinent results: complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 05:40 8.5 4.42* 12.9* 37.6* 85 29.3 34.4 15.1 241 06:05 9.8 4.52* 12.9* 37.9* 84 28.5 34.0 15.1 245 06:00 9.5 4.12* 12.3* 34.7* 84 29.9 35.5* 15.0 206 05:35 10.4 4.12* 11.9* 34.2* 83 28.9 34.8 15.2 194 02:18 11.8* 4.56* 13.5* 38.4* 84 29.7 35.2* 15.1 230 08:42 12.6* 4.99 14.3 41.8 84 28.6 34.1 14.9 255 03:35 8.3 5.22 15.0 43.5 83 28.8 34.5 14.9 254 renal & glucose glucose urean creat na k cl hco3 angap 05:40 116*1 21* 1.5* 137 3.9 100 26 15 06:05 105*1 21* 1.4* 137 3.9 99 27 15 06:00 106*1 25* 1.4* 137 4.5 100 27 15 05:35 104*1 24* 1.4* 136 4.2 102 26 12 22:00 115*1 26* 1.5* 135 4.3 102 25 12 02:18 126*1 31* 1.5* 135 4.5 101 26 13 14:35 128*1 31* 1.6* 138 4.8 104 26 13 08:42 120*1 29* 1.4* 139 4.4 103 30 10 03:35 106*1 29* 1.4* 141 4.2 103 27 15 enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 06:00 45* 86* 57 0.5 14:35 5660*1 08:42 123* 715* 7927*1 64 0.4 03:35 551 cpk isoenzymes ck-mb mb indx ctropnt 10:24 43* 15.79*1 14:35 215* 3.8 greater th2 08:42 332* 4.2 22.02*3 03:35 <0.014 chemistry totprot albumin globuln calcium phos mg uricacd iron cholest 05:40 8.7 3.6 2.2 06:05 2.9 2.0 06:00 8.4 2.3* 2.0 05:35 8.4 2.1* 2.1 22:00 8.5 2.1* 2.0 02:18 8.9 2.8 2.3 14:35 8.8 3.0 2.1 242* 08:42 9.1 3.5 2.1 14:35 242* 1101 40 6.1 180* pituitary tsh 06:00 4.7* tte () moderate to severe regional left ventricular systolic dysfunction, c/w cad. mild aortic regurgitation. moderate pulmonary hypertension. no lv thrombus seen with echo contrast. lvef of 30% cardiac cath () - lmca: no significant disease - lad: to just beyond origin - lcx: large om; diffuse 60% - rca: no significant stenosis brief hospital course: 83 year old male with history of hypertension presenting with anterior stemi complicated by paraxsymal afib. active issues: # anterior stemi: pt found to have st elevations anterio-laterally on arrival to the ed. he underwent cardiac catheterization revealing proximal lad thrombus requiring thrombectomy and des to proximal lad. tte showed lvef of 30%. he was started on aspirin, plavix, atorvastatin 80 mg po qdaily and iv heparin post-catheterization. treated with beta blocker. ace-inhibitor initially was deferred secondary to sbp<90. as blood pressure improved, was weaned up to metoprolol tartrate 25mg po tid and linsinopril 5mg po daily. iv heparin dc'd on once inr was theraputic to 2.2 on coumadin 2.5mg po daily. he will follow up with outpatient lab work to check inr, chem-7 and cbc on . he was discharged on asa, plavix, statin, metopolol succinate 75mg, lisinopril for his cad. # atrial fibrillation: during hospitalization, pt was noticed to flip in and out of afib with rvt to 130-150 and nsr with rates 60-75. he responded well to iv metoprolol and was started on amiodarone. pt remained in and out of afib through day of discharge. he will be discharged home on amiodarone. 200mg with close follow-up with dr. the week following discharge. # acute sytolic chf: tte showed lvef of 30%. clinically hypervolemic. pt resonded well to lasix 20-40mg iv daily with adequate diuresis. pt with 1/4 crackles bilaterally on d/c. pt discharged with lasix 20mg x 7 days. # htn: managed on metoprolol tartrate 25 mg po tid and linsinopril 5 mg po daily with blood pressures remaining in the 110-120s/50-70s. he was switched to metoprolol succinate 75 mg po daily upon discharge. inactive issues: # elevated tsh: pt noted to have tsh of 4 during hospitalization. this should be followed up as an outpatient and rechecked. tfts were not sent given tsh is an acute reactant. . transitional issues: full code confirmed. pt lives with son who is proxy and a ct fellow. pt to follow-up in clinic at this week. medications on admission: atenolol 50mg daily discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily) as needed for cad: lad des. disp:*90 tablet, delayed release (e.c.)(s)* refills:*3* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily): do not stop taking or miss for at least one year. disp:*30 tablet(s)* refills:*11* 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet sublingual as directed as needed for chest pain: call 911 if you still have chest pain after taking 2 tablets. . disp:*25 tablets* refills:*0* 5. amiodarone 200 mg tablet sig: one (1) tablet po twice a day. disp:*30 tablet(s)* refills:*0* 6. warfarin 2.5 mg tablet sig: one (1) tablet po once daily at 4 pm. 7. lasix 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 8. metoprolol succinate 50 mg tablet extended release 24 hr sig: 1.5 tablet extended release 24 hrs po once a day. disp:*45 tablet extended release 24 hr(s)* refills:*2* 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnosis 1. anterior stemi 2. atrial fibrillation with rapid ventricular response 3. acute systolic congestive heart failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital after having a heart attack. a thrombectomy of the clot in the blood vessel supplying your heart was performed and a stent was placed to reperfuse that blood vessel. you tolerated the procedure well without any complications. ultrasound of your heart showed decreased pump function and you were started on blood thinner to prevent clot formation in your heart. you were also started on several medications to protect your heart and help regain its function. following medication changes were made to your medical regimen: 1. start aspirin 325 mg by mouth daily 2. start atorvastatin 80 mg by mouth daily 3. start lisinopril 5 mg by mouth daily 4. start metoprolol succinate 75 mg by mouth daily 5. start plavix 75 mg by mouth daily 6. start coumadin 2.5 mg by mouth daily 7. start nitroglycerin as needed for chest pain. sit down and take up to 2 tablets 5 minutes apart. please call dr. if you have any chest pain. call 911 if you still have chest pain after taking two nitroglycerin tablets. 8. start amiodarone 200 mg twice daily 9. lasix 20mg daily for 7 days . do not stop taking your medications for any reason without speaking to your cadiologist . please weigh yourself daily in the morning before breakfast and call dr. if weight increases more than 3 pounds in 1 day or 5 pounds in 3 days. followup instructions: name: , s. address: , , phone: when: , , 4pm please go to the coumadin clinic down the before your appt to check your inr. we have communicated your medical history to them so they will take over your coumadin management on department: cardiac services when: wednesday at 1:20 pm with: , md building: sc clinical ctr campus: east best parking: garage md, procedure: coronary arteriography using two catheters left heart cardiac catheterization 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 congestive heart failure, unspecified unspecified essential hypertension acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation acute systolic heart failure 

Answer: The patient is high likely exposed to