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: sulfa (sulfonamide antibiotics) attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization, drug eluting stent to left circumflex coronary artery history of present illness: ms. is a 47 year old woman with past medical history significant for hyperlipidemia and smoking who complained of chest pain, severe nausea and diaphoresis about 5 minutes after running to friend's car on day of admission. chest pain was described as sudden onset, severe midsternal pressure, lasting hours. denied shortness of breath. she presented initially to , where she was found to have a posterior stemi and transferred to . at , she received apsirin, plavix, integrilin, heparin, nitroglycerin, morpine, and iv metoprolol with improvement in chest pain to . labs at were significant for negative troponin. st depressions were noted in v2-v4 and subtle st elevations in v6 and i. patient notes that chest pain started to get worse in ambulance in transportation to . patient was taken to cath lab at for posterior stemi. she notes that chest pain did not resolve until angioplasty was done in cath lab. cath showed normal left main and lad. left circumflex had occluded large bifurcating om to which ptca was done and des was placed. no residual occlusion post stent. dominant rca had 30% proximal lesion. there was concern for mitral regurgitation secondary to posterior mi, so an echo was done in the cath lab which did not show significant mitral regurgitation. . on review of systems, her chest pain has resolved, but she continues to have nausea. she denies shortness of breath. she denies any prior history of chest pain, dyspnea, stroke, tia, deep venous thrombosis, pulmonary embolism. she also denies orthopnea, palpitations, dyspnea on exertion. all of the other review of systems were negative. she does not take oral contraceptives. . past medical history: past medical history: 1. cardiac risk factors: dyslipidemia, smoking, family history 2. other past medical history: anxiety past surgical history: tubal ligation c-sections laparoscopies/laparotomies for endometriosis lmp: 2wks ago allergies: sulfa drugs - hx of anaphylaxis social history: lives with husband and 11 year old son. also has 19 year old daughter in college. both patient and husband with significant smoking hx and are current smokers. -tobacco history: smoking history x32 years, initially 2ppd, now about cigs/day -etoh: occasional -illicit drugs: denies family history: family history positive for cad in mother who passed at age 78, brother had mi at age 46, sister with mi at age 53. physical exam: admission examination: vs: t= 98.4 bp= 105/83 hr= 98 rr= 17 o2 sat= 98% on ra general: wdwn in nad, mildly anxious. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. mucus membranes mildly dry. neck: supple with jvp of 8 cm. cardiac: regular rhythm, rate 100, normal s1, s2. no murmurs/rubs/gallops appreciated. 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, but exam somewhat limited due to supine positioning. abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. right sided bandage soaked with blood. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ left: carotid 2+ dp 2+ pertinent results: 04:52am blood wbc-7.8 rbc-3.96* hgb-11.3* hct-34.9* mcv-88 mch-28.5 mchc-32.4 rdw-14.0 plt ct-220 06:05am blood wbc-6.0 rbc-3.51* hgb-10.4* hct-30.3* mcv-86 mch-29.5 mchc-34.1 rdw-13.6 plt ct-196 04:52am blood glucose-134* urean-14 creat-0.5 na-137 k-4.1 cl-104 hco3-21* angap-16 06:05am blood glucose-91 urean-13 creat-0.5 na-142 k-3.7 cl-112* hco3-21* angap-13 11:21pm blood ck(cpk)-3032* 04:52am blood ck(cpk)-2705* 04:34pm blood ck(cpk)-1605* 05:34am blood ck(cpk)-795* 11:21pm blood ck-mb-389* mb indx-12.8* ctropnt-10.6* 04:52am blood ck-mb-333* mb indx-12.3* ctropnt-6.29* 04:34pm blood ck-mb-125* mb indx-7.8* 05:34am blood ck-mb-36* mb indx-4.5 ctropnt-3.19* 04:52am blood calcium-8.5 mg-2.0 cholest-171 04:52am blood %hba1c-5.7 eag-117 04:52am blood triglyc-95 hdl-47 chol/hd-3.6 ldlcalc-105 08:39pm blood type-art rates-/20 o2 flow-2 po2-47* pco2-38 ph-7.37 caltco2-23 base xs--2 intubat-not intuba 08:39pm blood hgb-12.3 calchct-37 o2 sat-79 portable tte (focused views) done at 9:00:00 pm final the left atrium is normal in size. left ventricular chamber size is small. regional wall motion could not be adequately assessed due to suboptimal views. there may be basal to mid inferolateral hypokinesis but these segments are not well visualized. overall left ventricular systolic function is grossly preserved (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are not fully visualzed but appear structurally normal with good leaflet excursion. the mitral valve leaflets appear mildly thickened with trivial mitral regurgitation. there is trivial pericardial effusion. impression: mild regional left ventricular systolic dysfunction with preserved ejection fraction. no evidence of significant mitral regurgitation. portable tte (complete) done at 11:59:44 am final the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with basal to mid inferolateral hypokinesis/akinesis. overall left ventricular systolic function is normal (lvef>55%). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. cardiology report ecg study date of 9:15:52 pm sinus tachycardia. otherwise, findings are within normal limits. no previous tracing available for comparison. intervals axes rate pr qrs qt/qtc p qrs t 102 146 72 346/419 74 82 72 compared with the prior study (images reviewed) of , there is no definite change although image quality is suboptimal for comparison. cardiology report ecg study date of 6:04:14 am sinus rhythm. compared to tracing #1 there is no significant diagnostic change. intervals axes rate pr qrs qt/qtc p qrs t 85 146 72 376/419 73 81 75 cardiology report cardiac cath study date of final diagnosis: 1. single vessel coronary artery disease. 2. acute posterior st elevation mi. 3. left ventricular diastolic dysfunction. 4. successful placement of des in lcx. 5. successful angioseal of r groin. femoral vascular us right study date of 9:22 pm -- preliminary report -- no evidence of pseudoaneurysm or arteriovenous fistula. no soft tissue hematoma at the site of puncture in the right groin. brief hospital course: 47 year old woman with past medical history significant for hyperlipidemia, smoking, who presented with stemi, transferred from an outside hospital for pci with drug-eluting stent to left circumflex. # posterior stemi patient was found to have posterior stemi at outside hospital, transferred to for cardiac catheterization. her troponin was negative at the outside hospital. coronary angiography demonstrated a right dominant system with single vessel coronary artery disease and patent lmca and lad. she was found to have 30% stenosis of the rca and 100% stenosis of the mid left circumflex artery at the origin of a large bifurcating om1. she underwent successful ptca with a des placed in the lcx. her cardiac enzymes were checked on arrival to the ccu, peaking at ck-mb of 389 and troponin-t of 10.6. she was treated with 18 hours of eftifibatide. the patient had no further chest pain or shortness of breath after arrival to the ccu but did experience chest soreness for the next 24 hours. echo showed mild regional lv systolic dysfunction with basal to mid inferolateral hypokinesis/akinesis with normal rv wall motion and chamber size. she was started on aspirin, plavix, low dose metoprolol and continued on simvastatin. the day after the procedure, there was question of right femoral bruit, but the patient had no pain or hematoma in the right groin. the preliminary read on the right groin ultrasound was negative for fistula or aneurysm. the final read of this ultrasound will be followed up by the ccu team. the patient will followup with dr. as an outpatient in 2 weeks. she would benefit from starting on a low dose ace inhibitor as an outpatient if her blood pressure tolerates it. # anemia on the third day of hospitalization, the patient was noted to have a hematocrit drop from 37 to 30.9, which was likely dilutional. there was no hematoma noted in her right groin, at the site of the procedure. she did have some mid lower back pain briefly after lying supine for many hours after the procedure, but this pain resolved; she did not have any lower back pain localized to one side, and there were no other signs of retroperitoneal bleeding. she should get a repeat hematocrit drawn on at her primary care doctor's office to ensure that it is stable. she should seek medical attention if she begins to experience worsening lower back pain or becomes lightheaded or dizzy. # hypotension the patient was noted to have persistent hypotension with systolic blood pressures in the 90s. while sleeping, her systolic blood pressures did drop as low as the 70s. she was given over 3l of fluids intravenously and encouraged to take more po intake. her blood pressures remained in the 90s systolic upon discharge, but she was able to walk up and down the hallways without symptoms of lightheadedness or dizziness. she states that her blood pressures are normally about 120s/80s. she will follow up with her primary care physician next week. # tobacco abuse both patient and her husband have significant smoking history and are current smokers. she was counseled significantly on smoking cessation. the cardiology social worker also spoke with the patient about smoking cessation. # anxiety patient was noted to be somewhat anxious during this hospitalization, particularly with a new diagnosis of heart disease and being told she has had a large heart attack. she has a history of anxiety and was continued on her home dose of lorazepam as needed. nicotine withdrawal may have also been contributing to her anxiety, though she stated she had no urge to smoke and did not wish to use a nicotine patch. # hyperlipidemia patient has been taking simvastatin at home. she was continued on simvastatin 80mg daily during this hospitalization and should continue on it indefinitely. # code status: patient was full code during this hospitalization. medications on admission: simvastatin 80mg daily lorazepam 1mg - takes 1 tab prn daily and 2tabs qhs 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 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: place under , repeat every 5 minutes x 3. if no improvement in pain, call doctor or go to er. . disp:*100 tablet, sublingual(s)* refills:*0* 4. simvastatin 80 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 6. lorazepam 1 mg tablet sig: 1-2 tablets po hs (at bedtime) as needed for anxiety/insomnia. discharge disposition: home discharge diagnosis: primary: acute posterior st elevation myocardial infarction secondary: tobacco abuse, hyperlipidemia, hypotension discharge condition: stable, sbp 90s, a+ox3, ambulating without pain, lightheadedness, vital signs stable with exertion discharge instructions: dear mrs. , you were admitted to the hospital because you had a large heart attack in the back side of your heart. you were taken for a cardiac catheterization procedure, during which you had a stent placed in one of the arteries bringing blood to your heart. in order to keep this stent open you will be on several new medications and stop smoking. these interventions are critical as reobstructing your stent would be very dangerous. you were monitored closely in the cardiac intensive care unit for complications after your heart attack and you did very well. you did have low blood pressure but since you did not have any symptoms, it is safe for you to return home. you will need to watch carefully for lightheadedness, dizziness, back or groin pain and any other concerning symptoms. if any of these occur, please call dr or return to the hospital immediately. please review the attached list of medications and take everything as prescribed. you will need for follow up with your primary doctor to have your blood pressure and blood counts checked. you will also need to see dr (cardiology) in 2 weeks as written below. you can return to work in 1 week but be sure not to do any lifting. after you see dr , you can discuss gradually increasing your activity and exercise. it was a pleasure taking care of you, we wish you the best! followup instructions: please be sure to keep all of your followup appointments. appointment #1 md: dr specialty: primary care date/ time: at 8:15am location: phone number: special instructions for patient: this appt was already scheduled prior to your inpt stay. please keep this appt to discuss your inpt stay. appointment #2 md: dr specialty: cardiology date/ time: at 11am location: , bldg, phone number: 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) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery tobacco use disorder other and unspecified hyperlipidemia hypotension, unspecified 

Answer: The patient is high likely exposed to