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: penicillins attending: chief complaint: chest pain major surgical or invasive procedure: cardiac cath with cypher stent placement a. fib electrocardioversion with 300j x 2 history of present illness: pt is a 64 yof with pmh of htn, hyperchol, asthma and gerd who p/w sscp x 2 hours at work. took asa 325 mg and went to pcp's office where inferior st elevations. given 1 sl ntg which relieved pain totally. no n/v/palp/diaphoresis. normotensive 120-140 went to started on nitro gtt, plavix 150mg lopressor 5mg iv x1, integrillin gtt, hep gtt. pt denied doe, orthopnea, edema, syncope. . in cath lab @ received 2 (prox and mid rca, ci 4.0). . post cath on the floor pt went into rapid af 120s-170s with sbp 20s-100s. also noting intermittent chest pain when rate was high. denied sob. denied visual sxs, lightheadedness. received lopressor 11mg, received adenosine 6mg x1. pt transferred to ccu for further mgmt. . on transfer pt continued to complain of some chest pain. anesthesia was called and pt was shocked x2 with brief sinus rhythm, however she went back to rapid a. fib. after few beats. past medical history: hyperchol, htn social history: tobacco quit 20 yrs ago, denies etoh, coccaine family history: nc physical exam: exam bp 118/61 hr 159 rr 20 o2sat 98%8l . gen: elderly female in mild distress heent: mmm, perrl, jvp flat chest: bilateral diffuse wheezing. cvr: rrr, nl s1, s2. abdomen: soft, obese, nt ext: no edema, groin site with sheath in place. pertinent results: 09:10pm glucose-114* urea n-16 creat-0.8 sodium-145 potassium-3.9 chloride-108 total co2-26 anion gap-15 09:10pm ck(cpk)-72 09:10pm ck-mb-notdone ctropnt-<0.01 09:10pm calcium-8.9 phosphate-3.0 magnesium-1.7 09:10pm wbc-10.7 rbc-4.02* hgb-12.5 hct-37.1 mcv-92 mch-31.0 mchc-33.6 rdw-13.9 . ecg. evening post cath afib with rvr to 160 sinus rhythm . cath. 1. selective coronary angiography of this right dominant system revealed one vessel coronary artery disease. the left main was without angiographically apparent coronary artery disease. the left anterior descending artery had no angiographic evidence of coronary artery disease in the proximal portion. there was a 40% stenosis in the mid-lad. the distal lad was without evidence of coronary artery disease. the left circumflex artery had no angiograpic evidence of cad in the proximal, mid and distal segments. the right coronary artery had a 70% proximal stenosis and a 90% mid-vessel stenosis. 2. right heart catheterization revealed elevated right sided filling pressures. 3. successful pci of the proximal and mid rca with two 3.0 x 13 mm cypher des, post-dilated with a 3.25 mm balloon. . echo conclusions: 1. the left atrium is mildly dilated. 2. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal (no obvious wall motion abnormality is seen.) 3. the aortic valve leaflets are severely thickened/deformed. there is mild aortic valve stenosis. no aortic regurgitation is seen. 4. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. cxr : right lung cleared and perihilar interstitial abnormality in the left lung, which could represent either persistent edema or interstitial pneumonia. brief hospital course: this is a 64 year old female with htn, hyperlip s/p imi and on cath stents to rca placed was noted to be in rapid afib on the floor post cath. . ## cardiovascular - # ischemia - pt with rca disease now s/p des, pt was started on integrillin for 18 hours however this was stopped after pt was noted to have some bleeding from the gums. she was started on asa/plavix/statin/bb. bb were held as they worsened pt's breathing. low dose bb and acei can be started by pcp after discharge if bp tolerates it. home on statin/plavix/asa/ntg sl. . # pump - on initial exam pt was hypotensive and was given fluid boluses to maintain map>60. echo shows ef 55%. patient sent home lasix 20mg po qd given 2+ lower extremity edema on exam and daily goal of 0.5-1l negative. . # rhythm - given a. fib with rvr and hypotension pt was transferred to ccu, pt received 2 shocks at 300j which were unsuccessful in maintaing sinus rhythm. later converted on own to sinus. the following day after albuterol neb, reverted to af with rvr but with stable bp. metoprolol without effect, dilt drip initiated and then pt spont converted to sinus again after 1 hour. she stayed in sinus rhythm for 24 hours. however on tele she was noted to have some episodes of a.fib/flutter, most of these were short and pt spontaneously converted back to sinus rhythm. she was started on warfarin for anticogulation. also started on amiodarone 400mg tid. goal 400 mg tid x 3 days, 400 mg x 7 days, 400 once a day x 2 wks, 200mg therafter. given on/off a. fib pt was also started on diltiazem xr for rate control. on day of discharge, inr 1.1 so warfarin increased to 7.5mg qhs with planned inr/pt check pcp to results. . ## bleeding gums - likely secondary to integrillin which was discontinued and pt had no further episodes of this. . ## asthma - fluticasone and atrovent nebs. would avoid albuterol to prevent further tachycardia. pt was also noted to have interstitial pattern on cxr and completed azithromycin x 5 days for likely interstitial pna. home on oxygen 2l nasal cannula. . ## htn - intially started on bb, however given worsening wheezing and asthma bb was discontinued and can be reconsidered as outpt. should also start acei as tolerated. medications on admission: asa, zestril, hctz, albuterol. discharge medications: 1. lasix 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 4. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 5. nystatin 100,000 unit/g cream sig: one (1) appl topical (2 times a day). disp:*1 tube* refills:*2* 6. warfarin 2.5 mg tablet sig: three (3) tablet po at bedtime. disp:*30 tablet(s)* refills:*0* 7. codeine-guaifenesin 10-100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. disp:*250 ml(s)* refills:*0* 8. diltiazem hcl 180 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). disp:*30 capsule, sustained release(s)* refills:*2* 9. aspirin 81 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* 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 12. amiodarone 200 mg tablet sig: as directed tablet po bid (2 times a day): take 400mg twice daily until then 400mg once daily until then 200mg once daily. . disp:*60 tablet(s)* refills:*2* 13. outpatient lab work please check pt/inr this wed and have results faxed to dr. at ( (fax); (phone). 14. home oxygen therapy home oxygen therapy with nassal cannula on 2 liters. discharge disposition: home with service facility: discharge diagnosis: inferior myocardial infarction atrial fibrillation. hypertension discharge condition: stable discharge instructions: please continue to take all your medications as directed and follow up with all your appointments. you were started on several new mediacations in the hospital and it is important that you take all medications as prescribed. you should not stop the aspirin and plavix until your cardiologist say so. . given your atrial fibrillation you were also started on a blood thinner coumadin. it is important that you follow up with all your appointments and have your blood checked frequently and have the coumadin dose adjusted appropriately. . if you experience severe chest pain that is not relieved with rest or nitroglycerin please contact your cardiologist or return to the emergency room immediately. followup instructions: please follow up with your pcp to have your inr checked 1-2 days after discharge. please follow-up with dr. (cardiology) by calling ( to set up an appointment in months. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor other electric countershock of heart angiocardiography of right heart structures insertion of drug-eluting coronary artery stent(s) transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia unspecified essential hypertension atrial fibrillation asthma, unspecified type, unspecified acute myocardial infarction of other inferior wall, initial episode of care 

Answer: The patient is high likely exposed to