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: patient recorded as having no known allergies to drugs attending: chief complaint: stemi now s/p stents in lcx (100% - culprit lesion) and om1 (70%) with temp wire in for pre-cath brady in ed and with post-cath hypotension on dopa drip. major surgical or invasive procedure: coronary catheterization with stenting of the lcx and om1. history of present illness: 61 yo male smoker h/o hypercholesterolemia p/w cp and found to have stemi at . pain was substernal, heavy and crushing, and different than any other pain he has had. works as mechanic -initially attributed pain to lifting, but not as it increased in intensity. developed diaphoresis, sob, lay on ground and lost consciousness. awoke and called ems - got ntg in ambulance without relief. ekg showed 4mm ste in iii, avf and st depressions in v1-v4. in the ed a temp wire was placed for brady in the 20's. pain to balloon time roughly 2.5 hours. after cath the pt was hypotensive and put on a dopa drip. currently being weaned. in unit after procedure, pain free and no groin or back pain. . post-cath the patient had n/v x 1 with ? dark emesis. no guaiac was done. hct decreased 41 -> 34 but was then stable at 33. past medical history: hyperlipidemia social history: married with three children (35, 32, 25) who live in area. works as mechanic (heavy lifting). weekend social etoh of a few drinks. smokes ppd x 20yrs. no illicits family history: no cad, mi, sudden death, dm physical exam: v: 95/51 (dopa at 3), 69, 16, 95% ra g: nad, lying flat, interactive h: eomi, perrl, neck supple, no lad, op clear, no jvd, no bruits c: rrr, no murmurs, physiologic split s2, good distal pulses l: clear bilaterally a: soft, nt, nd, nml bs e: r groin with sheath in place, no hematoma, no ecchymosis. distal pulses symm. feet wwp bilat n: aandox3, cn ii-xii intact, mae, sensation intact, no drift pertinent results: ekg: prior to cath: st elevations iii, avf. st depr v1-3, 5. after cath: nsr with no st/tw changes . hct-41.3 02:01pm hct-34.6* 05:26pm hct-33.3* 01:19am hct-32.6* 06:28am hct-32.8* plt ct-302 07:00am hct-38.8* . 06:10am blood glucose-98 urean-10 creat-0.9 na-143 k-4.4 cl-108 hco3-25 angap-14 . 09:50am blood ck(cpk)-199* 02:01pm blood ck(cpk)-330* 05:26pm blood alt-29 ast-61* ld(ldh)-203 ck(cpk)-609* alkphos-70 totbili-0.4 01:19am blood ck(cpk)-652* 06:28am blood ck(cpk)-632* 07:00am blood ck(cpk)-283* . 09:50am blood ck-mb-3 09:50am blood ctropnt-<0.01 02:01pm blood ck-mb-33* mb indx-10.0* 05:26pm blood ck-mb-49* mb indx-8.0* ctropnt-1.88* 01:19am blood ck-mb-38* mb indx-5.8 ctropnt-1.53* 06:28am blood ck-mb-30* mb indx-4.7 07:00am blood ck-mb-8 . coronary cath comments: 1. selective coornary angiography of this codominant system revealed single vessel coronary artery disease. te lmca had no angiographically apparent flow limiting lesions. the lad had mild diffuse disease. the lcx was a large vessel and was codominant. the lcx was totally occluded after the om2. the om1 was a large branch with an 80% proximal stenosis. the rca was a codominant vessel with no angiographically apparent flow limiting stenosis. 2. resting hemodyncamics revealed elevated right snd left sided pressures with a pa pressure of 50mmhgand a pcwp of 25mmhg. the cardiac output was 3.41l/min and the cardiac index was 1.91l/min/m2. 3. left ventriculography was deferred. 4. successful predilation using a 2.0 x 15 voyager balloon, stenting using a 2.5 x 28 cypher stent of the acutely occluded cx with lesion reduction from 100% to 0%. the final angiogram showed timi iii flow with no dissection and no embolisation. there was jailing of the om2 with <50% residual stenosis. 5. successful direct stenting of the proximal om1 stenosis using a 2.5 x 18 cypher stent with lesion reduction from 80% to 0%. the final angiogram showed timi iii flow with no dissection and no embolisation. ( see ptca comments) final diagnosis: 1. angiographic evidience of single vessel coronary artery disease. 2. elevated right and left sided pressures. 3. acute inferior myocardial infarction pci with drug-eluting stenting of the mid co-dominant lcx. 4 successful drug-eluting stenting of the om1 . echo conclusions: ef > 55% 1.the left atrium is mildly dilated. 2.left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). 3. right ventricular chamber size is normal. right ventricular systolic function is normal. 4.the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. no aortic regurgitation is seen. 5.the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. 6.there is borderline pulmonary artery systolic hypertension. 7.there is no pericardial effusion. brief hospital course: brief overview: 61 yo smoker with dyslipidemia presented with stemi stented x2 in lcx (culprit 100-0%) and om1 (70% - 0%) with a pacer wire placed in cath lab for bradycardia from chb that resolved after cath. hypotensive post-cath and put on dopamine for 12 hours then weaned with good pressure. also had a hct drop post cath, which then stabilized and increased. he remained symptom free and had no arrhythmias on telemetry. he was placed on bb, acei, plavix, aspirin, high-dose statin and discharged home in stable condition. ## cv: -cad: the patient had 3 risks (age, lipid, smoker) and was found to have 2vd on coronary catheterization. lcx was the culprit lesion and was stented open with a des. in addition, om1 was stented. in the ed the patient was bradycardic to 20bpm and a temporary pacer wire was placed in the cath lab. post-stenting, st changes resolved and the pt's bradycardia also resolved. ce's trended down. however, the patient remained hypotensive and he received a dopamine drip for 12 hours. thereafter his bp climbed and he was weaned off pressors and started on both metoprolol and captopril (followed by lisinopril prior to discharge). toprol was not used in this patient as he chews his pills prior to swallowing them. . -pump: the patient had a post-even echocardiogram that showed an ef of 55% that was suggestive of little decrease in stroke volume/co. . -rhythm: the patient was brady in ed with temp wire placed at the cath lab. had chb, but resolved with stenting. the patient continued to be mildly bradycardic after the mi initially, however there was no evidence of a bundle block or av slowing or continued chb. . ##anemia - drop in hct after procedure not uncommon - will tx for <30. would continue to monitor hct or qd. could be dilutional. no hematoma, only small amt oozing at groin site that cleared by the second day post-mi. ##smoking - the patient was encouraged to quit. initially there was no nicotine patch as he was recently stented. however, he was counselled to use assistive devices prn at home. he suggested that he would do everything he could to stop smoking. the pt was counselled on this topic foer at least 30 minutes. . ## dispo - the patient was discharged home after being cleared by pt with good follow-up. medications on admission: atorvastatin 10mg discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily): take every day as directed to prevent stent closure. disp:*30 tablet(s)* refills:*2* 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily): take daily to decrease cholesterol and prevent coronary artery narrowing. disp:*30 tablet(s)* refills:*0* 4. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for angina: take one tablet for chest pain and wait 5 minutes. if the pain does not resolve, repeat up to 2 times. disp:*30 tablet, sublingual(s)* refills:*0* 5. lisinopril 5 mg tablet sig: one (1) tablet po once a day: take daily for blood pressure control and heart protection. disp:*30 tablet(s)* refills:*0* 6. metoprolol tartrate 25 mg tablet sig: three (3) tablet po twice a day: take as prescribed for blood pressure control and to protect your heart. disp:*180 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: acute myocardial infarction hypercholesterolemia hypotension discharge condition: stable stable stable stable discharge instructions: you were admitted to the hospital because of a myocardial infarction, also called "mi," or "heart attack." you were taken to catheterization, which opened the artery in your heart that had clogged. you are now going home. you will need to follow up with your dr. , your primary care doctor/cardiologist within 1 week. please call him for an appointment . you will be taking some new medications because of your mi. because you had stents placed in your heart during the catheterization, you will need to take aspirin and plavix every day. be sure not to miss a day. if you have any medical problems including chest pain, groin pain, groin bleeding, cold leg, lightheadedness, feeling like you are going to pass out, or any other worrisome symptoms, please seek immediate medical attention. followup instructions: dr. in one week - pt to call for appointment. will need k and cr checked as he has recently been started on an acei. cardiac rehab to start in appx 6 weeks. (will need to be arranged through dr. md procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor insertion of temporary transvenous pacemaker system 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 two vessels diagnoses: other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery pure hypercholesterolemia tobacco use disorder acute myocardial infarction of other anterior wall, initial episode of care atrioventricular block, complete 

Answer: The patient is high likely exposed to