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: 1. cardiac catheterization on with 2 to left anterior descending artery 2. cardiac catheterization on with to left circumflex artery history of present illness: a 66yom with htn who presented with increasing intermittent chest pain. patient described pain, chest tightness, associated with nausea, diaphoresis and shortness of breath, no radiation to the left arm/jaw or back that started on at ~3pm while working on some wood furniture. his pain was not relieved with rest and lasted for about 9 hours resolving around midnight on . his pain recurred on the afternoon of admission while patient was accompanying his wife to his wife's cardiologist appointment with dr. . given that his pain started again, ecg was done which showed nsr at 80bpm, nl. axis, q- waves in v2-v4, ii, iii and avf, and 3- elevations in v3-v6. he was sent immediatly to where he was started on a heparin gtt, nitro gtt and aggrastat gtt. he also received asa 81mgx4, plavix 300mg, and lopressor 5 mg iv. he was transferred to for urgent cath. on review of systems, pt. denied lower extremity edema, paroxysmal nocturnal dyspnea, and reports dyspnea on exertion when climbing about two flight of stairs. past medical history: hypertension left hernia groin repair gerd colonoscopy 2 years ago, internal hemorroids. left knee arthroscopy social history: social: lives with his wife and a cat. tobacco, 40 pack years, quit 7-8 years ago using nicorette gum after episodes of nocturnal dyspnea. occasional etoh. family history: brother recently underwent heart surgery; mother died of emphysema ~ 80; father died of heart problems at age ~70. physical exam: t: 95.8 bp 121/71 hr 66, rr 22 sats 98% on 2 l general: patient in no apparent distress heent: jvd ~ 9 cm, no lad lungs: clear to auscultation anteriorly cv: regular heart rhythm, s1-s2 normal, s3? soft holosystolic murmur at apex abdomen: soft, non tender, non distended. bowel sounds + extremities: no le edema, distal pulses strong bilaterally, right groin slight oozing, no hematoma, no bruit. neuro: alert and oriented x 3, cn ii-xii intact; motor, sensory, coordination, and language grossly normal. pertinent results: 10:40pm blood hct-36.5* plt ct-345 07:10am blood wbc-10.9 rbc-4.23* hgb-13.5* hct-37.0* mcv-88 mch-31.8 mchc-36.4* rdw-13.2 plt ct-281 10:40pm blood pt-13.1 ptt-43.6* inr(pt)-1.2 07:10am blood pt-12.6 ptt-37.0* inr(pt)-1.1 10:40pm blood glucose-144* urean-20 creat-0.7 na-137 k-4.9 cl-106 hco3-20* angap-16 07:10am blood glucose-107* urean-18 creat-0.9 na-140 k-4.1 cl-102 hco3-27 angap-15 10:40pm blood ck(cpk)-4005* 03:31am blood ck(cpk)-5033* 10:30am blood ck(cpk)-4195* 05:36am blood ck(cpk)-1348* 10:40pm blood ck-mb-greater th ctropnt-11.56* 03:31am blood ck-mb-greater th ctropnt-11.59* 10:30am blood ck-mb-403* mb indx-9.6* 10:40pm blood calcium-8.6 phos-2.7 mg-1.5* 07:10am blood calcium-9.0 phos-2.9 mg-2.1 03:31am blood triglyc-56 hdl-60 chol/hd-3.2 ldlcalc-118 . cardiac cath : 1. coronary angiography revealed a right dominant system. the lmca showed no angiographically apparent flow-limiting stenosis. the lad demonstrated a discrete 70% proximal stenosis immediately followed by a hazy 100% midsegment occlusion, with no collateral flow evident to the distal lad. the lcx demonstrated diffuse 50% proximal and midsegment stenoses with a 805 distal segment stenosis. the rca demonstrated a 100% proximal segment occlusion with minimal distal right to right collaterals. 2. cinematographic imaging of catheter injection into the left ventricle allowed approximation of left ventricular function, demonstrating anteroapical akinesis and inferior hypokinesis, with preserved anterobasal lv wall motion. ejection fraction is estimated to be 25-30%. 3. hemodynamic studies demonstrated significantly elevated right atrial pressures of 20 mmhg with moderately elevated pulmonary arterial pressures of 55 mmhg. pulmonary capillary wedge pressure was severely elevated at 30 mmhg, which is suggestive of severe left ventricular diastolic dysfunction and volume overload. cardiac index is severely depressed at 1.6 l/min/m2 (normal 2.5 or greater, with corresponding cardiac output of 2.9 l/min). there was no evidence of pressure gradients suggestive of mitral or aortic stenosis. 4. successful stenting of the lad with a 2.75 mm and a 3.0 mm taxus drug-eluting stent. final diagnosis: 1. three vessel coronary artery disease. 2. severe systolic and diastolic ventricular dysfunction. 3. moderate primary pulmonary hypertension. 4. acute anterior wall myocardial infarction. 5. successful stenting of the lad. . echo : the left ventricular cavity size is normal. there is moderate to severe regional left ventricular systolic dysfunction. resting regional wall motion abnormalities include mid to distal anteroseptal, anterior, and anteroalteral akinesis, apical akinesis, and basal inferior akinesis (thinned inferior wall). right ventricular chamber size is normal. there is focal hypokinesis of the apical free wall of the right ventricle. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . cardiac cath : 1. selective coronary angiography of the right dominant circulation was performed. the lmca was patent, as were all the lad stents. the lcx had a midvessel 70% lesion followed by a more distal 70% lesion. the rca was totally occluded proximally and was supplied by left-to-right collaterals. 2. successful pci of the lcx with two overlapping cypher des (3.0 x 23 mm and 3.0 x 18 mm). 3. unsuccessful attempt at pci of the totally occluded rca. 4. successful closure of the left femoral arteriotomy site with a perclose proglide device. final diagnosis: 1. two vessel coronary artery disease. 2. successful pci of the lcx. 3. unsuccessful attempt at pci of the rca. brief hospital course: a 66yom with h/o transferred from osh with evidence of acute anterolateral stemi. patient underwent cardiac cath on admission with successful 2 to lad. patient was transferred to ccu for further monitoring. he was kept on tirofiban for 18 hours, along with aspirin, plavix and statin. his enzymes peaked on with ck 5033 and mb>500, and then slowly trended down. an echo showed an ef 20-25%. the pt. was monitored on telemetry throughout the hospitalization. he remained in normal sinus rhythm, a reperfusion rhythm was noted during the first 24 hours post-cath, and later only occasional pvcs were recorded. . pt. was diuresed 1-2 l after admission, and was discharged on spironolactone. a beta-blocker and ace-inhibitor were slowly titrated up as his blood pressure tolerated. he was taken for a second cath on in order to fix the lcx lesion. he had successful pci of the lcx with two overlapping cypher des. unsuccessful attempt at pci of the totally occluded rca. patient did well after the procedure with no complications. . following cath and , heparin was started given risk of thrombus formation as bridge to warfarin. patient will have a follow-up echo in 3 months and the possibility of having an icd placed will be explored at that time if echo reports low ef and persistent wall motion abnormalities. . the pt. was provided a cardiac healty diet while in the hospital. electrolytes were monitored and repleted. pt. will have chem7 and pt/inr checked on tuesday, at dr. office. medications on admission: lisinopril protonix 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:*90 tablet(s)* refills:*2* 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. outpatient lab work please have chem 7 and pt/inr checked on tuesday, . send results to dr. office. 6. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain. disp:*30 tablet, sublingual(s)* refills:*2* 7. warfarin 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: st elevation anterior mi discharge condition: good, stable. discharge instructions: please continue to take your medications exactly as prescribed. . please continue to have your inr level checked regularly, and your coumadin dose will be adjusted as needed. . please follow up your appointments as scheduled. please make an appointment to see dr. (cardiology) within 1 month. . if you experience shortness of breath, chest pain, palpitations or any other symptoms that may concern you please call your cardiologist immediately or come to the emergency department. followup instructions: provider: phone: date/time: 10:00 . provider: , m.d. phone: date/time: 2:45 . provider: , follow-up appointment should be in 2 weeks. procedure: coronary arteriography using two catheters 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 congestive heart failure, unspecified unspecified essential hypertension acute myocardial infarction of anterolateral wall, initial episode of care 

Answer: The patient is high likely exposed to