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: chest pain, diaphoresis major surgical or invasive procedure: cardiac catheterization with thrombectomy and 3.0x23 mm cypher to proximal lad history of present illness: 56yof pmh of htn, dmii, dyslipidemia, presented to afternoon with a chief complaint of sudden onset substernal chest pain on extertion. on arrival, to the osh, an ekg was performed which deomonstrated st depressions in ii, iii, avf and st elevations v1-v4. she was given asa, nitrogliceryn, integrelin and heparin and transferred to for catheterization. . in the cath lab, the patient was shown to have a thrombotic subtotal occlusion of the lad at the septal-1 branch. thrombectomy was performed and a 3.0x23mm cypher was placed in the proximal lad with good flow documented post procedure. given 40mg iv lasix for pcwp>30. the patient had been nauseated but this seemed to increase post cath, with several episodes of emesis. the patient was given 300mg of plavix as concern that pt vomited up plavix load from prior to cath. while initially clear, the emesis was noted to become blood tinged after several bouts in cath lab. . on arrival to ccu post-cath, vitals were bp 111/93, hr 86 and a temp of 95.6. the patient was nauseated w/hemoptemesis x2. she was oriented x3. an ngt was placed and gastric lavage with 1 l of saline showed blood, which cleared to pink/blood tinged by last aliquot. past medical history: hypertension dyslipidemia cerebral anuresym s/p clipping? deaf in right ear. cva - ~, embolic?, was on coumadin for "7 years" gastritis - pt reports "acid pill" in past, denies egd social history: patient lives at home with husband, semi-retired, worked at . occassional etoh use, +tobacco 1 pack per day for 20 years. family history: mother had dm, father had ca, aunt died of mi. physical exam: vs: t98, bp 98/60, hr 90, rr 16, 98%6l gen: wdwn middle aged femaile nad, resp or otherwise. oriented x3 but was intermittently confused. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no s4, no s3. chest: mild crackles bil, resp were unlabored, no accessory muscle use. no crackles, wheeze, rhonchi. abd: obese, soft, ntnd, no hsm or tenderness. no abdominial bruits. ext: no c/c/e. r groin site with oozing, no sig hematoma. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp pertinent results: admission labs: 03:02am wbc-16.1* rbc-3.78* hgb-12.2 hct-35.1* mcv-93 mch-32.3* mchc-34.8 rdw-12.9 pt-14.8* ptt-94.4* inr(pt)-1.3* ck(cpk)-706* calcium-8.9 03:02am glucose-241* creat-1.0 sodium-140 potassium-3.1* chloride-103 total co2-26 anion gap-14 03:02am blood wbc-16.1* rbc-3.78* hgb-12.2 hct-35.1* mcv-93 mch-32.3* mchc-34.8 rdw-12.9 plt ct-84* 03:02am blood neuts-85.2* lymphs-12.3* monos-1.5* eos-0.8 baso-0.2 03:02am blood pt-14.8* ptt-94.4* inr(pt)-1.3* 03:02am blood plt smr-low plt ct-84* 03:02am blood glucose-241* creat-1.0 na-140 k-3.1* cl-103 hco3-26 angap-14 03:02am blood alt-24 ast-77* ld(ldh)-221 ck(cpk)-706* alkphos-83 totbili-0.3 06:50am blood ck-mb-362* mb indx-9.9* ctropnt-6.09* 03:02am blood calcium-8.9 phos-4.8* mg-1.6 06:50am blood cholest-202* 06:50am blood triglyc-113 hdl-49 chol/hd-4.1 ldlcalc-130* ldlmeas-131* . . pertinent labs/studies: wbc: 16.1 () -> 13.2 -> 12.0 -> 10.5 -> 9.0 -> 9.1 -> 8.9 () hct: 35.1 () -> 35.6 -> 31.4 -> 28.9 -> 30.5 -> 28.7 -> 28.5 () glucose: 241 () -> 119 () ck: 706 () -> 3654 -> 3306 -> 1510 () ck-mb: 362 () -> 278 -> 46 () tni: 6.09 -> 8.57 -> 4.50 alt 24, ast 77, ldh 221, ap 83, tbili 0.3 hba1c: 6.4% cholesterol 202, triglycerides 113, hdl 49, ldl 130 tsh 0.66 ekg: nsr, rate 87, nl axis, nl intervals, p waves enlarged, poor r wave progression precordial leads, st-elevations anterior. . cardiac cath : r dominant, single vessel coronary artery disease. lmca no apparent flow-limiting dz. lad had thrombotic subtotal occlusion near the septal-1 branch, timi ii flow in lad. small d1 had 80% ostial stenosis. lcx and rca had minimal luminal irregularities. mildly elevated r-sided filling pressure with rvedp 15 mmhg and elevated left sided filling pressure pcwp 35 mmhg. mild pulmonary arterial hypertension with a pa pressure of 44/32 mmhg. central aortic pressure was 131/89 mmhg. the cardiac index was low at 1.8 l/min/m2. 3. successful manual thrombectomy and placement of a 3.0x23mm cypher drug-eluting stent were performed in the proximal lad. final angiography showed timi iii flow, no apparent dissection, and no residual stenosis. (see ptca comments) 1. single vessel coronary artery disease. 2. severe left ventricular diastolic dysfunction. 3. mild pulmonary arterial hypertension. 4. mild right ventricular diastolic dysfunction. 5. reduced cardiac index. 6. placement of a drug-eluting stent in the proximal lad. . echo: mild symmetric left ventricular hypertrophy with moderate to severe regional left ventricular systolic dysfunction consistent with proximal lad coronary disease. depressed cardiac index. moderate diastolic dysfunction. preserved right ventricular systolic function. mild pulmonary hypertension. . . discharge labs: cbc: wbc 8.9, hgb 10.2, hct 28.7, plt 202 gluc 119, na 141, k 4.0, cl 107, hco3 25, bun 20, cr 0.9 ck 1510 ck-mb 46, tni 4.5 brief hospital course: patient is a 56 year old female with a history of hypertension, dyslipidemia, cerebral aneurysm clip presented with stemi, had placed in transferred to ccu with course complicated by post-procedure bloody vomitus with need for plavix reload, was tachycardic into the 100's overnight. . # cad/ischemia: patient presented to the hospital with substernal chest pain on exertion. patient was found to have st depressions in ii, iii, avf and st elevations v1-v4. patient was sent to the cath lab, where she had placed in the lad territory. after the procedure, the patient remained persistently tachycardic. she was given multiple doses of metoprolol iv and was started on toprol xl 50 mg, to which her pulse decreased. patient was started on atorvastatin 80 mg daily, asa 325 mg daily, captopril 6.25 mg tid, and plavix 75 mg daily. she was discharged on 2.5 mg lisinopril daily. patient did not have any acute events relating to her cad while she was in the hospital, and she will follow up with dr. on . please consider checking homocysteine level as an outpatient. . # hematemesis: patient reported nausea at time of chest pain. upon admission to ccu, patient denied chest pain but had three episodes of bloody vomitus (quantity <40cc each episode). ng lavage showed red blood on drawback. integrilin was held, but the patient continued to receive her plavix. gi was consulted, and the patient did not have any further episodes of hematemesis. the patient's hct dropped to 28.1 and remained at that level for the remainder of her hospital stay. . # type 2 diabetes: patient's glucose was 247 on admission, though this was in the setting of acute stress. patient had a hga1c checked on this admission, which was 6.4%. patient was placed on a sliding scale insulin while in the hospital. patient was advised to follow up with dr. regarding this issue. . # smoking cessation: patient was counseled on smoking cessation during this hospital stay. she was given nicotine lozenges, but the patient stated that she was interested in waiting until her current cardiac issue had resolved before attempting to quit smoking. patient was advised to follow-up on this issue with her pcp. . #. code: full . medications on admission: hctz 25 mg propranolol 120 mg omeprazole 20 mg reconciled with rite-aid in 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). disp:*30 tablet(s)* refills:*1* 3. simvastatin 80 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* 4. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*1* 5. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. discharge disposition: home discharge diagnosis: primary: stemi gi bleed secondary: tobacco abuse discharge condition: stable, on room air, ambulating without difficulty systolic bp in 90's, hr in 70's discharge instructions: you should return to the emergency department if you experience chest pain, shortness of breath, lightheadedness, palpitations, uncontrolled vomiting, black stools, or bright red blood per rectum. . while you were in the hospital, we made the following changes to your medications: 1. we started you on plavix. please do not stop taking this medication until instructed to do so by your cardiologist. stopping plavix may lead to serious adverse effects. 2. we started you on toprol xl 50 mg daily 3. we started you on lisinopril 2.5 mg daily 4. we started you on simvastatin daily 5. we started you on aspirin 325 mg daily . it is very important to your cardiac health that you stop smoking. you should abstain from cigarettes and follow-up with your primary care physician regarding smoking cessation strategies. . please return to the ed or your healthcare provider if you experience any chest pain, shortness of breath, fatigue, chills, fevers, or any other concerning symptoms. followup instructions: dr. (primary care) at 12:30 pm. . dr. (cardiologist) at 4 pm. . tests for consideration post-discharge: homocysteine level phone: . you can call the smokers?????? quitline at 1-800-try-to-stop (1- to obtain a free nicotine patch kit from the tobacco control program. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor insertion of other (naso-)gastric tube 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: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension acute myocardial infarction of other anterior wall, initial episode of care other chronic pulmonary heart diseases other and unspecified hyperlipidemia hematemesis other and unspecified coagulation defects diastolic heart failure, unspecified unspecified gastritis and gastroduodenitis, without mention of hemorrhage other abnormal glucose other agents affecting blood constituents causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to