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: anterior stemi major surgical or invasive procedure: cardiac catheterization with cypher stent placement to lad history of present illness: patient is a 51 yo male with history of atrial fibrillation, etoh abuse & prior lad stent placement who presented to with an anterior stemi is now s/p lad stent placement to restenosis. patient presented to osh c/o sharp, nonradiating, sudden onset sscp graded as . patient stated that symptoms occurred at rest and were accompanied by dyspnea, diaphoresis and nausea but no vomiting, syncope, palpitations or fatigue. as per patient, his symptoms lasted 2 hours before he called paramedics. he was transferred via ambulance to noshoba where ekg was performed demonstrating anterior stemi. his laboratory results showed elevated cardiac enzymes and lfts. cbc, coags , amylase & lipase were all wnl. patient had mild hyponatremia and hypocholemia but remainder of chem 7 was also wnl. mr. received plavix 600mg, nitro drip, morphine 2mg iv * 3 doses and ativan 1 mg iv before transfer to for cardiac catheterization. as per patient's cardiologist report, mr. has not been taking his prescribed medications and is s/p 5 day etoh binge. he was cardioverted 2 months ago but reverted to afib within one week. patient has been in afib since he was a teenager. past medical history: 1)atrial fibrillation 2)cad, s/p cardiac catheterization w/ coronary angioplasty to lad 3)angina 4)etoh abuse 5)tobacco (2-3ppd * >35yr) 6)h/o chest pain with negative ett (>10 years ago) 7)documented h/o cocaine use 8)undocumented h/o "back problems" social history: etoh use: 6pack/week, dui hx, aa tobacco use: (2-3ppd * >35yr) denies ivda works in landscaping/painting lives alone has a girlfriend family history: father: mi at 40 y.o, died of cva at 75 yo mother died of ca at age 80 y.o. sister alive and in good health physical exam: vitals t:97.3 bp:129/85 hr:114 rr: spo2:93% on 2l nc tele: afib w/ pvcs and frequent nsvt gen: wnwd, some apathy and anxiety noted heent: perrla, eomi, 2mm pupils, anicteric sclera, no scleral injection neck: soft, supple, no carotid bruits, no jvd, jvp @ 9cm cvs: regular irregular rhythm, s1&s2 heard, no rubs appreciated lungs: ctabl, no wheezes, rales or rhonchi abd: soft, nt, obese, no bruits heard, +bs*4 gu: foley catheter, patent & draining clean, clear urine, no hematuria ext: warm, well-perfused, 2+ distal pulses (tp & dp), no iliac bruits heard, incision site c/d/i. pertinent results: 11:00pm glucose-132* urea n-12 creat-0.8 sodium-129* potassium-4.8 chloride-92* total co2-25 anion gap-17 11:00pm alt(sgpt)-72* ast(sgot)-382* alk phos-53 tot bili-1.0 11:00pm magnesium-1.9 11:00pm wbc-17.3* rbc-4.17* hgb-14.2 hct-38.2* mcv-92 mch-34.1* mchc-37.2* rdw-13.5 11:00pm plt count-300 11:00pm ptt-32.8 06:15am blood wbc-8.5 rbc-3.82* hgb-12.6* hct-36.5* mcv-95 mch-33.0* mchc-34.6 rdw-13.4 plt ct-303 06:15am blood glucose-95 urean-11 creat-0.9 na-139 k-4.0 cl-103 hco3-29 angap-11 04:40am blood ck(cpk)-145 05:01am blood alt-45* ast-140* ck(cpk)-405* alkphos-44 totbili-0.8 12:08am blood ck(cpk)-543* 03:55pm blood ck(cpk)-918* 04:20am blood ck(cpk)-1860* 05:01am blood ck-mb-20* mb indx-4.9 12:08am blood ck-mb-31* mb indx-5.7 ctropnt-3.32* 03:55pm blood ck-mb-76* mb indx-8.3* ctropnt-4.11* 04:20am blood ck-mb-234* mb indx-12.6* ctropnt-5.08* 04:20am blood triglyc-140 hdl-53 chol/hd-2.1 ldlcalc-32 . ccath comments: 1- selective angiography of this right dominant system revelaed three vessel coronary artery disease. the lmca has 30-40% stenosis. the lad was diffusely diseased. the mid lad stents were 80% stenosed (late stent thrombosis) and there was evidence of progression of atherosclerosis in the unstented segments proximal and distal to the stents. the lcx had mild disease and the om1 had 70-80% stenosis. the rca had 70% tubular stenosis proximally. 2- legt ventriculography was deferred. 3- limited hemodynamic measurements demonstrated normal aortic proeesure and moderately elevated left-sided pressure with lvedp 24 mmhg. 4- angioplasty comments final diagnosis: 1. three vessel coronary artery disease. 2. left ventriculography was deferred. 3. acute anterior myocardial infarction, managed by acute ptca. 4. moderately elevated left sided pressure (lvedp 24 mmhg) . ccath : comments: 1) resting hemodynamics revealed mildly elevated right sided filling pressures and a severely elevated pulmonary capillary wedge pressure. the cardiac output was low. the systemic arterial blood pressure was borderline low. 2) initial coronary angiography revealed a distal 40% left main stenosis, a widely patent lad stent with timi 2 fast flow, the diagonal had normal flow but an 80% ostial stenosis, the cx had mild disease but the om1 had a 70% stenosis, and the rca had a 70% proximal stenosis. 3) successful placement of a 40cc iabp in the descending aorta via a 7f left femoral artery sheath and placed on 1 to 1 augmentation. final diagnosis: 1. three vessel coronary artery disease. 2. mildly elevated right sided filling pressures. 3. severely elevated pulmonary capillary wedge pressure. 4. low cardiac output. 5. intraaortic balloon pump placement at 1 to 1 augmentation. 6. restart heparin drip while iabp in place, routine acs and chf care per ccu team. . echo : conclusions: the left atrium is moderately dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. a left ventricular mass/thrombus cannot be excluded. overall left ventricular systolic function is severely depressed (ejection fraction 20-30 percent) secondary to severe hypokinesis of the anterior free wall, akinesis of the anterior septum, dyskinesis of the inferior septum (with aneurysm formation), and extensive apical akinesis (with focal dyskinesis). there is no ventricular septal defect. right ventricular chamber size is normal. there is focal hypokinesis of the apical free wall of the right ventricle. a right ventricular mass cannot be excluded. the aortic root is moderately dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. significant pulmonic regurgitation is seen. there is no pericardial effusion. impression: extensive anteroseptal and apical infarction brief hospital course: this is a 51 year old male with history of atrial fibrillation, etoh abuse & prior lad stent placement who experienced an anterior stemi to restenosis of lad. his hospital course is detailed below. 1) cad: the patient to an osh with elevated cardiac enzymes and was subsequently transferred to the ccath lab at . cardiac cath showed mild disease in lmca, moderate to severe disease in lcx, diffuse disease in rca and lad stent restenosis & thrombosis with diffuse disease with progression of disease proximal to the stent. the lad was restented with two cypher stents. the l diag was treated with balloon angioplasty. overnight it was notd that his st segments remained elevated in anterior leads. the next morning on , mr. c/o sob after getting oob. he denied chest pain, n/v or diaphoresis. however, ekg showed worsening of st segment elevation. cardiac enzymes trended up to ck 1860 ck-mb 234 & mb index 12.6. the patient was rushed emergently to cath lab where the recently stented vessels were deemed patent but cardiogenic shock was diagnosed with ci of 1.7. an iabp was placed and patient was transferred back to ccu. in the ccu the patient course improved and eventually the iabp was discontinued on . he remained stable throughout the rest of his hospitalization. an echo showed ef 20-30% with akensis of the anterior septum, dyskinesis of inf septum, and extensive apical akinesis. therefore, due to his apical akinesis and his h/o afib, he was restarted on coumadin with a heparin bridge. he was also started on digoxin for both rate control and its ionotropic effect. he was continued on asa and plavix and should continue these indefinitely due to his history of restenosis of his prior bare metal stent. we discharged him on asa, plavix, atorvastatin, lisinopril, metoprolol, digoxin and provided smoking cessation counselling. . 3) afib: this patient had a documented h/o afib and is currently followed by cardiologist, dr. . we continued the patient on coumadin & amiodarone. we also added metoprolol for rate control. he was moniotred on telemetry throughout his hospitalization. . 4) etoh abuse & tobacco use: the patient was put on a ciwa scale with ativan prn for dt prevention. he was also supplemented with folate and thiamine. he was provided with a nicotine patch and an etoh addiction consult & tobacco cessation consult. . medications on admission: toprolol zetia lipitor coumadin amiodarone 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. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. hexavitamin tablet sig: one (1) cap po daily (daily). 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. nicotine 14 mg/24 hr patch 24hr sig: one (1) patch 24hr transdermal daily (daily). disp:*30 patch 24hr(s)* refills:*2* 8. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. metoprolol succinate 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 10. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. warfarin 5 mg tablet sig: 1.5 tablets po hs (at bedtime). disp:*45 tablet(s)* refills:*2* 12. folic acid 1 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: 1) anterior stemi 2) cardiogenic shock discharge condition: stable discharge instructions: 1) please keep your follow-up appointments with your pcp and your cardiologist. it is important that you continue to monitor your health with your providers. 2) smoking and drinking are bad for your health and are particularly dangerous with your heart condition. absolutely, under no conditions should you smoke or drink. please talk to your pcp if you need help quitting. there are programs and medications that can assist you. breath, fever, chills, nausea, or vomiting. 4) do not engage in sexual activity until you are able to tolerate climbing two flights of stairs without experiencing any chest pain. followup instructions: you will bed called by dr. office to schedule a follow-up appointment in weeks. please call with any questions. please call your pcp, . , at to schedule a follow-up appointment in weeks. you will need to have your inr level checked on monday at your usual outpatient lab. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter implant of pulsation balloon angiocardiography of right heart structures 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 congestive heart failure, unspecified acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation cardiogenic shock 

Answer: The patient is high likely exposed to