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: iodine; iodine containing / penicillins / shellfish attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catherization with bare metal stent to mid and distal right coronary artery. history of present illness: history of presenting illness: 72 yo woman with h/o cad s/p imi (lad had 50% stenosis after d1, lcx had 70% om2 stenosis, rca with proximal des) presents with chest pain 2 hours. per the patient, she was taking a shower when she noticed some chest tightness at 8:30am. she took some nitroglycerin and her chest pain seemed to resolve. 15 minutes later the pain returned and continued to progress. she described it as a severe pressure, substernal that radiated to both arms (l>r). she denied any sob, nausea, vomitting, diarrhea, fevers, chills, cough, diaphoresis. she decided to come to the ed for further evaluation. in the ed, she had the following vital signs: 98.2 80 85/62 12 98%nrb. her ekg revealed st elevations in the inferior leads and reciprocal depressions in the lateral leads. she was sent to the cath lab for revascularization. in the cath lab, she underwent angiography which showed no obstructive disease in the lmca, lad, lcx. it did show 99% stenosis of the distal rca secondary to a clot. they also noticed a mid rca lesion of approximately 90%. they aspirated the clot in the distal rca placed 2 bare metal stents in the distal and the mid-rca. her pain, st elevations, and hypotension all resolved promptly after this intervention. she was sent to the ccu for further management. in the ccu, the patient remained chest pain free. she denies any symptoms and claimed she felt much better. . on review of systems, she denies any prior history of joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. all of the other review of systems were negative. past medical history: past medical history: 1. cardiac risk factors: tobacco abuse (60 pack year) 2. cardiac history: -cabg: none -percutaneous coronary interventions: comments: cath report : 1. selective coronary angiography of this right dominant system revealed two vessel coronary artery disease. the lmca was patent. the lad had 50% stenosis after d1. the lcx had 70% om2 stenosis. the rca had proximal 40% and 100% stenoses distally at the crux. 2. resting hemodynamics demonstrated elevated right and left sided pressures (mean ra pressure was 15mmhg, mean pcwp 20mmhg). there was evidence of moderate pulmonary hypertension. the cardiac index was normal at 2.02 l/min/m2. 3. successful ptca/stenting of the distal rca with a 3.0x18mm cypher des posted to 3.5mm in the proximal portion with excellent results (see ptca comments). final diagnosis: 1. two vessel coronary artery disease. 2. elevated filling pressures. 3. successful stenting of the rca. -pacing/icd: 3. other past medical history: rheumatoid arthritis with moderate joint deformity requiring chronic prednisone and methotrexate therapy. spinal stenosis with radiculopathy. chronic back pain social history: -tobacco history: 1 ppd for 60 years -etoh: none -illicit drugs: none -used to work as a farmer, grew up in novascotia family history: no family history of early mi. mom - deceased, alzheimer's. father - deceased at 54 y.o. in a car accident, has 6 brothers and 1 sister, no fh of cad or dm. 1 brother died of gastric cancer. one brother has . physical exam: vs: t=98.2 bp=144/88 hr=94 rr=20 o2 sat=100% nrb general: overweight elderly woman in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. neck: supple with jvp wnl. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. groin without hematoma, ttp, or bruit. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: dp pulses 2+ bl, pertinent results: admission: 10:55am blood wbc-13.7* rbc-4.24 hgb-13.2 hct-40.0 mcv-94 mch-31.0 mchc-32.8 rdw-17.2* plt ct-355 10:55am blood pt-12.2 ptt-22.5 inr(pt)-1.0 10:55am blood neuts-58.8 lymphs-31.4 monos-6.0 eos-2.9 baso-0.9 10:55am blood glucose-124* urean-18 creat-0.7 na-140 k-3.7 cl-105 hco3-26 angap-13 10:55am blood ck(cpk)-44 08:19pm blood ck(cpk)-278* 05:27am blood ck(cpk)-250* 07:00am blood ck(cpk)-119 10:55am blood ctropnt-<0.01 08:19pm blood ck-mb-35* mb indx-12.6* ctropnt-0.38* 05:27am blood ck-mb-31* mb indx-12.4* ctropnt-0.36* 07:00am blood ck-mb-7 ctropnt-0.26* 07:00am blood calcium-8.7 phos-3.3# mg-2.0 11:02am blood k-3.5 discharge: 07:00am blood wbc-12.2* rbc-3.60* hgb-11.4* hct-33.9* mcv-94 mch-31.8 mchc-33.7 rdw-17.1* plt ct-252 07:00am blood plt ct-252 07:00am blood glucose-74 urean-18 creat-0.7 na-142 k-3.9 cl-106 hco3-30 angap-10 ekg : sinus rhythm with two to three millimeter st segment elevation in the inferior leads and one millimeter st segment elevation in leads v4-v6. st segment depression of one to two millimeters in leads v1-v2 and st segment depression of two millimeters in lead avl. this is consistent with a large area of nterolateral, inferior and posterior myocardial infarction. compared to the previous tracing of acute injury pattern in the inferior-posterior region is new. echo : the left atrium and right atrium are normal in cavity size. there is mild regional left ventricular systolic dysfunction with mild hypokinesis of the basal inferior and inferolateral segements. overall left ventricular systolic function is normal (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high cardiac output. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. there is an anterior space which most likely represents a promient fat pad. impression: mild focal lv systolic dysfunction consistent with inferior ischemia/infarction. no pathologic valvular abnormality seen. mild pulmonary artery systolic hypertension. compared with the prior study (images reviewed) of , mild inferior and inferolateral hypokinesis is seen on the current study. cardiac catheterization : 1. cardiac catheterization in this right dominant system revealed single vessel coronary artery disease. the lmca, lcx, and lad were without significant obstructive coronary artery disease. the rca had a 90% stenosis in the mid-portion, and a 99% stenosis with thrombus in the distal portion. 2. resting hemodynamics revealed normal blood pressure of 121/72 mmhg. 3. successful ptca, manual aspiration thrombectomy, and placement of a 4.0x12mm vision bare-metal stent in the mid rca and a 3.5x12mm vision bare metal stent in the distal rca were performed. final angiography showed normal flow, no apparent dissection, and a 5% residual stenosis in the mid rca. (see ptca comments.) final diagnosis: 1. one vessel coronary artery disease. 2. placement of bare metal stents in the mid and distal rca. brief hospital course: 72 yo woman with h/o cad (lad had 50% stenosis after d1, lcx had 70% om2 stenosis, rca with proximal des) presents with inferior stemi due to late stent thrombosis (4 years later), now s/p bms x 2 in mid and distal rca. . # stemi: patient with inferior stemi that was successfully treated with thrombectomy and pci with 2 bms placed one in the 99% occluded distal rca and another in the 90% occluded mid rca lesion. pt also with hypotension on presentation suggestive of cardiogenic shock, which has since resolved after pci in mid and distal rca. this may also have been secondary to nitroglycerin. pt was treated with integrillin for a total of 18 hours, started and continued on aspirin 325mg po daily, supplemental o2, plavix loaded and then 75mg po daily, and simvastatin increased from 20mg po daily to 80mg po daily. heart rate was kept near 60 and bp<140/90, by adding metoprolol 12.5mg po tid as pressures allow and uptitrated to 25mg po tid. the ccu team strongly encouraged smoking cessation (spent 15 minutes with pt who has been precontemplative, but now will consider quitting). tte showed normal systolic global function (ef 55%) but with inferior hypokinesis c/w imi. pt was continued on a low sodium diet and physical therapy was consulted. the pt had some episodes of mild ectopy with a few runs of nsvt. the patient remained cp free since the catheterization for the remainder of the admission. the patient was scheduled to see in cardiology on . . # rheumatoid arthritis: no active issuses. continued prednisone 5mg po daily. pt to continue weekly mtx tx at home. continued gabapentin for chronic pain. medications on admission: gabapentin 100 mg po tid prednisone 5 mg po daily metoprolol tartrate 25mg po bid folic acid 1 mg po daily simvastatin 20 mg po daily aspirin ec 81 mg po daily acetaminophen 325-650 mg po/ng q6h:prn pain hctz 25mg po daily calcium/vitamin d vitamin b12 discharge medications: 1. tylenol ex str arthritis pain 500 mg tablet sig: 1-2 tablets po three times a day as needed for pain: no substitutions. disp:*270 tablet(s)* refills:*2* 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch transdermal once a day for 6 weeks. disp:*30 patches* refills:*1* 5. nicotine 7 mg/24 hr patch 24 hr sig: one (1) patch transdermal once a day for 2 weeks. disp:*14 patches* refills:*0* 6. simvastatin 80 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 7. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take up to 3 tablets 5 minutes apart, call 911 if you still have chest pain after 3 tablets. . disp:*25 tablet, sublingual(s)* refills:*0* 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 9. cyanocobalamin 50 mcg tablet sig: one (1) tablet po once a day. 10. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 11. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 12. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 13. metoprolol succinate 50 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po once a day. disp:*45 tablet sustained release 24 hr(s)* refills:*2* 14. calcium oral 15. ranitidine hcl 150 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 16. outpatient lab work please check cbc on wednesday and call results to dr. at . diag 280.0 discharge disposition: home discharge diagnosis: st elevation myocardial infarction coronary artery disease . secondary: rheumatoid arthritis gastric ulcer discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had a heart attack because the stent in your right coronary artery was partially clotted and because of a new blockage in the same artery. the artery was fixed and 2 new bare metal stents have been placed. you will need to take aspirin and plavix every day for at least one month and probably longer to keep the stents open. do not stop taking aspirin and plavix unless dr. tells you not to. you will see your new cardilogist and should go to cardiac rehab when dr. tells you it is ok. please stop smoking to prevent another heart attack and to make your new medicines more effective. this is the single most important thing you can do for your health. medication changes: 1. start taking aspirin (increase to 325 mg) and plavix every day to keep the stent from clotting off 2. increase the simvastatin to 80 mg daily 3. change the short acting metoprolol to long acting (succinate) and take 1.5 tables daily 4. stop taking hydrochlorothiazide 5. do not take motrin or aleve for your arthritis pain, take the high dose tylenol instead. 6. start using a nicotine patch to help you quit smoking. you will take 14mg every day for 6 weeks, then the dose is decreased to 7mg for an additional 2 weeks. 7. take nitroglycerin for chest pain as described in the handout. if you take this medicine, make sure to call dr. . 8. stop taking prilosec (the purple pill) as this can interfere with the plavix. you can take ranitidine instead twice daily. please talk to dr. about this. . your blood count went down after the procedure. we would like you to check the blood count again on wednesday . you can go to the hospital at . followup instructions: primary care: , p. phone: date/time: office will call you with an appt. . cardiology: dr. phone: date/time: wednesday at 11:30am. . gastroenterology: : phone: ( date/time: please keep any scheduled appts. . rheumatology: provider: , md phone: date/time: 10:30 procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization 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 tobacco use disorder long-term (current) use of steroids other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure cardiogenic shock acute myocardial infarction of other inferior wall, initial episode of care other complications due to other cardiac device, implant, and graft rheumatoid arthritis gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction spinal stenosis, unspecified region 

Answer: The patient is high likely exposed to