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 / ace inhibitors attending: chief complaint: rca dissection major surgical or invasive procedure: cardiac catheterization with placement of 4 bare metal stents intra-operative (catheterization) trans-esophageal echocardiogram history of present illness: 75 y/of with hypertension, hl and exertional angina who initially presented for elective cardiac catheterization c/b rca dissection, being transferred to the ccu for further management. . briefly, patient complained of exertional angina for several weeks. she described chest discomfort radiating to jaw while walking on treadmill or riding exercise bike vigorously. also experianced dyspnea and chest discomfort while walking up 1 flight of stairs. symptoms always resolved with rest. exercise stress test on was concerning for ischemia: after 8 minutes on protocol, peak hr of 116 (80% predicted for age), patient developed recurrent angina and ekg showing 0.5mm st depressions in infero-lateral leads. given positive stress test, patient was referred for elective coronary catheterization. . this morning, he underwent coronary catheterization which showed calcification in coronary arteries with diffuse disease in rca with proximal 90% stenosis and distal 60-80% stenosis. the catheterization was complicated by an rca dissection with retrograde extention to the right sinus of valsalva. she received four bare metal stent to the rca: 2 overlapping distal, 1 non-overlapping proximal, and 1 ostial integrity stents. following ostial stent depolyment, contrast was no longer seen flowing into the sinus. post-catheterization tee showed unchanged ai, functioning leaflets and no pericadial effusion. she was transfered to the ccu in stable condition. . on arrival to the ccu, she endorsed mild left sided chest and jaw pain that had significantly improved compared to what she had experienced in the cath lab. she endorsed comfortably breathing and denied other complaints. . on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable chest pain as per hpi; she denied paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: - diabetes, + dyslipidemia, + hypertension 2. cardiac history: - moderate ai, moderate mr 3. other past medical history: - left breast cancer s/p mastectomy in - gerd - hemorrhoids - pneumonia x2 (in 's) - hiatial hernia - s/p hysterectomy - osteopenia - s/p tonsillectomy - s/p adenoidectomy - s/p appendectomy social history: retired, lives with husband. very active lifestyle, going to gym daily - tobacco history: - etoh: drinks approx 4oz red wine daily - illicit drugs: denies family history: - no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. - mother: died at age 83 of chf - father: died in 80s of cva physical exam: admission exam: vs: t=98.4 bp=127/80 hr=93 rr=14 o2 sat=100% on 2l general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 8cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, systolic murmur loudest at apex. no thrills, lifts. lungs: left mastectomy scar noted. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ discharge exam: tc 98.0, tm 98.4, bp 128-146/49-68, hr 58-88, rr 16-18, sats 95-99% on ra general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 8cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, systolic murmur loudest at apex. no thrills, lifts. lungs: ctab abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. no femoral bruits. 2+ pulses in radial/dp pertinent results: admission labs (): hct-32.2* glucose-218* urean-17 creat-0.6 na-134 k-3.8 cl-99 hco3-23 angap-16 calcium-9.5 phos-3.7 mg-2.1 04:09pm blood ck(cpk)-69 06:00am blood ck(cpk)-98 04:09pm blood ck-mb-4 ctropnt-<0.01 06:00am blood ck-mb-5 ctropnt-less than . imaging: intra-operative tee (): conclusions no atrial septal defect is seen by 2d or color doppler. the left ventricle is not well seen but overall left ventricular systolic function is normal (lvef>55%). there are simple atheroma in the aortic arch. a mobile density is seen in the aortic sinus at the right coronary cusp consistent with an intimal flap/aortic dissection.the flap extends minimally above the sinus of valsalva.the aortic valve leaflets (3) are mildly thickened. mild to moderate (+) aortic regurgitation is seen. moderate (2+) mitral regurgitation is seen. there is no pericardial effusion. impression: dissection flap at the right coronary sinus, largely contained within the sinus of valsalva. preserved global lv systolic function with mild to moderate aortic regurgitation and moderate mitral regurgitation. . cta of chest (): findings: trace pericardial sluid is noted. there is multivessel coronary arterial calcification and mitral annular calcifications. density in the right coronary artery is compatible with known stent. the proximal rca appears low attenuation centrally, but assessment is limited by overlying stent and non-gated study. close to the origin of the rca, a minimal linear mural irregularity at the proximal aorta is seen (4,58), which likely represents a small focal dissection as noted at time of coronary angiogram. no distal propagation is seen. some calcification at the left anterolateral papillary muscles is noted (6,61). this is likely due to prior ischemia. the pulmonary arterial tree is opacified without evidence of pulmonary embolism. there is no mediastinal, hilar, or axillary lymphadenopathy by ct size criteria. with the exception of trace bibasilar dependent atelectases , the lungs are clear. central airways remain patent. limited subdiaphragmatic evaluation demonstrates hyperdense material within the gallbladder, compatible with vicarious excretion of contrast status post recent cardiac catheterization. a tiny hiatal hernia may be present. the left adrenal gland is mildly prominent, without focal nodularity. a small non-specific 7mm hypodensity is seen at the dome of the right hepatic lobe (4,68), too small to characterize. bone window: no focal concerning lesion. mild multilevel thoracic spondylosis is present. mild levoconvex thoracic curvature is noted. impression: 1. tiny linear irregularity at the aortic root adjacent to the rca origin compatible with known tiny dissection. no propagation seen. 2. apparent opacification of the rca proximally may be artifactual related to stent and non-gated study, but clinical correlation is advised. 3. coronary calcification and small area of calcification at the tip of anterolateral papillary muscle. . cardiac cath (): report not yet finalized . discharge labs: 08:35am blood wbc-7.2 rbc-3.77* hgb-11.8* hct-32.7* mcv-87 mch-31.2 mchc-36.0* rdw-12.6 plt ct-299 08:35am blood glucose-119* urean-17 creat-0.6 na-137 k-4.0 cl-102 hco3-24 angap-15 08:35am blood calcium-9.5 phos-3.6 mg-2.0 brief hospital course: assessment and plan mrs. is a 75 year-old woman with htn, hld and exertional angina s/p elective cardiac catheterization c/b rca dissection with placement of 4 bms in the rca. # coronaries: patient has known cad identified on cardiac cath now s/p rca dissection during cardiac catheterization and placement of 4 bms to rca. patient received integrillin during procedure. chest pain has significantly improved. discussed with patient importance of avoiding valsalva or manuvers that increase intra-thoracic pressure. cta report not finalized but per radiology wet read no significant dissection still noted post-proceedure although contrast timing sub-optimal for evaluation. before cta pt received premedication with benadryl, prednisone, and mucomyst/iv hydration. nitro gtt was weaned off and cardiac enzymes were stable. pt will be continued on asa indefinitely and will need to take plavix 75 mg daily for at least 1 month. plan will be for repeat cta 2-3 weeks after discharge to re-evaluate rca dissection. pt will follow-up with dr. in outpatient setting. # pump: patient has no know chf symptoms. lvef was not obtained durring tee performed in cath lab. patient has remained hemodynamically stable during hospitalization. # rhythm: patient was in sinus rhythm. she has no known dysrhythmia. was monitored on tele in the ccu and then on the floor but no signficiant arrhythmias noted. # htn: patient with hx of htn on only metoprolol as home bp med. day after cath pt was started on 25mg daily of losartan for better bp control and metoprolol increased from 50 mg po tid to 200 mg po daily. # hld: patient takes rosuvastatin 20mg daily at home and was on atorvastatin 80mg while admitted. she was discharged on her home regimen of rosuvastatin 20 mg po daily. #code: full (confirmed with patient) medications on admission: - ciprofloxacin 250 mg prn uti - hydrocortisone acetate - 25 mg suppository - 1 rectally up to tid prn irritation and pressure - metoprolol tartrate 50mg - omeprazole 20 mg capsule, delayed release(e.c.) daily - rosuvostatin 20 mg daily - vitamin c 500 mg daily - asa 81 mg daily - calcium carbonate- vitamin d3 500 mg (1,250 mg)-400 u tablet daily - geriatric mvi w/iron 1tab daily - magnesium 250mg 4 tabs daily discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. metoprolol succinate 200 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*2* 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 5. losartan 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. rosuvastatin 20 mg tablet sig: one (1) tablet po once a day. 7. vitamin c 500 mg tablet sig: one (1) tablet po once a day. 8. calcium carbonate-vitamin d3 500 mg(1,250mg) -400 unit tablet sig: one (1) tablet po once a day. 9. geriatric multivit w/iron-min tablet sig: one (1) tablet po once a day. 10. magnesium 250 mg tablet sig: four (4) tablet po once a day. 11. hydrocortisone acetate 25 mg suppository sig: one (1) rectal once a day as needed for irritation and pressure . discharge disposition: home discharge diagnosis: primary diagnosis: coronary artery disease coronary artery dissection secondary: hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital after a small tear in one of your coronary arteries occurred during your cardiac catheterization. to help stabilize the artery and to open up your coronaries which were found to have some narrowings, 4 bare metal stents were placed in your coronary arteries. your chest pain improved significantly the next day and a ct scan of your chest showed no worsening of the tear in your artery. you were started on plavix 75 mg daily and aspirin 325 mg daily. you must take the plavix every day for at least the next month and take the aspirin daily indefinitely in order to help keep your stents from clotting. it is very important that you take these medications every day otherwise you are at risk for clots forming in your stents. we also increased your metoprolol dose and started a new blood pressure medication called losartan to help keep your blood pressure in a good range. you will follow-up with dr. and will likely get a repeat ct scan or your heart in weeks. the following changes were made to your medications: - metoprolol dose increased to metoprolol xl 200 mg by mouth once daily - added losartan 25 mg by mouth once daily for blood pressure - added clopidogrel (plavix) 75mg by mouth daily for at least the next month - it is very important that you do not miss s of this medication. please talk with dr. about when it is ok to stop taking this medication. - increased aspirin dose from 81 mg daily to 325mg by mouth daily - continue your other home medications you should refrain from lifting weights greater than 20 pounds for 1 month after your hospital discharge. followup instructions: follow-up with dr. in weeks. please call her office to make sure that you have an appointment. the number to call is . you will likely have a repeat ct scan of your heart in weeks. you should refrain from lifting weights greater than 20 pounds for 1 month after your hospital discharge. procedure: insertion of non-drug-eluting coronary artery stent(s) injection or infusion of platelet inhibitor diagnostic ultrasound of heart right heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of four or more vascular stents diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia unspecified essential hypertension personal history of malignant neoplasm of breast personal history of tobacco use mitral valve insufficiency and aortic valve insufficiency other and unspecified angina pectoris cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified complications of procedures not elsewhere classified other nonspecific abnormal results of function study of cardiovascular system family history of other cardiovascular diseases dissection of coronary artery personal history of allergy to other specified medicinal agents 

Answer: The patient is high likely exposed to