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: cp/stemi major surgical or invasive procedure: cath and stent placement history of present illness: this is a 60 yom with no significant pmhx who was transferred from for stemi. patient states episode began this morning while taking a shower. it started with a cough that would not abate. this was associated with nausea and diaphoresis. he then began to have +sscp which he describes as a burning pain and thought it was his usual hearburn. the pain, nausea, diaphoresis continued and he was taken to the ed. he denied any sob, palpitations or radiating pain. he had one episode of bilious emesis and . ecg was done and showed anterior st elevations. he was given plavix 600mg po x 1, asa 325mg po x 1, heparin iv gtt, zofran 8mg iv x 1, lopressor 5mg iv x 1, ntg gtt, morphine 2mg iv x 1. aggrastat iv gtt was started on the . he was transferred to for further management. . patient is now s/p cardiac cath. currently, he denies any chest pain, sob, palps, n/v, or diaphoresis. he does report back pain which is chronic and is exacerbated today while lying flat. he does report recenct doe while he was raking leaves 2 weeks ago. otherwise he denies any doe at work or climbing stairs. of note, he has been taking amoxicillin for 10 days for sinusitis, and also for a tooth extraction which was done this past friday. he reports some subjective fevers and chills last week but none for the past few days. . on review of systems, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, hemoptysis, black stools or red stools. he denies exertional buttock or calf pain. all of the other review of systems were negative. past medical history: s/p cholecystectomy social history: -tobacco history: smoked 1 pack per month for two years in high school -etoh: occasional -illicit drugs: none family history: father died of mi at 58. mother with stroke physical exam: ccu admission 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 8 cm. 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. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: 2+ radial, femoral and dp . pertinent results: 04:45am blood wbc-8.1 rbc-4.58* hgb-13.6* hct-39.1* mcv-85 mch-29.8 mchc-34.8 rdw-13.7 plt ct-353 12:44pm blood wbc-8.2 rbc-4.47* hgb-13.4* hct-37.9* mcv-85 mch-30.0 mchc-35.4* rdw-13.6 plt ct-348 04:45am blood glucose-111* urean-17 creat-0.8 na-137 k-4.0 cl-105 hco3-25 angap-11 12:44pm blood glucose-112* urean-14 creat-0.7 na-136 k-4.4 cl-106 hco3-23 angap-11 04:45am blood ck(cpk)-982* 08:10pm blood ck(cpk)-1868* 12:44pm blood alt-62* ast-244* ck(cpk)-3357* alkphos-128* totbili-0.3 04:45am blood ck-mb-90* mb indx-9.2* ctropnt-2.85* 08:10pm blood ck-mb-207* mb indx-11.1* ctropnt-5.38* 12:44pm blood ck-mb-greater th ctropnt-15.22* 12:44pm blood calcium-8.7 phos-3.6 mg-2.2 cholest-201* 12:44pm blood triglyc-65 hdl-44 chol/hd-4.6 ldlcalc-144* cath comments: 1. selective coronary angiography of this right dominant system demonstrated 3 vessel coronary artery disease. the lmca had no angiographically apparent disease. the lad had a 50% proximal, 100% mid after the origin of a 2nd large diagonal branch. the distal lad was very small with diffuse disease. the lcx had a 80% proximal stenosis prior to a large omb. the rca had a 50-60% mid stenosis. 2. limited resting hemodynamics revealed a left ventricular enddiastolic pressure of 35 mmhg. the mean systemic arterial pressure was 110 mmhg (phasic 143/95 mmhg). 3. successful manual aspiration thrombectomy, ptca and placement of a 2.5x23mm cypher stent were performed in the mid-lad. the stent was post-dilated using a 2.75mm diameter balloon. final angiography showed normal flow, no appparent dissection, and no residual in-stent stenosis. (see ptca comments.) 4. intravascular ultrasound of the mid-lad following the pci showed a minimum cross-sectional area of 4.5 mm2 in the lad just proximal to the placed stent. 5. the right common femoral arteriotomy was successfully closed using a perclose device. final diagnosis: 1. three vessel coronary artery disease. 2. severe diastolic dysfunction of the left ventricle. 3. stage i systemic arterial hypertension. 4. placement of a drug-eluting stent in the mid-lad was performed. echo the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with focal hypokinesis of the distal septum, and distal left ventricular segments/apex. tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). the remaining left ventricular segments contract normally. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. mitral valve leaflets are normal with trivial regurgitation. the estimated pulmonary artery systolic pressure is normal. there is an anterior space which most likely represents a fat pad. impression: suboptimal image quality. regional left ventricular systolic dysfunction consistent with mid to distal lad disease. brief hospital course: 60 yo male with no significant pmhx who was transferred from for stemi. 1. stemi: on cath he was noted to have three vessel coronary artery disease, with an acute thrombus within the lad. he underwent thrombectomy and to the mid-lad. he was also noted at that time to have 80% stenosis in his lcx. this lesion was not intervened upon, however should be evaluated at a future date with a stress test to determine if it is hemodynamically significant. the patient was maintained on asa 325mg, plavix 75mg, metoprolol 12.5 mg , lisinopril 2.5mg and atorvastatin 80mg daily. repeat cardiac enzymes trended down during the ccu stay. on echo, there is mild regional left ventricular systolic dysfunction with focal hypokinesis of the distal septum, and distal left ventricular segments. as his ef was normal and there was no evidence of apical aneurysm, the decision was made not on coumadin. he was discharged on this medication regimen with strict instructions to continue to prevent recurrence of symptoms. 2. sinusitis: most likely not bacterial in origin as the patient remained afebrile during his stay. more likely to be allergic or viral in origin. the patient was treated with fluticasone nasal spray. medications on admission: amoxicillin 500mg tid . medications on transfer: ondansetron 8mg iv x 1 aspirin 81 x 4 metoprolol 5 x 2 ntg sl x 1 heparin 4000 at 655 am, gtt at 1000/hr tirofiban to go up in flight promethazine prior to flight clopidogrel 600 morphine 2mg discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily): take every day for one year. 2. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 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. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal (2 times a day). disp:*1 bottle* refills:*2* 6. plavix 75 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: st elevation myocardial infarction sinusitis discharge condition: stable vs, right groin without ecchymosis or hematoma. discharge instructions: you had a heart attack and a clot was found in your left coronary artery. this was cleared in the catheterization lab and a drug eluting stent was placed in that artery to keep it open. you will need to take a full dose (325mg) aspirin and clopodigrel (plavix) every day for at least one year and possibly longer. do not miss or stop taking plavix unless dr. tells you to. your artery and vain in your right groin had catheters to perform the procedure. you will need to watch your right groin carefully for signs of bleeding or bruising. if you notice that the area is more tender, has a growing lump underneath the skin or bruising that is growing, call dr. or dr. right away. no lifting more than 10 pounds for one week. no driving until friday. you may shower but no baths or pools for one week. you can remove the dressing on your right groin and replace it with a band-aid. you have been started on the following new medicines: 1. clopodigrel (plavix): to keep the stent open and prevent clots. 2. aspirin: to prevent blood clots 3. metoprolol: a beta blocker that decreases your heart rate and helps you heart to recover 4. lisinopril: an ace inhibitor that lowers your blood pressure and helps your heart to recover. 5. atorvastatin: a cholesterol lowering drug. . you will need to have a stress test/echo with dr. , please speak to him about this at your first appt. . please call dr. if you have any further chest pain, trouble breathing, sweating, nausea, vomiting, dizziness, abdominal pain or any other unusual symptoms. please get a blood pressure cuff and take your blood pressure once a day at different times of the day. keep a log of your blood pressures and show this at all your doctor's visits. followup instructions: cardiology: provider: , building, . at 2:45pm. phone: ( . primary care: dr. phone: date/time: at 3:00pm. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures 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 intravascular imaging of coronary vessels diagnoses: coronary atherosclerosis of native coronary artery acute myocardial infarction of other anterior wall, initial episode of care other chronic sinusitis long-term (current) use of aspirin 

Answer: The patient is high likely exposed to