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: penicillins attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with placement of 3 drug eluding stents to right coronary artery history of present illness: 66 year old female with history of htn, hyperlipidemia, bilateral hip osteoarthritis s/p right thr presents with chest pressure this morning, now admitted to the ccu for continued management following pci for inferolateral . patient was in her usual state of health two days ago when she experience the onset upper back pain and throat burning at rest, as though someone was "sitting on her chest". these symptoms were in intensity, lasted about 30 minutes, and resolved without intervention. there were no other associated symptoms. over the past two days, the patient reports feeling more sweaty than usual, which she attributed to the weather. this morning, she reports the sudden onset of similar symptoms while lying in bed- throat burning, upper back pain, and chest pressure, . the symptoms persisted, and she presented to . initial vital signs were 97.7 177/98 hr 78 rr 16 o2 sat 97%, ecg at showed st elevation in iii and avf with reciprocal changes. troponin i was noted to 0.56. creatinine 1.2, bun 39. patient received nitro sl, asa 325, clopidogrel 600 mg, atorvastatin 80 mg, morphine, metoprolol, heparin, and integrilin. blood pressure was 138/83 prior to transfer to for pci. in the cath lab at , initial vital signs were 123/72, hr 65. heparin was converted to bivalrudin, and integrilin was continued. diltiazem 500 mcg x 1 was given, along with ntg boluses. arterial access was gained through right radial artery. after wire was across rca lesion and balloon inflated, blood pressure dropped to 84/53, and hr was 53. 3 were placed, dopamine was started, and atropine was given. a right heart cath was then performed, and ra pressures were 8/9/6, pa pressures 36/13/21, pa sat 79%, pcwp 13, with ci 4.22. patient was then transferred to the ccu for continued management. upon arrival to the ccu, patient reported feeling tired. she denied and chest pressure, throat symptoms, or back pain. she had no other complaints. 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 for mild dyspnea on exertion over the past few months (climbing stairs). denies paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. she does note some unintential weight gain due to inactivity and diet (high cholesterol/fat) past medical history: hypertension hyperlipidemia right hip osteoarthritis s/p thr left hip osteoarthritis macular degeneration social history: -tobacco history: 30 pack year history, quit 20 years ago -etoh: denies -illicit drugs: denies patient lives alone in . she worked in the sheriff's office in . family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death. brother has cad s/p cabg. another brother died of a problem, not related to heart attacks per patient. physical exam: admission physical exam: vs: 80/43 -> 101/55, hr 88, rr 16, 92% on ra, 100% on 2 liters. general: pleasant female, no distress. 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 cm when supine. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. ii/vi late peaking systolic murmur best heard at lusb. 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 anteriorly. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. sheath in right femoral vein. 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 physical exam: vs: tm 98.2 tc 97.0 hr 77-82 rr 18 bp 105-141/56-77. general: pleasant female, aaox3. heent: mmm, op clear. neck: no appreciable jvd. cardiac: rr. normal s1, s2. ii/vi late peaking systolic murmur best heard at lusb. lungs: nonlabored. ctab abdomen: soft, ntnd. no hsm or tenderness extremities: no edema pertinent results: admission labs: 11:45am blood wbc-6.6 rbc-3.92* hgb-11.2* hct-34.1* mcv-87 mch-28.6 mchc-32.9 rdw-13.3 plt ct-217 11:45am blood neuts-71.2* lymphs-25.9 monos-2.0 eos-0.3 baso-0.6 11:45am blood pt-16.0* ptt-83.7* inr(pt)-1.5* 11:45am blood glucose-163* urean-34* creat-1.0 na-137 k-4.0 cl-107 hco3-18* angap-16 11:45am blood ck(cpk)-467* 11:45am blood calcium-7.9* phos-3.1 mg-1.9 cardiac enzymes: 11:45am blood ck-mb-46* mb indx-9.9* ctropnt-0.69* 09:27pm blood ck-mb-44* 04:01am blood ck-mb-21* ctropnt-0.95* lipids: 07:49am blood triglyc-137 hdl-70 chol/hd-2.2 ldlcalc-60 discharge labs: 07:23am blood wbc-7.1 rbc-3.59* hgb-10.2* hct-31.4* mcv-88 mch-28.5 mchc-32.6 rdw-13.4 plt ct-212 07:23am blood pt-10.5 ptt-28.2 inr(pt)-1.0 07:23am blood glucose-89 urean-28* creat-1.0 na-140 k-4.1 cl-107 hco3-23 angap-14 07:23am blood calcium-8.4 phos-3.6 mg-2.1 micro: none imaging: echo: left atrium: normal la size. right atrium/interatrial septum: normal ra size. normal interatrial septum. no asd by 2d or color doppler. left ventricle: mild symmetric lvh with normal cavity size and global systolic function (lvef>55%). suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. no resting lvot gradient. no vsd. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. aortic valve: mildly thickened aortic valve leaflets (3). no as. trace ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. no ms. trivial mr. tricuspid valve: mildly thickened tricuspid valve leaflets. no ts. physiologic tr. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: no ps. pericardium: no pericardial effusion. general comments: suboptimal image quality - poor apical views. conclusions the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. cardiac cath preliminary lad 30% mid lcx 80% ostial om1, 80% mid circumflex rca 90% mid, 70% distal, 70% distal hemodynamics: ra mean 6 pa 36/13 pcwp 10 aorta 112/48 hr around 90 bpm brief hospital course: principle reason for admission ms. is a 66 year old female with hypertension (htn), hyperlipidemia (hld), osteoarthritis who presented with chest pressure found to be due to inferolateral st elevation myocardial infarction (), with persistent hypotension after balloon inflation requiring dopamine. she was weaned off the dopamine during the first 24 hours post-cath and remained stable hemodynamically and chest pain free. active problems # - st elevation in iii greater than ii, with st depression in i, avl suggested that right coronary artery was the culprit lesion. the patient had 3 placed in the rca but still had lcx 80% ostial om1, 80% mid circumflex which was not treated given her hypotension (see below). in the cath lab, she was started on intregrillin which was continued for 12 hours and then discontinued. her post-intervention echo showed preserved lv ejection fraction (60%) and no focal wall motion abnormalities. -new medications: -aspirin 81mg qday -plavix 75mg po qday -atorvastatin 80mg po qday -f/u the patient continues to have stenosis of the lcx and need for intervention on this can be addressed at follow-up with dr. #blood pressure control: while in the cath lab, the patient had hypotension after inflating the balloon in rca. her right heart cath had normal pressures so a temporary vagal response was the most likely etiology of her hypotension. she was started on dopamine drip in the cath lab. pcwp was 10, so slight hypovolemia may have contributed- patient received a total of 1200 cc normal saline and was able to wean off dopamine drip within the first 24 hours. she had no evidence of infection to suggest sepsis as an etiology of hypotension. her blood pressure was stable on her home regimen: lisinopril 10 mg daily and metoprolol succinate 50 mg daily. # hyperlipidemia-changed rosuvastatin to atorvastatin 80 mg daily for better risk factor modification. admission ck was 253, ast/alt 36/20, lipid panel ldl 60, hdl 70, tg 137. # osteoarthritis- used acetaminophen for pain control; held celebrex due to possible interaction with coronary artery disease. # right knee cyst: she continued to have pain behind right knee and exam was consistent with cyst. ultrasound confirmed this. advised her to use tylenol for pain control. transitional issues: - will likely need intervention to left circumflex - monitor for side effects of medications including muscle aches from atorvastatin and bleeding - monitor symptoms of osteoarthritis and consider changing pain regimen as an outpatient medications on admission: celebrex 200 mg daily lisinopril 10 mg daily rosuvastatin 20 mg daily zyrtec 10 mg daily multivitamin daily ocuvite daily discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol succinate 50 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:*0* 5. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for allergy symptoms. 6. multivitamin tablet sig: one (1) tablet po daily (daily). 7. ocuvite oral 8. crestor 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis st elevation myocardial infarction . secondary diagonosis: hypertension hyperlipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , you were admitted to the hospital because you were having chest pain. your ekg and lab work showed that you had a heart attack, called myocardial infarction. you had 3 stents placed in the right artery of your heart to open this up and restore blood flow to your heart. you were started on new medications to help modify your risk for further heart disease. it is especially important for you to take aspirin and plavix daily for one year and possibly longer. do not stop taking aspirin and plavix or miss or the stent may clot off and cause another heart attack. you initially went to the icu but you remained stable after the stents were placed and now you are ready to be discharged. you should follow-up with your doctors below. it is important to bring all your medications to each appointment so your doctors update their records and adjust the as needed. the following changes were made to your medications: start taking the following meds: - aspirin 81 mg daily to keep the stent open and prevent another heart attack. - plavix (clopidogrel) 75 mg daily to keep the stent open and prevent another heart attack. - metoprolol succinate 50 mg daily to lower your heart rate - increase rosuvastatin (crestor) to 40 mg daily to lower your cholesterol . stop taking the following meds: -celebrex- this medication is not good to take right after having a heart attack. if you need to take something for pain we recommend you take tylenol instead (maximum of 4g in one day) it was a pleasure taking care of you in the hospital! followup instructions: dr. . name: pa when: tuesday at 1:45pm address: ,, , phone: department: cardiac services when: friday at 9:00 am with: , m.d. building: campus: east best parking: garage procedure: combined right and left heart cardiac catheterization injection or infusion of platelet inhibitor coronary arteriography using a single catheter insertion of drug-eluting coronary artery stent(s) excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery unspecified essential hypertension personal history of tobacco use other and unspecified hyperlipidemia acute myocardial infarction of inferolateral wall, initial episode of care osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh synovial cyst of popliteal space 

Answer: The patient is high likely exposed to