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: ace inhibitors attending: chief complaint: stemi major surgical or invasive procedure: cardiac catheterization, 2 cardiac catherterization history of present illness: history of presenting illness: mr. is a 63 year-old physician with hypertension who presented to the ed today for chest pain. he is relatively active at baseline and runs on the treadmill three times weekly without difficulty. about 2 weeks ago, he had an episode of mild exertional chest pain while running in the cold which resolved with rest. there was no recurrence. however, this morning at 5:30am he developed midsternal chest pain initially increasing to radiating down both arms (not to neck or back), and accompanied by nausea. he initially attributed this to gerd and took antacids without improvement. his wife then called ems. ems gave him asa 325mg and nitro sl x 3 with decrease in pain to . he remained hemodynamically stable. . on ed arrival, vs were 98 155/89 61 18 99%3l. ekg reviewed stemi anterolateral st elevations with reciprocal changes inferiorly. code stemi was called. he was loaded with plavix and started on a heparin gtt. he was then taken emergently to the cath lab, reportedly pain-free. he was found to have a long, 80% mid-lad lesion as well as a 70% hazy om1. timi 3 flow in all vessels and patient pain-free but the significant anterior st elevations persisted on ecg so des were placed to both his mid-lad and om1. patient started on integrillin. post-procedure ekg shows improved but persistent anterolateral st elevations. he is transferred to the ccu for monitoring. nitro gtt is being weaned. . 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, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for minimal sensation of chest pressure, about . no dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: - diabetes, - dyslipidemia, + hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: 3. other past medical history: gerd hypothyroidism bph elevated psa with negative prostate bx in right proximal fifth metatarsal fracture in social history: -tobacco history: quit smoking 40 years ago (~10 pack-year history) -etoh: ~1 bottle wine/month -illicit drugs: none family history: his father died at age (cause unknown). his mother has cad s/p 3-vessel cabg at age 75, died of colon cancer. no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: on ccu admission: vs: t=98 bp=112/67 hr=69 rr=11 o2 sat=98% 2l nc general: wdwn caucasian male in 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 no jvd. 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, obese, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominal bruits. extremities: no c/c/e. no femoral bruits. r femoral site with small hematoma, minimally ttp, no bruit skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ dp 1+ pt 1+ left: carotid 2+ femoral 2+ dp 1+ pt 1+ pertinent results: admission: 08:40am blood wbc-8.8 rbc-4.74 hgb-14.3 hct-40.9 mcv-86 mch-30.0 mchc-34.8 rdw-14.1 plt ct-257 08:40am blood neuts-54.9 lymphs-35.1 monos-6.2 eos-3.1 baso-0.7 08:40am blood pt-14.6* ptt-150* inr(pt)-1.3* 08:40am blood glucose-134* urean-31* creat-1.2 na-139 k-3.8 cl-103 hco3-29 angap-11 08:40am blood calcium-9.0 phos-2.6* mg-2.1 01:24pm blood %hba1c-5.6 eag-114 enzymes: 08:40am blood ck(cpk)-150 04:32pm blood ck(cpk)-790* 09:59pm blood ck(cpk)-697* 04:59am blood ck(cpk)-538* 05:52am blood ck(cpk)-675* 08:40am blood ck-mb-6 08:40am blood ctropnt-<0.01 04:32pm blood ck-mb-84* mb indx-10.6* ctropnt-1.89* 09:59pm blood ck-mb-71* mb indx-10.2* ctropnt-1.65* 04:59am blood ck-mb-48* mb indx-8.9* 05:52am blood ck-mb-49* mb indx-7.3* ctropnt-1.62* discharge: 05:52am blood wbc-13.4* rbc-4.60 hgb-14.1 hct-38.8* mcv-84 mch-30.6 mchc-36.3* rdw-14.2 plt ct-216 05:52am blood pt-13.2 ptt-23.6 inr(pt)-1.1 05:52am blood glucose-105* urean-20 creat-1.1 na-136 k-4.3 cl-103 hco3-24 angap-13 05:52am blood calcium-9.2 phos-2.3* mg-2.2 . micro: mrsa screen (final ): no mrsa isolated. . imaging: pcxr: impression: normal cardiomediastinal silhouette. . tte: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with mild hypokinesis of the distal half of the anterior and distal septal and apex. the apex is not aneurysmal and the remaining segments contract well (lvef >50%). the estimated cardiac index is normal (>=2.5l/min/m2). no masses or thrombi are seen in the left ventricle. right ventricular chamber size is normal. with borderline normal free wall function. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. conclusions: normal left ventricular cavity size with regional systolic dysfunction c/w cad (mid-lad distribution). mild pulmonary hypertension. compared with the report of the prior study (images unavailable for review) of , there is now mild hypokinesis of the distal anterior, septal, and apical segments with lvef 50%. there is now mild pulmonary artery hypertension. . cardiac cath: : 1. selective coronary angiography in this right dominant system revealed two vessel disease. the lmca was normal. the lad had an 80% mid vessel stenosis. the lcx had a hazy 70% stenosis in the first obtuse marginal branch. the rca was without significant disease. 2. limited resting hemodynamics showed normal left sided filling pressures with central aortic pressure of 122/74 with a mean of 95 mmhg. 3. successful ptca and stenting of mid lad with 2.5x28mm promus drug eluting stent postdilated proximally to 2.75mm. 4. successful ptca and stenting of om1 with 3.0x23mm promus drug eluting stent postdilated with 3.0mm balloon. final diagnosis: 1. two vessel coronary artery disease. 2. anterior stemi 3. successful pci of lad with des. 4. successful pci of om1 with des. . : 1. limited selective coronary angiography of this right dominant system revealed no angiographically apparent obstructive coronary artery disease. the lmca had no angiographically apparent disease. the lad had a patent stent with a 30% mid-stent irregularity with a 60% lesion at the origin of the jailed diagonal with normal flow. the lcx had a patent om stent. the rca was no engaged. 2. limited hemodynamics showed normotension final diagnosis: 1. two vessel coronary artery disease. 2. patent stents in lad and om1. 3. normotension. brief hospital course: 63yo m with htn who p/w cp at rest, found to have ste in anterior precordial leads, now s/p cath showing lad and lcx disease, but no definitive culprit lesion and s/p placement of 2 des, pain free but with persistent st elevations, improved compared to prior. . # coronaries: pt. with history and ecg changes concerning for stemi with no known cad. now s/p cath with placement of des x2, though no definitive culprit lesion. integrillin gtt was continued 18h post cath. nitro gtt was initially weaned but pt. developed cp again once off nitro gtt, so restarted without much improvement. pt. had further episodes of cp and was taken back to the cath lab which showed patent stents and stable disease. nitro gtt was off post cath. atorvastatin 80mg was started. asa 325mg was started and transitioned to 81mg at discharge. plavix 75mg was started and should be continued for at least 1 year. atenolol was stopped and patient was discharged on metoprolol succinate 50mg daily. given allergy to , pt. also discharged on low dose valsartan. a1c <6%. ecg showed improved but persistent st elevations at discharge, cp free. echo as below. . # pump: beta blockade as above. tte showed lvef of >50% with mild regional left ventricular systolic dysfunction with mild hypokinesis of the distal half of the anterior and distal septal and apex. no overload on exam throughout admission. . # insomnia/anxiety: pt. understandably anxious surrounding events, reports taking triazolam prn at home. he was started on ambien 5mg qhs prn insomnia and lorazepam 0.5mg po prn anxiety, which he required throughout his admission. he was asked to follow up with his pcp for continuing prescriptions for benzodiazepines. . # gerd: stable, continued famotidine and started gi cocktail prn for symptomatic relief. . # hypothyroidism: stable, continued home levothyroxine. . # transitional issues: - may need benzo prescription for anxiety - titrate beta blocker, - tte to follow up post stemi medications on admission: 1. atenolol 25mg po qhs 2. ambien 5mg po prn insomnia 3. levothyroxine 125mcg po daily 4. pepcid 20mg discharge medications: 1. aspirin 81 mg tablet sig: one (1) tablet po twice a day. disp:*62 tablet(s)* refills:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*31 tablet(s)* refills:*2* 3. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 4. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 5. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 6. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take up to 3 tabs, 5 minutes apart, then go to emergency room if still having pain. disp:*30 tablet, sublingual(s)* refills:*0* 7. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). disp:*31 tablet(s)* refills:*2* 8. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*31 tablet sustained release 24 hr(s)* refills:*2* 9. simvastatin 80 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*11* discharge disposition: home discharge diagnosis: st elevation myocardial infarction discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted for chest pain and found to have a heart attack. you were taken to the cardiac catheterization lab where two drug-eluting stents were placed. as you had chest pain afterwards with persistent ekg abnormalities, you were taken back to the catheterization lab where you were found to have no changes from prior. you had no further chest pain. . the following changes were made to your medications: - start aspirin 81mg twice a day - start plavix 75mg daily for at least a year - stop atenolol - start metoprolol succinate 50mg daily - start simvastatin 80mg daily - start valsartan 80mg daily - start nitroglycerin sublingual tabs, 1 tab every 5 minutes when having chest pain up to 3 tabs. if you are still having chest pain after 3 tabs, go to your local emergency room. . do not stop your aspirin or plavix without first discussing with your cardiologist. followup instructions: department: when: tuesday at 11:45 am with: , (works with dr md building: (, ma) campus: off campus best parking: on street parking . dr. had no open appointment slots for 8 weeks, which we felt was too long for you to wait to be seen. you can make an appointment to follow up with him after the appointment below. . department: cardiac services when: thursday at 10:20 am with: , md building: sc clinical ctr campus: east best parking: garage procedure: coronary arteriography using two catheters left heart cardiac catheterization left heart cardiac catheterization coronary arteriography using a single catheter 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 two vessels diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension unspecified acquired hypothyroidism acute myocardial infarction of other anterior wall, initial episode of care other chronic pulmonary heart diseases personal history of tobacco use hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) anxiety state, unspecified insomnia, unspecified 

Answer: The patient is high likely exposed to