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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with anjiojet to pl branch of the right coronary artery history of present illness: 42 yr old male with history of factor xii defiency, total occlusion rpl with des in who presented to osh with chest pain, found to have nstemi, tranferred to for intervention. . patient reports that he has been experiencing chest pain for the past 2 months, but despite repeated attempts to seek medical care, was never diagnosed. starting 2 days prior to admission, pain became more severe, , located substernally, radiating to the left should and jaw, associated with nausea, and diaphoresis. patient took tylenol with no improvement. . he presented to earlier today with nqwmi earlier today with troponin of 14. ekg showed twi and q waves in iii and avf without st changes. ck-mb 76 and trop 13.65. he received aspirin 325mg po, slng 0.4mg x3, and zofran 4mg iv x3. he was given 600mg plavix and asa 325mg in the cath lab. nitrolgycerin was started at 20mcg iv/minute. he received 2500 units iv heparin periprocedurally. ptt was >130 prior to receiving heparin. cardiac catheterization via right radial artery showed late in stent thrombosis but no other acute disease. he requested transfer to for further intervention. . on arrival at the , his vital signs were 72 127/68 15 99%ra. catheterization performed radially showed plv state stent thrombosis. pt underwent unsuccessful aspiration thrombectomy and angiojet without ptca. he was continued on integrellin but iv heparin was discontinued given abnormally elevated ptt. he was given 40mg of protamine for reversal and sent to the ccu. hematology was consulted for assitance for monitoring anticoagulation. prior to transfer to the ccu he developed chest pain and nitro gtt was reinitiated at 3mcg/minute. . on the floor he continued to complain of chest pain, left shoulder and jaw pain, and back pain. . on review of systems, he denies a history of difficulty with epistaxis, gingival bleeding, bruising. he has had wisdom teeth pulled over the past 2 weeks without evidence of excessive bleeding or transfusion requirement. he denies brbpr. denied 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. no fevers or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. past medical history: past medical history: 1. cardiac risk factors: diabetes, dyslipidemia, hypertension . disease, factor xii deficiency, head injury in past, hypertension 2. cardiac history: cad s/p mi - percutaneous coronary interventions: taxus (des) x 2 to plv 3. other past medical history: abd infection treated with antibiotics obesity pancreatitis (attributed to triglyceridemia) traumatic brain injury as a child prolonged ptt, with normal pt and tt. evaluated by heme-onc in , thought to be consistent with factor xii deficiency with no clinical sequelae. social history: social history is significant for the absence of current tobacco use. there is no history of alcohol abuse. patient is currently unemployed but works as an internet writer. he lives with his parents in . family history: there is a family history of premature coronary artery disease or sudden death (brother had an mi at age 39 and had stent placed.) physical exam: general: obese gentleman, oriented x3 heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink neck: supple with jvp of 6 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: ctab, no crackles, wheezes or rhonchi. abdomen: soft, nt/nd. obese.. extremities: no c/c/e. no femoral bruits. right tr band site without hematoma. 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+ pertinent results: 02:50am blood wbc-6.3 rbc-4.35* hgb-13.6* hct-38.1* mcv-88 mch-31.3 mchc-35.7* rdw-14.3 plt ct-162 08:03pm blood neuts-82.9* lymphs-12.8* monos-4.0 eos-0.3 baso-0 02:50am blood plt ct-162 05:45pm blood lmwh-0.53 08:04am blood heparin-0.20* 02:50am blood glucose-108* urean-6 creat-0.7 na-143 k-3.7 cl-110* hco3-21* angap-16 03:29am blood ck(cpk)-150 03:43am blood ck(cpk)-280 03:29am blood ck-mb-10 mb indx-6.7* ctropnt-1.26* 08:04am blood ck-mb-19* 03:43am blood ck-mb-20* mb indx-7.1* ctropnt-1.20* 02:50am blood calcium-8.9 phos-2.7 mg-2.2 08:04am blood triglyc-379* hdl-38 chol/hd-5.3 ldlcalc-89 ldlmeas-124 11:19am blood apolipoprotein a (little a)-pnd . cardiac catheterization : final diagnosis: 1. severe coronary artery disease: see above comments section 2. asa 325 mg daily indefinitely 3. continue to hold clopidogrel therapy 4. integrilin (eptifibatide) for 18 hours 5. heparin for a goal ptt 50-80 for 48 hrs and then potential relook angiography if persistent symptoms 6. r 6fr radial artery sheath removed and tr band applied without complications . echo : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with inferior/inferolateral hypokinesis. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. the left ventricular inflow pattern suggests impaired relaxation. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. compared with the report of the prior study (images unavailable for review) of , left ventricular systolic function is probably similar or slightly more impaired (inferolateral hypokinesis noted in the current study). . ecg : sinus rhythm. inferior wall myocardial infarction. early r wave progression. consider posterior involvement. minor st-t wave abnormalities. compared to the previous tracing there is less artifact. . cxr : impression: ap chest compared to : lungs are fully expanded and clear. there is no pleural abnormality. heart size is normal. mediastinal widening to the left of midline extending from the aortic knob which is partially obscured to the thoracic inlet is unchanged since , therefore unlikely due to malignancy or other active process. it could be a large fat collection or vascular anomaly, particularly left-sided svc. i do not think this warrants additional imaging investigation. brief hospital course: 42 yr old male with history of factor xii deficiency, total occlusion rca pl with des in , presents with chest pain, found to have nstemi with thrombosis in the rca pl. . # cad: nstemi on admission with elevated cardiac enzymes. catheterization showed large thrmobus burden inthe distal rca at the distal bifurcation into the pda/pl origin. patient kept on nitroglycerin gtt and iv morphine. thrombectomy was attempted by aspiration and angiojet, but the pl brance remained totally occluded. decision was made to medically manage. patient kept on aspirin, started plavix 75 mg qd, coumadin 5 mg qd which was bridged with lovenox. metoprolol dose was increased to 25 mg to decrease cardiac work. daily ekg showed no progression of nstemi. cardiac enzymes peaked and then trended down. . # fever: one episode of fever during the hospitalization. workup included ua and cxr which were both negative. no diarrhea to suggest c. diff. urine culture negative. blood culture no growth to date on discharge and should be followed. . # factor xii deficiency: patient is known to have this rare disorder which was diagnosed by hematology/oncology in when des was placed. this condition is clinically not associated with increased rate of bleeding despite the elevated prr (>150 for patient at baseline) but is associated with arterial and venous thrombosis per literature. hematologist/oncology service was consulted and decision was made to start patient on lovenox rather than on lovenox rather than heparin gtt for cad, due to the difficulty for titration of heparin gtt given elevated ptt. patient was started on coumadin for anticoagulation prior to discharge. . # drop in hematocrit: hematocrit dropped from 38 -> 33.5 after hospital day 1. no active signs of bleeding, and recovered spontaneous to 38 prior to discharge. . # hld: elevated triglycerides and cholesterol despite being on statin at home. fenofibrate was started and should be continued after discharge. . to be followed by primary care doctor: - blood cultures medications on admission: - aspirin 325 mg daily - simvastatin 80 mg qd - metoprolol 25 mg - tylenol prn for chest pain discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily) as needed for cad: s/p plv late stent thrombosis. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 4. fenofibrate micronized 48 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* 7. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. disp:*30 tablet(s)* refills:*2* 8. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for chest pain. disp:*20 tablet(s)* refills:*0* 9. enoxaparin 150 mg/ml syringe sig: one (1) syringe subcutaneous q12h (every 12 hours). disp:*8 syringe* refills:*2* 10. simvastatin 80 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: non st elevation myocardial infarction factor 7 deficiency hypertension hyperlipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had a heart attack that was caused by a blockage in your stent in your right coronary artery branch. we were unable to remove the clot or drill through it. but we gave you on medicines to prevent the stent from more clotting. it is extremely important that you continue to take these medicines every day unless dr. tells you to stop them. you continued to have chest pain after the procedure that we do not think is because of your heart. we want you to take prilosec every day to see if this helps the chest pain and you can take tramadol, a pain medicine, at home for the chest pain as well if it helps. please follow up with the providers listed below. . we made the following changes to your medicines: 1. start taking prilosec twice daily 2. continue to take aspirin daily to prevent blood clots and another heart attack. you need to take an aspirin every day for the rest of your life. 3. start taking plavix (clopidogrel) every day to prevent the stent from developing a clot again. do not stop taking plavix or miss unless dr. tells you it is ok. 4. start taking coumadin to prevent further blood clots. you need to take this medicine every day in the evening at the dose that your nurse practitioner tells you to. the dose may be different according to your blood levels. you will need to have your coumadin level (inr) checked on monday at your np office. 5. lovenox is a short acting blood thinner that you inject twice daily. you will need to take this injection until the coumadin level is therapeutic. , np, will tell you when you can stop taking this medicine. 6. start fenofibrate to lower your triglycerides, a type of fat in your blood 7. start lisinopril to lower your blood pressure and help your heart work better. 8. start tramadol to use if you have chest pain. please only take every 6 hours. 9. continue to take the simvastatin and metoprolol as before. followup instructions: primary care: , np signature heathcare phone: (, monday at 10 am please confirm this appt on friday. . cardiology: , md phone: ( at 10:15am procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor injection or infusion of other therapeutic or prophylactic substance excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel procedure on vessel bifurcation diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft accidents occurring in other specified places fever, unspecified chronic pancreatitis congenital deficiency of other clotting factors personal history of traumatic brain injury 

Answer: The patient is high likely exposed to