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: exertional dyspnea major surgical or invasive procedure: cardiac catheterization, stent placement in left anterior descending coronary artery. history of present illness: the pt is a 47 yo obese man with htn, hpld, smoking admitted to on with new onset chf, now admitted to the ccu following acute stemi on the floor now s/p cath, thrombectomy and des stentx2 of 100% occlusion of lad. pt was admitted after several months of progressive dyspnea and exertional chest pain (from unlimited et to dyspnea at rest pta) as well as orthopnea and pnd. pt was ruled out for mi on admission with negative cardiac enzymes and ekg and started on o2, lisinopril and lasix for presumed chf, with resolution of sx. on the night of pt began to feel mild epigastric cp but had negative cardiac enzymes and an unchanged ekg. tte the following morning showed decreased lv wma and diastolic dysfunction. at approximately 12pm on , the pt had severe epigastric cp radiating to his jaw accompanied by dyspnea, nausea and diaphoresis. ekg showed st elevations in i, vl, v3-v6. pt was taken to the cath lab, with cath showing 3 vessel disease and 100% occlusion of mid-lad. thrombectomy and desx2 placement restored flow and relieved sx. pt tolerated the procedure well and arrived in the ccu with stable vital signs and mild cp. past medical history: years 1. cardiac risk factors: dyslipidemia, hypertension, (-) diabetes 2. cardiac history: -cabg: none -percutaneous coronary interventions: see cath report below -pacing/icd:none 3. other past medical history: htn hpld gerd social history: pt lives in in a house with his mother and brother. is very happy with this living situation. pt has never been married and has no children. he works 4 nights a week from pm at the in . he used to drink "a case a night" for ~8 years from when he was 18-25 years old. currently has one drink ocassionally. pt quit smoking two years ago, has smoke 2 ppd for >35 years. endorses marijuana use in the past, otherwise no other illicit drug use. denies ivdu. not currently sexually active. he saw his pcp for the first time last week, and before that did not see a doctor for many years. he enjoys fishing and hunting. . family history: no family history of heart disease, htn, dm, cancer that pt is aware of. mother - 66 yo, osa and a " problem" father - 82 yo, recently had a foot amputated physical exam: vitals: t: 96.8 bp: 153/105 p: 72 r: 20 o2: 100% ra at rest, 96% ambulatory w/ tachypnea general: obese. alert, oriented, no acute distress. heent: sclera anicteric, mmm, whitish material on uvula and soft palate. perrla, eomi. on fundoscopic exam, red reflex present with no obvious hemmorhages or exudates. neck: supple, jvp not elevated, no lad. jvp assesment limited by large neck girth. lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, soft ii/vi systolic murmur abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. exam limited by body habitus. ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cn ii-xii intact, visual acuity 20/50 r, 20/70 l with glasses. reflexes 2+ in all extremities. no babinski sign. normal gait. pertinent results: selected lab results: 06:00pm glucose-99 urea n-18 creat-1.1 sodium-139 potassium-4.1 chloride-102 total co2-26 anion gap-15 06:00pm ck(cpk)-105 06:00pm ctropnt-0.01 06:00pm ck-mb-5 06:00pm wbc-8.2 rbc-5.03 hgb-14.2 hct-40.5 mcv-80* mch-28.3 mchc-35.2* rdw-13.5 06:00pm neuts-66.2 lymphs-26.5 monos-4.7 eos-1.5 basos-0.9 06:00pm plt count-261 06:00pm pt-13.3 ptt-26.9 inr(pt)-1.1 06:01am blood ck-mb-4 ctropnt-<0.01 probnp-546* 06:01am blood iron-78 cholest-267* 06:01am blood caltibc-369 ferritn-118 trf-284 06:01am blood hdl-44 chol/hd-6.1 06:01am blood tsh-3.2 06:10am blood glucose-92 urean-21* creat-1.2 na-139 k-4.2 cl-102 hco3-30 angap-11 06:10am blood calcium-9.4 phos-3.7 mg-2.2 06:10am blood alt-29 ast-14 alkphos-75 totbili-0.8 . ekg: nsr, left axis deviation with lvh . cxr: 1. kerley b lines in the lower lobes without evidence of cardiac enlargement may represent acute cardiac decompensation. clinical correlation is recommended. 2. pleural thickening along the right lateral chest wall and the horizontal fissure with no evidence of focal pulmonary consolidations. . echo () the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. there is mild regional left ventricular systolic dysfunction with focal akinesis of the basal inferior wall and entire inferolateral wall. the remaining segments contract normally. overall left ventricular systolic function is mildly depressed (lvef= 40-45 %). transmitral doppler and tissue velocity imaging are consistent with grade ii (moderate) lv diastolic dysfunction. 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. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: suboptimal image quality. mild ventricular hypertrophy with moderately dilated left ventricle and regional left ventricular systolic function consistent with coronary disease. moderate diastolic dysfunction. mild pulmonary hypertension. . cardiac catheterization () 1. selective coronary angiography of this right dominant system revealed three vessel disease. the lmca was widely patent. the lad was totally occluded in the mid-vessel. the lcx had a 80% stenosis in the om1 branch. the rca was diffusely diseased with a 70% lesion in the mid-vessel. 2. limited resting hemodynamics revealed a severely elevated lvedp at 30mmhg. there was mild systemic arterial hypertension with a central aortic pressure of 148/86mmhg. 3. successful thrombectomy and stenting of the mid lad with a 2.75 x 23 mm and a 2.5 x 8 mm xience des. the stents were post dilated with a 2.5 x 20 mm quantum maverick balloon at 16 atm twice. final angiography revealed no residual stenosis in the stent, no dissection and normal flow. (see ptca comments) final diagnosis: 1. three vessel coronary artery disease. 2. left ventricular diastolic dysfunction. 3. successful stenting of the mid lad brief hospital course: 47 yo w htn, hpld admitted to the floor for chf and subsequently admitted to ccu for acute stemi s/p stent of 100% lad occlusion. . dyspnea: patient presented with shortness of breath with exertion. he diuresed well with lasix 20 mg po and was started on beta blocker, aspairn, and ace therapy. . st-elevation myocardial infarction: patient had a stemi with a 100% mid lad occluion and 3vd. he had a successful pci and stent placement and remained hemodynamically stable. he was treated with asparin, plavix (12months), statin, ace, beta blocker, integrillin. his ck peaked at 51 on . he had an ef of 40-45% prior to his mi and no signs of failure post mi. he was discharged on medical management for coronary artery disease. - he should have a follow up echo to assess cardiac function. - also needs follow-up stress test to eval for residual deficits. . hypertension: controlled on metoprolol and lisinopril. . hyperlipidemia: continued on lipitor 80mg po daily . acid reflux: continued on pantoprozole 40mg po daily medications on admission: omeprazole 20 mg daily atenolol 25 mg daily multivitamin discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: 1) st elevation myocardial infarction 2) congestive heart failure 3) hypertension 4) hypercholesterolemia discharge condition: stable discharge instructions: you were admitted with increasing shortness of breath likely due to congestive heart failure. in addition, during your stay we diagnosed you with high cholesterol (hypercholesterolemia) and high blood pressure (hypertension). you also described symptoms consistent with obstructive sleep apnea, a disorder of breathing during sleep that can be contributing to your blood pressure. during your admission you developed chest pain that was found to be due to an occlusion of one of the arteries bringing blood to your heart causing a heart attack. you had an urgent catheterization to visualize the lesion and place a stent. at that time several other not complete, and not urgent obstructions were noted that will need to be followed up after you recover from your heart attack. we made the following changes to your medications: 1) start aspirin 2) start plavix: please take this every day, do not stop taking unless dr. tells you to. 3) start lisinopril 4) start metoprolol 5) start atorvastatin 6) stop atenolol on discharge, you should be sure to follow up with your pcp, . . an appt has been made for you. you should call your pcp ( or go to the closest emergency room if you experience any of the following: chest pain, worsening chest tightness, worsening shortness of breath, leg or ankle swelling, any episodes of waking up from sleep short of breath, palpitations, or any other symptoms that concern you. . please stop smoking. information was given to you on admission regarding smoking cessation and reviewed at discharge. . weigh yourself every day and call dr. if your weight increases more than 3 pounds in 1 day or 6 pounds in 3 days. follow a low sodium diet. information about this was given to you on discharge. followup instructions: primary care and cardiology: dr. : phone: date/time: tuesday at 11:45am. please follow up with dr. to discuss the following: 1) your hospital course 2) sleep study to evaluate for obstructive sleep apnea 3) pulmonary function tests to evaluate for obstructive lung disease. you will need a repeat echocardiogram and a stress test to evaluate the severity and urgency of the other partial obstructions in your heart. procedure: coronary arteriography using two catheters left heart cardiac catheterization 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 single vessel diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery pure hypercholesterolemia tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension acute myocardial infarction of other anterior wall, initial episode of care obesity, unspecified acute diastolic heart failure 

Answer: The patient is high likely exposed to