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: stemi major surgical or invasive procedure: cardiac catheterization with stent placement history of present illness: pt is an 83 yo male, with htn, dm, cad s/p cabg x 5 in (lima-->d2, svg--> d1, svg-->lad, svg--> plv, svg--> pda), who presents with 1 day of chest pain, found to have stemi, and is s/p catheterization here. in ett mibi showed st depressions in v5-v6 with imaging study showing a medium-sized inferior wall defect and mild inferior wall hypokinesis with lvef 64%. pt was treated medically and underwent cardiac catheterization showing right dominant circulation, lmca with minimal distal narrowing, lad with multiple proximal, mid and distal stenosis, and diag 1 with 90% stenosis. lcx-90% stenosis and rca-100% acute thrombotic occlusion. pt was taken for acute cabg. since , pt has been doing well, symptom free. on the day of admission, pt went to va for his regular interval pcp . he went home afterwards, and had an "" mid-chest "dull" pressure feeling. no radiation to the jaw, arm, back, or abdomen. no n/v or diaphoresis. mild sob. pt went to the ed, and was found to have stemi inferiorly. right sided leads showed v4 ste .5 mm. he was taken to catheterization emergently. cath showed: ra 8, rv 38/0, pa 40/15 (mean 24), pcw 15. lmca no obstructive disease, rca 90% mid, complex to distal, svg patent to om2, lad, pda. co 4.67, ci 2.53. driver stent to rca (acute marginal supplied to inferior wall). of note, three balloons were ruptured during catheterization. upon arrival to ccu pt with "" chest pain that has persisted since it started with above characteristics. he was started on nitro gtt. past medical history: 1. cad s/p cabg x 5 in - lima-->d2, svg--> d1, svg-->lad, svg--> plv, svg--> pda. 2. htn- since ' 3. gout-last flare 03' 4. bph- better control recently 5. dm-"in good control" per va notes 6. nephrolithiasis-treated by outside urologist. resolved with lithotripsy 10-12 years ago. social history: lives in . he is married for 20 years to his second wife (first wife died of cancer). one grown daughter from first marriage. 2 step children in their 20s. never smoked. etoh: drinks per week. does adls, yardwork. family history: no dm, htn in family. mother died in mid-50s, unknown cause of death. physical exam: vs: t: 100.0; bp: 137/59; hr: 64; rr: 12; o2: 97% ra gen: laying in bed, plethoric face, speaking in full sentences in nad neck: laying at 180 degrees, no jvd cv: rrr s1s2. no m/r/g lungs: cta anteriorly abd: soft, nt, nd. ext: right groin: sheath still in place. dp 1+ b/l. warm extremities. trace edema b/l. neuro: cn ii-xii grossly intact without focal deficit. pertinent results: ekg: ste ii, iii, avf (iii>ii). pr prolongation at .24. qrs borderline .12. cath showed: ra 8, rv 38/0, pa 40/15 (mean 24), pcw 15. lmca no obstructive disease, rca 90% mid, complex to distal, svg patent to om2, lad, pda. co 4.67, ci 2.53. driver stent to rca (acute marginal supplied to inferior wall). of note, three balloons were ruptured during catheterization. ________________________________ labs on admission: 03:30pm wbc-18.7* rbc-5.42 hgb-17.3 hct-50.3 mcv-93 mch-32.0 mchc-34.5 rdw-12.7 plt count-162 neuts-95.7* bands-0 lymphs-2.2* monos-2.0 eos-0 basos-0.1 hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal pt-13.4 ptt-24.5 inr(pt)-1.1 caltibc-306 ferritin-211 trf-235 iron-128 ck-mb-4 ctropnt-0.01 ck(cpk)-122 glucose-213* urea n-22* creat-1.2 sodium-145 potassium-3.6 chloride-104 total co2-28 ________________________________ cardiac labs: 03:30pm blood ck(cpk)-122 01:29am blood ck(cpk)-267* 06:05am blood ck(cpk)-375* 03:15pm blood ck(cpk)-413* 03:30pm blood ck-mb-4 03:30pm blood ctropnt-0.01 01:29am blood ck-mb-23* mb indx-8.6* 06:05am blood ck-mb-38* mb indx-10.1* ctropnt-0.54* 03:15pm blood ck-mb-41* mb indx-9.9* ctropnt-0.61* 07:15am blood ck-mb-25* mb indx-11.1* ctropnt-0.91* _________________________________ other labs: 08:30pm blood ret aut-1.1* 03:30pm blood caltibc-306 ferritn-211 trf-235 _________________________________ labs upon discharge: 07:15am blood wbc-9.0 rbc-4.61 hgb-14.7 hct-42.3 mcv-92 mch-31.9 mchc-34.8 rdw-12.8 plt ct-136* 07:15am blood glucose-162* urean-24* creat-1.1 na-141 k-4.0 cl-104 hco3-25 angap-16 07:15am blood calcium-8.6 phos-2.1* mg-1.9 brief hospital course: 1. cardiac a. pt was s/p inferior stemi and stent to rca. right sided pressures were normal so there was not an rv infarct. pt was monitored in the ccu secondary to possible in-stent thrombus given the multiple balloon ruptures and difficulty with catheterization (see cath report). there was not a problem and pt did well. we kept pt on asa and started plavix. ace inhibitor and beta blocker were kept at the outpt dose. he was on atorvastatin (80 mg) while in the hospital but we had to switch him back to zocor as that was on the va formulary where he got his medication. additionally, he was on a nitro gtt for pain control which was d/cd on hd #2. mr. was kept on a tight regular insulin sliding scale post-mi. b. pump- ef 50% by mibi at osh last year, which was now 40% according to echo here with inferior and posterolateral hypokinesis to akinesis. we continued an ace inhibitor for afterload reduction and mortality benefit. additionally, there was initial concern for an rv infarct and pt received 3l ivf for preload. c. rhythm- on ekg pt had mild first degree av block. given the rca involvement there was concern for nodal involvement; however ekg remained stable. pt was monitored on telemetry. d. pt with longstanding htn. we continue beta blocker, ace inhibitor, and calcium channel blocker. bp was well controlled 2. diabetes pt with dm2. we held his metformin initially given the possibility of needing further intervention. he was on a riss for tight glucose control. metformin was restarted upon discharge. 3. bph- we continued flomax and finasteride. 4. increased hct- on admission, pt with a hct of 50.3. he had no evidence of pancreatitis and other possibilities included: hemachromatosis (pt with bronzy skin, plethoric face), polycythemia , and dehydration. iron studies showed unlikely hemachromatosis. after pt received hydration, hct went down to normal (low 40s). 5. leukocytosis- wbc 18.7 on admission. there was no evidence of infection on ros and physical exam. cxr was negative for an acute process. wbc trended down and leukocytosis was likely secondary to stress response and demargination. 6. gout- we continue allopurinol. indomethacin was held given the acute cad process. 7. ppx- subcutaneous heparin, took pos, riss, and pain control. 8. f/e/n- / cardiac heart healthy diet. pt received nutrition counseling regarding diet. 9. access- pivs. 10. code status- full code. this was discussed with pt. medications on admission: 1. asa 325 qday 2. atenolol 25 qday 3. felodipine 10 mg qday 4. lisinopril 40 qhs 5. allopurinol 300 qday 6. metformin 500 sa, 2 tab po before dinner. 7. simvastatin 40 mg qday 8. proscar 5 mg qday 9. flomax- 0.4 mg qday 10. indomethacin 25 mg qday prn discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 4. zocor 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 6. tamsulosin hcl 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po hs (at bedtime). 7. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). 8. felodipine 5 mg tablet sustained release 24hr sig: two (2) tablet sustained release 24hr po daily (daily). 9. lisinopril 20 mg tablet sig: two (2) tablet po hs (at bedtime). 10. metformin hcl 500 mg tablet sig: one (1) tablet po twice a day. discharge disposition: home discharge diagnosis: st elevation myocardial infarction systolic chf diabetes type ii bph gout first degree heart block discharge condition: stable discharge instructions: please make all appointments and take all medications as listed in the discharge paperwork. seek medical attention if you have any of the following : chest pain, shortness of breath, fevers, chills, tingling in your jaw or arm. followup instructions: please follow up with your primary care provider weeks. you need to follow up with your cardiologist at the va in 1 week! procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor aortography diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled systolic heart failure, unspecified 

Answer: The patient is high likely exposed to