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 of sudden onset. major surgical or invasive procedure: cardiac catheterization and placement of drug-eluting stent to rca history of present illness: mr. is an 81yo m with history of htn, questionable dyslipidemia and osa, admitted to 6-ccu on via ed, w/ complaint of one hour episode of substernal chest pressure/tightness radiating up into the neck awaking him from sleep. the pain was associated with diaphoresis but no shortness of breath. his wife gave him a full aspirin and the pain went away. she called ems, and he was chest pain free upon available to the er. . in the er, initial vitals were 97.5, 84, 162/80, 16, 97% 2l nc. initital ekg showed first degree av block and st elevations in the inferior leads. while in the ed, his cp recurred, and he was sent to the cath lab as a . he was plavix loaded with 600mg, started on heparin drip and given morphine. patient was hemodynamically stable the whole time with heart rates in the 80s and blood pressures 150s-160s/80s. . in the cath lab, he had a subtotal ostium pl branch rca lesion and des was placed. he developed increased respiratory distress with some coughing and questionable svt with cough. patient received lasix 20mg iv for this and was transiently on nrb. his pcw on cath was 33. . 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 absence of current chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. upon reflection, he has felt more fatigued that usual with exertion but denies frank dyspnea. past medical history: 1. cardiac risk factors: hypertension, questionable dyslipidemia 2. cardiac history: evidence of prior inferior mi on ekg in 3. other past medical history: rhinitis osa on cpap bph gout obesity hard of hearing. s/p ventricular shunt years ago. hypogonadism (low t) social history: - tobacco history: none - etoh: rare - illicit drugs: none family history: father had history of cad. no family history of cancer or diabetes. physical exam: admission physical examination: vs: t= 97.1 bp= 173/85 hr= 61 rr= 15 o2 sat= 95% 5l nc general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 4 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: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab anteriorly, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ . discharge physical examination: vs: tm/tc:99.8/98.2 hr:65-91 bp:127-134/78-88 rr:18-20 02 sat:94% ra in/out: 24h:720/925, last 8h: 480/400 weight: 106.5 tele: af to sr with conversion pause. rate of af up to 120. no vt noted. . general: 81 yo m in no acute distress heent: perrla, no pharyngeal erythemia, mucous membs moist, no lymphadenopathy, jvp non elevated chest: ctabl no wheezes, no rales, no rhonchi cv: s1 s2 normal in quality and intensity rrr no murmurs rubs or gallops abd: soft, non-tender, non-distended, bs normoactive. ext: wwp, no edema. no sig hematoma or ecchymosis at left groin site. dps, pts 2+. neuro: cns ii-xii intact. 5/5 strength in u/l extremities. gait wnl. skin: no rash psych: a/o, making jokes pertinent results: admission labs 05:14am blood wbc-8.2 rbc-5.16 hgb-18.2* hct-50.2 mcv-97 mch-35.4* mchc-36.3* rdw-15.2 plt ct-195 05:14am blood neuts-68.5 lymphs-24.6 monos-3.5 eos-2.5 baso-0.9 05:14am blood pt-12.6 ptt-22.1 inr(pt)-1.1 05:14am blood glucose-157* urean-19 creat-1.5* na-142 k-3.7 cl-104 hco3-26 angap-16 05:14am blood ck(cpk)-145 01:36pm blood ck(cpk)-798 05:05am blood ck(cpk)-319 05:14am blood ctropnt-0.40* 01:36pm blood ck-mb-69* mb indx-8.6* ctropnt-2.53* 08:57pm blood ck-mb-45* mb indx-8.1* ctropnt-2.73* 05:05am blood ck-mb-23* mb indx-7.2* ctropnt-2.50* 05:14am blood %hba1c-5.1 eag-100 05:14am blood cholest-174 05:14am blood triglyc-137 hdl-43 chol/hd-4.0 ldlcalc-104 . discharge labs 06:20am blood wbc-6.6 rbc-4.53* hgb-16.2 hct-44.0 mcv-97 mch-35.8* mchc-36.8* rdw-15.1 plt ct-155 06:20am blood glucose-99 urean-17 creat-1.3* na-141 k-3.8 cl-105 hco3-24 angap-16 . imaging cardiac cath: 1. coronary angiography in this right dominat system demonstrated single vessel disease. the lmca was patent. the lad had <50% proximal stenosis, and diffuse irregularities. the lcx had no angiographically apparent disease. the rca had a subtotal ostium occlusion posterolateral branch. 2. resting hemodynamics revealed elevated right and left sided filling pressures with rvedp of 16 mmhg and pcw of 33 mm hg. there was moderate pulmonary arterial systolic hypertension with pasp 54 mm hg. the cardiac index was low at 2.2 l/min/min2. there was normal arterial systolic and mildly elevated diastolic pressures at the aortic level with sbp 136 mmhg and dbp of 94 mmhg. 3. left ventriculography was differed. 4. successful ptca and stenting of the distal rca into the pl branch with a 3.0 x 18 mm promus des (see ptca comments). 5. successful lfa angioseal (see ptca comments). final diagnosis: 1. single vessel coronary artery disease. 2. moderate biventricular diastolic dysfunction. 3. moderate pulmonary arterial hypertension. 4. successful pci of the distal rca into the rpl with a 3.0 x 18 mm promus des. 5. successful lfa angioseal. . ecg: sinus rhythm. a-v conduction delay. st segment elevations in leads ii, iii and avf with st segment depressions in leads v2-v3 and v5-v6 and leads i and avl consistent with acute transmural ischemia in the inferoposterior distribution. relatively flat st segment in lead v1 raises suspicion for acute right ventricular infarction. compared to the previous tracing st segment changes are new. . trans-thoracic echocardiography the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild to moderate regional left ventricular systolic dysfunction with severe hypokinesis of the basal inferior and inferolateral walls. the remaining segments contract normally (lvef = 45-50 %). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta and arch are mildly dilated.the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . impression: mild symmetric left ventricular hypertrophy with regional systolic dysfunction c/w cad (pda distribution). mild-moderate aortic regurgitation. mild-moderate mitral regurgitation. dilated thoracic aorta. brief hospital course: mr. is a 81yo m with history of htn and osa, who was admitted with an inferior . . acute # inferior - pt taken to cath and shown to have a subtotal ostium occlusion in the posterolateral branch of the rca. there was successful ptca and stenting of the distal rca into the posterolateral branch with a 3.0 x 18 mm promus drug-eluting stent. he was continued on aspirin and started on plavix, acei, statin, and switched to metoprolol from his home atenolol. . # chf: no history of chf but has not had an echo since stress echo in . echo showed ef 45-50% with mild to moderate regional left ventricular systolic dysfunction with severe hypokinesis of the basal inferior and inferolateral walls, mild-moderate aortic and mitral regurgitation, and dilated thoracic aorta. . # rhythm: evidence of first degree av block on ekg back in as well as now. he was monitored on telemetry and found to be in paroxysmal atrial fibrillation. he was anticoagulated with heparin drip and bridged to pradaxa for long-term anticoagulation. . chronic # hypertension: his home amlodipine was held in favor of starting acei, and he was switched from his home atenolol to metoprolol for better cardioprotection. he was slowly titrated up to 50 mg metoprolol , which was equivalent to his home atenolol dose. he was also put on lisinopril 5mg. . # hyperlipidemia: per notes, he has history of hyperlipidemia,but patient reports good cholesterol levels. lipid panel showed hdl 43, chol/hdl 4.0, ldl 104. he was started on atorvastatin 80mg daily for cardioprotection. . # obstructive sleep apnea: he was continued on cpap. . # bph: he was continued on home tamulosin and finasteride. . # low testosterone: wife reports pt takes 200mg every 2 weeks. he was put on testosterone patch while in-house. . transitional # pt will have follow-up with dr. on monday . . # pt will have follow-up with dr. on monday . medications on admission: amlodipine - 10 mg tablet - 1 tablet(s) by mouth once a day atenolol - 50 mg tablet - 1 tablet(s) by mouth once a day finasteride - 5 mg tablet - 1 tablet(s) by mouth once a day tamsulosin - 0.4 mg capsule, ext release 24 hr - 1 capsule(s) by mouth once a day testosterone cypionate - 200mg/ml, 1ml every two weeks aspirin - (otc) - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day bisacodyl - dosage uncertain calcium citrate-vitamin d3 - (otc) - dosage uncertain multivitamin - (prescribed by other provider) - dosage uncertain omega-3 fatty acids-vitamin e - (otc) - dosage uncertain discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 2. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. metoprolol succinate 100 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:*2* 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. dabigatran etexilate 150 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 6. crestor 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 7. testosterone cypionate (bulk) miscellaneous 8. bisacodyl 5 mg tablet, delayed release (e.c.) oral 9. calcium citrate + d oral 10. multivitamin tablet sig: one (1) tablet po once a day. 11. omega 3 fish oil oral 12. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 13. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). discharge disposition: home discharge diagnosis: inferior myocardial infarction hypertension atrial fibrillation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure taking care of you during your hospitalization at . you were admitted because you had a heart attack. images of your heart showed that critical vessels that supply blood to your heart were blocked, and so a stent was placed in order to keep the blood vessel open. it is extremely important that you take aspirin and plavix every day for one year to prevent the stent from clotting off and causing another heart attack. do not stop taking aspirin and plavix or miss unless dr. says it is ok. you developed a very common irregular heart rhythm called atrial fibrillation. you have tolerated this well but you now have an increased risk of stroke. therefore, we have started blood thinner called dabigitran or pradaxa to prevent a stroke. this medicine can cause easy bleeding so you may bruise easily or your gums could bleed with vigorous brushing. however, you also could have bleeding in your bowel that will give you dark or bloody stools, lightheadedness and dizziness. call dr. right away if you experience these symptoms. please start taking the following medications in addition to your home medications: 1. metoprolol succinate to lower your heart rate and help you heart recover from the heart attack 2. rosuvastatin (crestor) to lower your cholesterol 3. plavix to prevent the stent from clotting off and causing another heart attack. 4. aspirin to prevent the stent from clotting off and causing another heart attack. 5. lisinopril to lower your blood pressure and help your heart recover 6. pradaxa: to prevent a stroke from your atrial fibrillation please stop taking the following medications: 1. amlodipine (the lisinipril will replace amlodipine) 2. atenolol (the metoprolol will replace atenolol) followup instructions: department: cardiac services when: monday at 10:40 am with: , md building: campus: east best parking: garage department: healthcare of when: monday at 9:20 am with: . , md building: (, ma) ground campus: off campus best parking: parking on site procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation mitral valve insufficiency and aortic valve insufficiency hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified other and unspecified hyperlipidemia acute myocardial infarction of other inferior wall, initial episode of care chronic systolic heart failure obesity, unspecified other testicular hypofunction 

Answer: The patient is high likely exposed to