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: dissection of lad and diagonal branch major surgical or invasive procedure: cardiac catheterization and placement of 3 stents in lad history of present illness: mr. is a 62m w/ cad, hx mr, htn, hyperlipidemia who had chest pressure and palpitations on sunday am . he presented to his community physician, . . he during denies sob at rest or on exertion, lightheadedness orsyncope. he denied pnd, orthopnea, or peripheral edema. per documentation, his most recent stress testing was performed in and demonstrated an ef of 65%. patient's previous pci interventions are summarized below. patient referred to for lh catheterization. during the lh cath procedure today, there was evidence of a moderate lesion in the lad, with flow distal to the wire at 0.72 ration, so it was decided to intervene on the lesion, which was located near diag take off. catheterization was complicated by dissection occurring at diag and lad. three stents were then placed in lad, no stents to diag, with some flow through diag branch. the patient had persistent chest pain after the procedure. he has 2/10 chest pain at last report. approach was r radial. the patient was transferred to the ccu for observation s/p complication. on arrival to the floor, patient had 2/10 chest pain, was otherwise comfortable but slightly sedated. patient was afebrile, 60, 113/68, 19, 94%ra. review of systems on review of systems, he denies recent fevers, chills or rigors. all of the other review of systems were negative. cardiac review of systems is notable for absence of dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, syncope or presyncope. the patient has some sub-sternal chest pain, . past medical history: cad cardiac risk factors: cad, dyslipidemia, hypertension cardiac history: - percutaneous coronary interventions: s/p stenting om3 (80%) in . angiography demonstrated a right dominant coronary circulation. the left main was free of significant obstruction. the lasd had 50-60% bifurcation stenosis involving origin of d1. the lcx had 80% hazy stenosis of a large om3. the rca had 50% stenosis of the distal rca involving the orign of pda and pl branches. -s/p ptca of om3 (for in stent restenosis) with stent to distal lcx and r-pda - mitral regurgitation other past medical history: knee replacement, left back surgery shoulder surgery social history: lives with wife and son, age 25. retired marine engineer. tobacco: quit etoh: none contact upon discharge: , wife. c: will provide home care services: none family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory physical exam: admission exam: vs: afebrile, 60, 113/68, 19, 94%ra. general: oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. neck: supple with jvp of 8 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, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. r radial wrist guard on. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ discharge exam: vitals: tc 98.7 tm 100.1 bp 97-119/57-76 hr 66-82 rr 18 o2 98 ra general: oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. neck: supple with jvp of 8 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, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. r radial wrist guard on. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ pertinent results: admission labs: 05:50am blood wbc-15.7* rbc-4.40* hgb-13.2* hct-39.6* mcv-90 mch-29.9 mchc-33.2 rdw-13.6 plt ct-222 05:50am blood pt-10.7 ptt-29.4 inr(pt)-1.0 05:50am blood glucose-151* urean-13 creat-0.9 na-137 k-3.9 cl-103 hco3-23 angap-15 06:30pm blood ck(cpk)-620* 05:38pm blood ck-mb-32* 05:50am blood ck-mb-104* 11:14am blood ck-mb-83* ctropnt-1.23* 06:30pm blood ck-mb-49* mb indx-7.9* ctropnt-1.08* 05:38pm blood mg-1.6 05:50am blood calcium-8.5 phos-3.4 mg-2.6 relevant labs: 05:38pm blood ck-mb-32* 05:50am blood ck-mb-104* 11:14am blood ck-mb-83* ctropnt-1.23* 06:30pm blood ck-mb-49* mb indx-7.9* ctropnt-1.08* c. cath: 1. severe single vessel coronary artery disease. 2. normal systemic arterial blood pressure. 3. successful pci of the lad with bms complicated by diagonal branch dissection (see ptca comments). 4. continue aspirin indefinitely. 5. continue prasugrel 10 mg daily for minimum 1 month, with 3 months better and 12 months optimal. 6. monitor closely in ccu. 7. follow renal function and cycle cardiac enzymes. echo: the left atrium is elongated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. overall left ventricular systolic function is low normal (lvef 50%) secondary to apical hypokinesis. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. discharge labs: 06:58am blood wbc-11.0 rbc-4.29* hgb-12.6* hct-39.0* mcv-91 mch-29.5 mchc-32.4 rdw-13.7 plt ct-232 06:58am blood pt-11.4 ptt-27.5 inr(pt)-1.1 06:58am blood glucose-120* urean-18 creat-1.1 na-141 k-4.4 cl-106 hco3-26 angap-13 06:58am blood calcium-8.9 phos-3.3 mg-2.1 brief hospital course: 62m w/ cad, hx mr, htn, hyperlipidemia who presented w/ chest pressure and palpitations on sunday am . he had an elective coronary catheterization today that demonstrated a lesion in the lad, complicated by dissection of lad. three stents were placed in the lad. the patient was transferred to the ccu for observation. # cad / lad dissection- moderate lesion in cad on this coronary catheterization, with flow ratio of 0.7. lesion near the first diagonal. during intervention, dissection was appreciated. three stents were placed in the lad. radial approach. pt was loaded w/ prasugrel 60mg in the cath lab. patient was transferred to ccu after cath for monitoring where he continued to have chest pain overnight and into the next morning requiring nitro gtt to resolve pain. he had some slight lateral st-depressions, which may demonstrate some ischemia of the diagonal branch near the lesion. this was thought to be iatrogenic stenting and possible jailing of the diagonal, so he was started on heparin drip and treated for stemi. his ce were trended. ck-mb peaked at 104 and trop at 1.23, then trended down. an echo was obtained which showed elongated left atrium, mild ra dilation, mild symmetric lvh with lvef 50%, and lv apical hypokinesis. rv normal. 1+ mr. was treated with prasugrel 10mg , 325, and switched from home simvastatin to high dose atorvastatin for treatment of acute stemi. his metoprolol was restarted and uptitrated to 75mg xl qd. # htn: patient normotensive on arrival to ccu. held beta blocker on arrival since he received xl the previous night and hr was in 50s, then restarted and uptitrated to 75mg qd. # hld: placed pt on high dose atrovastatin rather than home simvastatin due to stemi. transitions of care: - will f/u with pcp and cardiologist as outpt - will take aspirin 325mg x1 month and then back to 81mg qd medications on admission: clopidogrel - (prescribed by other provider) - 75 mg tablet - one tablet(s) by mouth at bedtime metoprolol succinate - (prescribed by other provider) - 50 mg tablet extended release 24 hr - one tablet(s) by mouth at bedtime nitroglycerin - (prescribed by other provider) - dosage uncertain pantoprazole - (prescribed by other provider) - 40 mg tablet, delayed release (e.c.) - one tablet(s) by mouth once a day in am simvastatin - (prescribed by other provider) - 40 mg tablet - one tablet(s) by mouth at bedtime medications - otc aspirin - (prescribed by other provider) - 81 mg tablet, chewable - one tablet(s) by mouth at bedtime niacin - (prescribed by other provider) - 250 mg capsule, extended release - one capsule(s) by mouth at bedtime omega-3 fatty acids-fish oil - (prescribed by other provider) - dosage uncertain discharge medications: 1. nitroglycerin sublingual 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po qam (once a day (in the morning)). 3. niacin 250 mg tablet sig: one (1) tablet po once a day. 4. omega-3 fatty acids-fish oil oral 5. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily): take for 1 month, then go back to taking aspirin 81mg daily. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 6. prasugrel 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. metoprolol succinate 25 mg tablet extended release 24 hr sig: three (3) tablet extended release 24 hr po once a day. disp:*90 tablet extended release 24 hr(s)* refills:*2* 8. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: dissection of lad s/p stent placement discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you came into the hospital for a cardiac catheterization. the procedure was complicated by injury to one of the coronary arteries. thus, you were transferred to the cardiac intensive care unit for monitoring over night and did very well and were then transferred to the floor. you did have some chest pain which resolved. the following changes were made to your medications: -stop taking plavix -stop taking simvastatin -increase metoprolol xl to 75mg daily -increase aspirin to 325mg daily for 1 month, then you can resume taking 81mg daily -start taking prasugrel 10mg daily; do not stop taking this medication without first speaking directly to your cardiologist -start atorvastatin 80mg daily (instead of simvastatin) -start lisinopril 10mg daily on discharge, please follow up with your cardiologist and primary care doctor below. it was a pleasure taking care of you, we wish you all the best. followup instructions: name: , z. address: , , phone: appt: at 3:15pm name: , address: ,lower level, , phone: appt: at 11:20am md, procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders unspecified essential hypertension percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia dissection of coronary artery 

Answer: The patient is high likely exposed to