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: history of present illness: mr. is a 37-year-old gentleman with no known past medical history (as he has not seen a physician in many years). he has no known cardiac risk factors and no family history of coronary artery disease. the patient presented to an outside hospital at 7 a.m. on complaining of severe back pain that was mostly left-sided and scapular in nature. the patient states that the pain began on when the patient was outside in his yard at in the cold air putting together a basketball net for one of his children. the patient states that the pain came on suddenly, went across the middle of his back (infrascapular), left greater than right, with no associated shortness of breath. no nausea or vomiting, and no radiation of the pain. the patient states that a few days prior to the initiation of the back pain, he had flu-like symptoms; describing fatigue and muscle aches with subjective fevers and chills. he denies any upper respiratory symptoms. no cough. no congestion. he denies gastrointestinal symptoms. he states that his main symptoms were fevers, chills, weakness, and bach ache. over the evening of , he states that the back pain was coming in waves, and he began to have associated diaphoresis. the pain was so bad by the morning of that he "couldn't lay flat," so he went to the emergency department at a local hospital. in the emergency department, he described the pain as . with morphine, the pain was decreased to . the patient was noted to have the following electrocardiogram changes at the outside hospital; he had q waves in ii, iii, avf, v4 through v6. he had an r wave in v1 (suggestive of a posterior myocardial infarction), and he had 1-mm st elevations in v4 through v6. at the outside hospital, the patient was given aspirin, three sublingual nitroglycerin tablets, nitroglycerin paste, morphine sulfate (2 mg intravenously times four), lopressor (5 mg intravenously times one), and was started on a heparin drip. he was then transferred to for cardiac catheterization. past medical history: the patient denies any significant past medical history; although, he has not seen a physician in many years. past surgical history: no past surgical history. cardiac risk factors: coronary artery disease risk factors include no known elevation of cholesterol. he is a nonsmoker. no family history. the patient is obese and states that he has been for years. he weighs approximately 250 pounds and is 5 feet 11 inches tall. medications on admission: the patient was taking a multivitamin and motrin as needed for back pain. allergies: he has no known drug allergies. family history: no history of cardiac disease. no diabetes. his father died secondary to lung cancer from a long smoking history. he has no communication with his mother. has one sister who is healthy. social history: the patient owns a cleaning and maintenance service on . he has two people who work for him, but does a lot of the maintenance on his own; which includes heavy lifting. he does not smoke and has never smoked in the past. he drinks alcohol occasionally; drinking a few beers per week. he denies intravenous drug abuse and denies cocaine use. review of systems: on review of systems, the patient complained of subjective fevers with chills times three to four days. the back pain (as stated in the history of present illness) began on and continued until and was associated with diaphoresis as of the morning of . he denied nausea, vomiting, and diarrhea. no upper respiratory symptoms. no urinary tract infection symptoms. at baseline, the patient states he can walk one to two miles with no difficulty. he plays football and basketball with his sons. has never had chest pain, and he has never had to stop exercise for shortness of breath or chest pain. however, the patient states for the last few years he does not regularly exercise. physical examination on presentation: vital signs revealed heart rate was 89, blood pressure was 135 to 155/85 to 87, respiratory rate was 18, oxygen saturation was 96% on 3 liters, and afebrile. in general, the patient was in no apparent distress. he was lying flat in bed and denied pain. head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light and accommodation. extraocular muscles were intact. jugular venous pressure at the angle of the jaw. heart examination revealed a regular rate and rhythm. normal first heart sound and second heart sound. no murmurs, rubs, or gallops. the lungs revealed bibasilar crackles. abdominal examination revealed obese, soft, nontender, and nondistended. positive bowel sounds. the extremities were warm with no edema and good distal pulses. neurologically, alert and oriented times three. cranial nerves ii through xii were grossly intact. pertinent laboratory values on presentation: other data from the outside hospital revealed his hematocrit was 50.9. his white blood cell count was 17.9, and his platelets were 209. he chemistries revealed sodium was 141, potassium was 4, chloride was 100, bicarbonate was 28, blood urea nitrogen was 10, creatinine was 1, and blood glucose was 119. albumin was 4.3. at the outside hospital, his initial creatine kinase was 1892, with a mb of 151, and a troponin of 4.14. status post catheterization at 4 p.m. at , his creatine kinases peaked at 9753, with a mb of 862, and a troponin of greater than 50. at 7 p.m. (status post catheterization), his creatine kinases were 7259, with a mb of 570. also, after the catheterization, his electrocardiogram changes had not resolved significantly. his electrocardiogram showed a normal sinus rhythm, with a rate of 90 to 100, a leftward axis, normal intervals, q waves in ii, iii, avf, v4 through v6, and r wave in v1, st elevations of around 1 mm in v4 through v6. radiology/imaging: significant laboratory data revealed cardiac catheterization which showed the following hemodynamics; right atrial pressure of 12, right ventricular pressure of 45/10, pulmonary artery pressure elevated at 42/27, pulmonary artery pressure mean was 32, pulmonary capillary wedge pressure was 27. cardiac output was 5.14. cardiac index was 2.2. angiography at catheterization showed left anterior descending artery with no tight stenoses, left circumflex was 100% occluded in the medial portion, and the right coronary artery showed no tight stenoses. for intervention, the patient had an angio-jet thrombectomy and stent to his medial circumflex. assessment: this is a 37-year-old gentleman with no known past medical history presenting with a large inferolateral posterior myocardial infarction with a large infarct territory by electrocardiogram findings and significant creatine kinase leak. the patient has unknown risk factors since no medical followup. he was status post a stent to the circumflex. hospital course by system: 1. cardiovascular system: (a) coronary artery disease: for his coronary artery disease, the patient had a stent to his left circumflex. he was placed on plavix 75 mg p.o. q.d. and aspirin 325 mg p.o. q.d. he was continued on an integrilin drip for 18 hours. his creatine kinases were cycled. his peak, as stated above, was 9753, and his creatine kinases continued to trend down. his creatine kinase on was 3774, with a mb on that creatine kinase of 174. his creatine kinase on had gone down to 902, with a mb of 21. for his coronary artery disease, the patient was placed on a beta blocker which was titrated up as tolerated. he was persistently in sinus tachycardia with heart rates ranging anywhere from 80 to 120. therefore, by the day of discharge (on ), he was on metoprolol 75 mg p.o. b.i.d. he was discharged on atenolol 75 mg p.o. q.d. the patient was also placed on an ace inhibitor to help prevent remodeling after this large infarct. he was tolerating captopril 12.5 mg p.o. t.i.d. by the day of discharge, and this was changed to lisinopril 2.5 mg p.o. q.d. the patient's cholesterol panel was checked, and his cholesterol values were the following: his total cholesterol was 234, with an high-density lipoprotein of 38, an low-density lipoprotein of 168, and triglycerides of 138. the patient was empirically started on atorvastatin 20 mg p.o. q.h.s. prior to these levels coming back, and he was continued on this throughout his hospital course. a homocystine level was also checked as the patient had no known risk factors; it was felt that he could possibly have hypercoagulable state. however, his homocystine level was normal at 6.4. as far as other risk factors, the patient had a random sugar of 140 on admission. therefore, a hemoglobin a1c was sent; however, this value did not return by the day of discharge. it was felt that the patient could have glucose intolerance; however, further fasting sugars came back 100 or less, so this was less likely but should be followed up as an outpatient. (b) pump: the patient had an echocardiogram on . the echocardiogram showed the following: the patient had an ejection fraction of 35%. his left atrium a normal in size. there was a moderate regionally left ventricular systolic dysfunction with akinesis of the inferoposterior wall and hypokinesis of the lateral wall. the right ventricular chamber size and free wall motion were stated to be normal. the aortic root was moderately dilated. the aortic valve leaflets appeared structurally normal with good leaflet excursion, and no aortic regurgitation. the mitral valve leaflets were structurally normal with mild-to-moderate 1 to 2+ mitral regurgitation, trivial pericardial effusion. as stated above, the patient was started on an ace inhibitor to help prevent remodeling and was titrated up to 12.5 mg p.o. t.i.d. which he tolerated without orthostasis or hypotension. as the patient had an evaluated pulmonary capillary wedge pressure of 26 in the catheterization laboratory, and he had signs of congestive heart failure on physical examination and chest x-ray, he was given three doses of 20 mg lasix intravenously. he diuresed well to this and was euvolemic by the day of discharge. (c) rhythm: the patient continued to have sinus tachycardia, status post his myocardial infarction. his beta blocker was titrated up (as stated above), so that he was at 75 mg p.o. b.i.d. of lopressor by the day of discharge. he had no telemetry events other than sinus tachycardia. given that the patient had a significantly large myocardial infarction and had some left ventricular hypokinesis, and electrophysiology study was considered; however, it was decided that as his ejection fraction was greater than 30%, his risk of st depressions was relatively low. therefore, he did not require an electrophysiology followup at this point. 2. renal system: with such high elevations in creatine kinases, there was some concern that the patient may be at risk for rhabdomyolysis. therefore, a urinalysis was checked on and . on neither urinalysis was there evidence of rhabdomyolysis and no evidence of infection. the patient's creatinine remained stable at 1 to 1.1. discharge disposition: the patient was seen by physical therapy during his admission. he was able to ambulate without chest pain or back pain, and his heart rate and blood pressure rose appropriately. he did not desaturate. discharge instructions/followup: 1. the patient was instructed to follow up with a cardiac rehabilitation facility on ; which he was interested in doing. 2. it was also emphasized to the patient the importance of no heavy lifting or labor for at least two to three weeks status post his large myocardial infarction. as he is the owner of a maintenance company, he said this may be difficult, and it was stressed to the patient multiple times that he needs to stay away from the activities for at least two to three weeks. 3. the patient was to follow up (as stated above) with cardiac rehabilitation and to establish a cardiologist on . discharge status: the patient was discharged to home. medications on discharge: (the patient was discharged on the following medication) 1. atenolol 75 mg p.o. q.d. 2. lisinopril 2.5 mg p.o. q.d. 3. atorvastatin 20 mg p.o. q.h.s. 4. plavix 75 mg p.o. q.d. (to be continued for nine months status post catheterization with intervention). 5. aspirin 325 mg p.o. q.d. 6. ranitidine 150 mg p.o. b.i.d. , m.d. dictated by: medquist36 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 diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders other chronic pulmonary heart diseases obesity, unspecified acute myocardial infarction of inferoposterior wall, initial episode of care heart disease, unspecified unspecified disorder of lipoid metabolism 

Answer: The patient is high likely exposed to