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: penicillins attending: chief complaint: s/p rca pci, hypotension major surgical or invasive procedure: 3/7/09-3 drug eluting stents to the right coronary artery history of present illness: the pt is a 67y/o m with a pmh of cad s/p multivessel ptca , recently underwent catheterization for angina on demonstrating a 90% proximal rca lesion along with a 90% mid rca lesion with an aneurysmal section between the two lesions. at that time the proximal lesion was dilated with balloon angioplasty but attempts to dilate the distal lesion were unsuccessful due to an inability to cross the lesion with a balloon. he presented today for repeat attempt at intervention on the distal lesion of his rca and possible stenting of the proximal lesion. . coronary angiography revealed an rca with serial 70-90% calcific disease with proximal aneurysmal disease. rotational atherectomy was performed followed by baloon angioplasty. 3 overlapping xience stents were placed. final angiography revealed normal flow with no dissection or residual stenosis in the stents. post procedure the patient became hypotensive with sbp to 70s. dopamine was started at 10mcg/kg then weaned off. pt received 2.5l ivf total, dopamine was restarted at 5mcg/kg. small hematoma noted in l groin. . on arrival to the ccu the patient is resting comfortably in no acute distess. denies chest pain or shortness of breath. denies n/v, no lightheadedness. the pt reports he has not exerted himself since discharge and has noted no chest discomfort. he has no peripheral edema or claudication. no cough, fever, myalgias, arthralgias, headache or rash. the rest of the review of systems is negative in detail. past medical history: hypertension hyperlipidemia cad, s/p poba x 5 vessels in 5/93 followed by atherectomy x 2 vessels in , rca pci polypectomy anemia anxiety arthritis tonsillectomy calcified hematoma on the lateral right knee, s/p resection pilonidal cyst, s/p removal s/p sebaceous cyst removal from social history: he is married with three grown children. he does not smoke and drinks glasses of etoh per day. he is a retired financial manager for a defense contractor. family history: his uncle died of mi at age 46; another uncle had cabg in his 60s and died of a mi in his 70s. his wife ??????s cell phone # is . physical exam: vitals: t 97.1, hr 79, bp 93/54, rr 11 o2 99% ra gen: alert and oriented x3, nad heent: mmm cv: rrr, no mrg, no s3/s4, flat jvp resp: ctab no w/r/r abd: soft, nt/nd, nabs, l groin - small hematoma, no oozing ext: no edema, 1+ pt/dp pulses pertinent results: 12:00am hct-27.7* 04:05pm glucose-118* urea n-13 creat-0.7 sodium-141 potassium-3.9 chloride-109* total co2-26 anion gap-10 04:05pm estgfr-using this 04:05pm ck(cpk)-31* 04:05pm ck-mb-notdone ctropnt-<0.01 04:05pm calcium-8.1* phosphate-2.8 magnesium-1.6 04:05pm wbc-10.6# rbc-3.69* hgb-12.1* hct-33.0* mcv-89 mch-32.7* mchc-36.6* rdw-13.7 04:05pm neuts-87.6* lymphs-8.5* monos-3.3 eos-0.4 basos-0.2 04:05pm plt count-221 04:05pm pt-14.2* ptt-28.4 inr(pt)-1.2* 12:30pm hct-31.3* . ecg: - sinus bradycardia rate 54bpm, pr prolonged at 218ms, nl axis, no st changes. . catheterization : 1. planned pci with access via 7f long sheath in left femoral artery. we used long sheath due to iliac tortuosity. 2. limited hemodynamics with bp 110/65 with hr 59 in sinus initially. patient did require transient pacing during rotational athrectomy. at the end of the procedure patient had a profound vagal episode requiring atropine and dopamine for a few minutes. this was thought to be due to blood loss during long procedure as well as bladder distention. 3. stenting of rca with 3 overlapping xience 28mm stents after rotational athrectomy with a 1.25mm burr. the distal stents are 2.5mm and the most proximal stent was 3mm posted to 4mm in aneurysmal segment and at the ostium. 4. patient transferred to ccu for monitoring after sheath pull manually in the holding area. final diagnosis: 1. one vessel coronary artery disease. 2. complex intervention to rca with rotational athrectomy and 3 drug eluting stents. . catheterization : 1. coronary angiography of this right dominant system revealed single vessel coronary artery disease. the lmca had no obstructive lesions. the lad and lcx had minimal luminal irregularities. the rca had a proximal 90% stenosis leading into a large aneurysm, followed by diffuse disease in the mid-segment. 2. limited resting hemodynamics revealed normal systemic arterial blood pressure (sbp 123 mm hg) and left ventricular filling pressure (lvedp 11 mm hg). there was no gradient upon pullback of the catheter from the lv to the aorta. 3. left ventriculography was deferred. 4. successful ptca of the proximal rca with a 2.5mm balloon (see ptca comments). final diagnosis: 1. single vessel coronary artery disease. 2. successful ptca of the proximal rca. brief hospital course: the patient is a 67y/o m with a pmh of cad s/p multivessel ptca , known complex rca lesion with 90% proximal and 90% mid rca lesion with an aneurysmal section between the two lesions, s/p balloon angioplasty and 3 drug eluting stents with procedure complicated by hypotension. . #. hypotension - the patient developed hypotension during rotational atherectomy requiring atropine and dopamine, dopamine was weaned off during the case however he became hypotensive again following arterial sheath pull. pt developed small l groin hematoma however hct stable on recheck. etiology most likely vagal related to procedure. weaned off dopamine after map>60. pt received 2l ivf post-procedure, continue ivf prn. cycled hct to rule out bleed which was stable. monitored groin site for expansion of hematoma which was stable. . #. cad - s/p multivessel ptca , known complex rca lesion with 90% proximal and 90% mid rca lesion with an aneurysmal section between the two lesions, s/p balloon angioplasty and 3 xience stents to rca today. continue asa, plavix. intergrilin hold post procedure given l groin hematoma. metoprolol and accupril held while hypotensive but once stabilized were restarted. continued statin. . #. hypertension - restarted lower dose of metoprolol because of hypotension at 25mg po bid and then readded accupril. . #. hyperlipidemia - continue statin . #. anemia: h/o this per pt but reports hct stable over many years with no intervention needed. stable in mid-30s. post cath stable at 26. . #. general care- cardiac/diabetic diet, replete lytes prn, access - piv x 2, prophylaxis - heparin sc, bowel regimen, code - full. discharged when clinically improved. medications on admission: clopidogrel 75 mg tablet one tab daily diazepam 5 mg tablet 1 tab daily metoprolol tartrate 50 mg tablet mulitvitamin 1 tablet once a day nitroglycerin 0.4 mg tablet prn accupril 10 mg tablet daily simvastatin 10 mg tablet daily aspirin 325 mg tablet daily b-complex with vitamin c tablet daily docusate sodium 100 mg capsule daily discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 5. quinapril 5 mg tablet sig: two (2) tablet po daily (daily). 6. multivitamin capsule sig: one (1) capsule po once a day. 7. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) sublingual q5min as needed for chest pain. 8. diazepam 5 mg tablet sig: one (1) tablet po once a day. 9. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). discharge disposition: home discharge diagnosis: primary: coronary artery disease hypotension hyperlipidemia discharge condition: stable, on room air, ambulating without assistance discharge instructions: you were admitted to fix the blockage in your right coronary artery. this was successful by cardiac catheterization and you now have 3 stents to this artery to open up the blood flow. . we have decreased your metoprolol from 50mg twice a day to 25mg by mouth twice a day. please continue taking your aspirin and plavix and do not stop taking these medications unless directed to do so by a physician or there can be serious consequences to your health including death. . follow up: provider: , md phone: date/time: 2:40 please also call to schedule a follow up appointment with your primary care doctor, dr. within the next month. . . if you develop any of the following, chest pain, shortness of breath, cough, sweating, fever/chills, nausea, vomiting, diarrhea or lightheadedness please call your doctor of go to your local emergency room. followup instructions: provider: , md phone: date/time: 2:40 please also call to schedule a follow up appointment with your primary care doctor, dr. within the next month. . procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents diagnoses: other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery unspecified essential hypertension percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia anxiety state, unspecified other postprocedural status arthropathy, unspecified, site unspecified 

Answer: The patient is high likely exposed to