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, arm pain major surgical or invasive procedure: - catheter placement, coronary thrombectomy, coronary artery infusion of eptifibatide, intravascular ultrasound, coronary angiography coronary catheterization with placement of 2 bare metal stents to mid lad. history of present illness: this is a 32 year-old with a pmh significant for htn, insulin-dependent diabetes mellitus who presents with a 3-day history of chest and arm pain that developed with exertion with some exertional dyspnea and fatigue. . the patient awoke sunday () feeling well and went to the laundry mat walking 1-block with bags full of laundry and developed some exertional dyspnea and left arm pain that radiated in a pulsatile fashion to his fingers; without frank chest pain, but with some diaphoresis. when he returned home, his dyspnea improved with rest. however, his left arm pain progressed to right arm pain even while resting. this pain continued through monday and early tuesday morning he noted the left arm pain was in intensity and was sharp in character, radiating to the left shoulder and back with some chest discomfort that was constant. he presented to the bu student health center tuesday pm and they gave him aspirin 325 mg po x 2 and called ems. he was biba to the ed for further management. . in the ed, initial vs 102 114/85 20 99% 2lnc. an ekg showed sinus tachycardia @ 119, na/ni, 2--elevations in lead v2-6, 1-mm st-elevations in leads avl, i and inferior lead reciprocal changes. he received metoprolol 5 mg iv x 1, heparin bolus of 4000 units iv and ativan 2 mg po x 1. he was emergently rushed to the cardiac cath where the patient was noted to have an abrupt cut-off at the mid-lad with visible vessel thrombus of the mid-lad and distal reconstitution with distal-lad disease; underwent aspiration and ballooning of lad via rfa access (closed with angioseal). in the , he was given plavix 300 mg loading dose. integrillin gtt was started and heparin gtt was continued. in the cath he was also diaphoretic with a blood glucose of 390 mg/dl. he remained chest pain free, but had on-going arm pain following the procedure. . on arrival in the ccu, the patient has some on-going left arm pain while resting flat, but no chest pain, diaphoresis, palpitations or nausea. . cardiac review of systems is notable for absence of paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or pre-syncope. . ros: the patient denies a history of prior stroke/tia, deep venous thrombosis or pulmonary embolus. they deny bleeding at the time of prior procedures or surgeries. denies headaches or vision changes. no cough or upper respiratory symptoms. denies dizziness or lightheadedness; no palpitations. no nausea or vomiting, denies abdominal pain. no dysuria or hematuria. no change in bowel movements or bloody stools. denies muscle weakness, myalgias or neurologic complaints. no exertional buttock or calf pain. past medical history: 1. insulin-dependent diabetes mellitus (diagnosed at age 19 year-old - blood glucose runs in the 150-200 mg/dl range; takes lantus and humalog) 2. hypertension social history: patient lives at home with his wife, who is 9-weeks pregnant. he denies any smoking history. he stopped drinking 8-years ago for spiritual reasons. he is a bu graduate student who just moved here from , va/dc for graduate school studying practical theology. he notes significant stress related to semester deadlines. he denies recreational substance use. family history: denies family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death. strong family history of diabetes, hypertension and stroke. physical exam: admission exam vitals: 98.6 / 98.6 138/87 112 23 100% 2lnc general: appears in no acute distress. alert and interactive african american male. heent: normocephalic, atraumatic. eomi. perrl. nares clear. mucous membranes moist. neck: supple without lymphadenopathy. jvd difficult to assess given body habitus. cvs: pmi located in the 5th intercostal space, mid-clavicular line. regular rate and rhythm, without murmurs, rubs or gallops. s1 and s2 normal. no s3 or s4. resp: respirations unlabored, no accessory muscle use. clear to auscultation bilaterally without adventitious sounds. no wheezing, rhonchi or crackles. stable inspiratory effort. abd: soft and obese, non-tender, non-distended, with normoactive bowel sounds. no palpable masses or peritoneal signs. extr: no cyanosis, clubbing or edema, 2+ peripheral pulses derm: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: cn ii-xii intact throughout. alert and oriented x 3. strength 5/5 bilaterally, sensation grossly intact. gait deferred. pulse exam: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: admission labs: . 11:40am blood wbc-7.5 rbc-6.16 hgb-14.6 hct-46.1 mcv-75* mch-23.7* mchc-31.7 rdw-12.9 plt ct-244 11:40am blood pt-11.5 ptt-27.3 inr(pt)-1.1 11:40am blood fibrino-572* 08:00pm blood urean-10 creat-0.8 na-130* k-4.1 cl-97 05:00am blood calcium-8.7 phos-4.3 mg-2.0 . pertinent labs and studies: 08:00pm blood ck(cpk)-387* 05:00am blood ck(cpk)-275 12:36pm blood ck(cpk)-218 08:00pm blood ck-mb-7 05:00am blood ck-mb-6 ctropnt-0.32* 12:36pm blood ck-mb-4 ctropnt-0.28* 11:40am blood lipase-35 05:00am blood %hba1c-11.5* eag-283* 05:00am blood triglyc-180* hdl-35 chol/hd-3.4 ldlcalc-48 cholest-119 . cardiac cath - french xblad3.5 guide provided good support. crossed with prowater very easily into the distal lad. this did not restore flow in the apical lad and visible thrombus was seen to occlude the vessel there. administered intracoronary integrilin (180 mcg/kg x 2) and performed catheter based thrombectomy using the export catheter with significant clot removal/dissolution. administered intracoronary vasodilators. perfomed intravascular ultrasound using the atlantis catheter and this revealed mild diffuse atherosclerosis throughout the lad and residual subocclusive thrombus in the proximal lad. a choice pt xs was redirected into various branches of the distal lad and an uninflated 2.0 mm balloon was used to "dotter" across the apical vessel clot, but this did not restore flow. it was decided that we would administer 18 hours of integrilin and iv heparin for at least 48 hours rather than cause distal embolization with stent, balloon or rheolytic thrombectomy. final angiography revealed normal flow to the apical lad where there was timi 0 flow and filling via faint collaterals. there was 20-40% residual thrombus in the proximal lad. he left the laboratory in stable condition with no chest pain. . cxr - the cardiomediastinal and hilar contours are normal. the lungs are essentially clear. there is no pleural effusion or pneumothorax. impression: no acute cardiopulmonary process. echocardiogram the left atrium is mildly dilated. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). doppler parameters are most consistent with grade ii (moderate) left ventricular diastolic dysfunction. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic arch is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: suboptimal image quality. mild symmetric left ventricular hypertrophy. normal global and regional biventricular function. no evidence of intracardiac shunt with agitated saline administration. . 2d-echo - the left atrium is mildly dilated. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). doppler parameters are most consistent with grade ii (moderate) left ventricular diastolic dysfunction. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic arch is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: suboptimal image quality. mild symmetric left ventricular hypertrophy. normal global and regional biventricular function. no evidence of intracardiac shunt with agitated saline administration. . cardiac cath: findings: estimated blood loss: <100 cc hemodynamics (see above): coronary angiography: left dominant lmca: no angiographically-apparent cad. lad: unchanged 60-80% subocclusive thrombus proximal lad. visible thrombus in apical lad with "train track" appearance with some flow in apex. lcx: no angiographically-apparent cad. rca: not injected. known nondominant and free of disease. . interventional details xb3 guide. crossed with prowater wire and performed ivus interrogation using the infraredx catheter. this demonstrated significant thrombus in the proximal lad with a rvd of 5.1 cm. there was very little atheroma. the decision was made to proceed with direct stenting. a 4.0 x 22 mm integriti stent was deployed and postdilated with a 5.0 mm balloon and residual thrombus was visible distal to this stent and thought to be due to uncovered (rather than due to prolapse or "toothpasting") thrombus. a distal overlapping 4.0 x 15 mm integriti stent was deployed and postdilated to 5.0 mm. final angiography revealed normal flow, no dissection and 0% residual stenosis in the stent, no thrombus in the lad up to the apex and no change in the apical lad appearance. . assessment & recommendations 1. secondary prevention cad, chf. 2. plavix (clopidogrel) 75 mg daily x 12 months. 3. heparin at 1700 u/hr as bridge to therapeutic warfarin. 4. suggest warfarin inr . 5. asa 81 mg qd. 6. consider cardiac mri. . 2d-echo - the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. no mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. compared with the prior study (images reviewed) of three days ago, , the findings are similar. medications on admission: 1. lantus 16 units sc at nighttime 2. humalog 20 units sc prior to meals 3. metformin 1000 mg po bid 4. hctz 12.5 mg po daily 5. lisinopril 10 mg po daily discharge medications: 1. insulin glargine 100 unit/ml solution sig: eighteen (18) units subcutaneous at bedtime. 2. insulin lispro 100 unit/ml solution sig: twenty (20) units subcutaneous three times a day, prior to meals. 3. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. 4. hydrochlorothiazide 12.5 mg tablet sig: one (1) tablet po once a day. 5. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. outpatient physical therapy outpatient physical therapy for mechanical left shoulder pain. 9. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: may repeat every 5 minutes for a maximmum of 3 doses (15 minutes of treatment). disp:*30 tablet, sublingual(s)* refills:*1* 10. warfarin 7.5 mg tablet sig: one (1) tablet po once a day: you labs will have to be drawn while on this medication. disp:*30 tablet(s)* refills:*0* 11. enoxaparin 120 mg/0.8 ml syringe sig: one (1) syringe subcutaneous q12h (every 12 hours): continue until dr. tells you to stop. disp:*14 syringe* refills:*0* 12. metoprolol succinate 100 mg tablet extended release 24 hr sig: two (2) tablet extended release 24 hr po daily (daily). disp:*60 tablet extended release 24 hr(s)* refills:*2* 13. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 14. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 15. outpatient radiology cardiac mri one month from discharge. 16. outpatient radiology outpatient echo within the next month. 17. outpatient work pt/inr on wednesday . please fax results to dr. at . discharge disposition: home discharge diagnosis: primary diagnoses: 1. acute anterolateral st-segment elevation myocardial infarction 2. grade ii, diastolic heart dysfunction . secndary diagnoses: 1. insulin-dependent diabetes mellitus 2. hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: patient discharge instructions: . you were admitted to the coronary care unit (ccu) at on 6 regarding management of your chest pain and shortness of breath. you were found to have an anterolateral st-segment elevation myocardial infarction (heart attack) and went to the cardiac catheterization urgently where we attempted to remove the thrombus or clot in your heart artery. you were medically managed with anti-platelet therapy and anticoagulants following your first procedure and a second catheterization was planned. this showed persistent clot in your heart artery and required 2 bare metal stents be placed in that artery. you chest pain resolved and you were monitored without any additional events. . please call your doctor or go to the emergency department if: * you experience new chest pain, pressure, squeezing or tightness. * you develop new or worsening cough, shortness of breath, or wheezing. * you are vomiting and cannot keep down fluids, or your medications. * if you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include: dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit, or have a bowel movement. * you experience burning when you urinate, have blood in your urine, or experience an unusual discharge. * your pain is not improving within 12 hours or is not under control within 24 hours. * your pain worsens or changes location. * you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. * you develop any other concerning symptoms. . changes in your medication reconciliation: . * upon admission, we added: aspirin 325mg by mouth daily for one month. following this, you should take 81mg by mouth daily. plavix (clopidogrel) 75mg by mouth daily for 1 year metoprolol extended release 200mg by mouth daily nitroglycerin sublingually 0.4 as needed for chest pain atorvastatin 80mg by mouth daily lovenox 120mg injection twice daily until our primary care doctor tells you to stop. warfarin 7.5mg by mouth daily at 4pm iron 300mg by mouth twice daily. . * the following medications were changed on admission: take lisinopril 20mg daily (you were previously on 10mg daily) . * you should continue all of your other home medications as prescribed, unless otherwise directed above. you will need a follow up cardiac mri and echo. followup instructions: please call dr. office to schedule a follow up cardiology appointment. you should be seen by dr. in the next 7-10days. his office can be reached at: (. name: he, md location: diabetes center address: , phone: appointment: wednesday 2:00pm *your appointment will be about 2-3 hours long. you will be meeting with an educator as well as the doctor. . primary care: department: when: thursday at 8:20 am with: , md building: campus: east best parking: garage . cardiology: department: cardiac services when: wednesday at 9:00 am with: , md building: campus: east best parking: garage procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization left heart cardiac catheterization transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension acute myocardial infarction of anterolateral wall, initial episode of care unspecified disease of pericardium long-term (current) use of insulin obesity, unspecified diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled heart disease, unspecified family history of diabetes mellitus family history of other cardiovascular diseases family history of stroke (cerebrovascular) 

Answer: The patient is high likely exposed to