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: patient recorded as having no known allergies to drugs attending: chief complaint: fatigue, dyspnea on exertion major surgical or invasive procedure: cardiac catheterization with stent placed at left anterior descending artery history of present illness: yo woman with htn brought to ed from her facility after c/o several weeks of doe after walking across the room, fatigue. history is difficult to obtain from pt secondary to dementia, most history is provided by nephew. chest pain, dizziness, paraesthesias. past medical history: dementia kyphosis hypertension social history: lives in facility no tobacco physical exam: t 98.0 hr 80s bp 110/80 rr 14 94% ra no acute distress, obese, oriented to person only no jvd cardiac exam rrr nl s1s2 no mrg soft b/l basilar rales abdomen soft no nd nabs extremities with trace edema pertinent results: echo: measurements: left atrium - long axis dimension: *4.7 cm (nl <= 4.0 cm) left atrium - four chamber length: *5.5 cm (nl <= 5.2 cm) right atrium - four chamber length: 4.9 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: *1.3 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: *1.2 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.5 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 3.3 cm left ventricle - fractional shortening: *0.27 (nl >= 0.29) left ventricle - ejection fraction: 35% (nl >=55%) aorta - valve level: 2.9 cm (nl <= 3.6 cm) mitral valve - e wave: 0.8 m/sec mitral valve - a wave: 0.8 m/sec mitral valve - e/a ratio: 1.00 mitral valve - e wave deceleration time: 183 msec tr gradient (+ ra = pasp): *45 to 50 mm hg (nl <= 25 mm hg) interpretation: findings: left atrium: mild la enlargement. right atrium/interatrial septum: normal ra size. left ventricle: mild symmetric lvh. normal lv cavity size. moderately depressed lvef. no lv mass/thrombus. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic root diameter. aortic valve: mildly thickened aortic valve leaflets. trace ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. moderate (2+) mr. tricuspid valve: moderate to severe tr. moderate pa systolic hypertension. pericardium: no pericardial effusion. conclusions: 1. the left atrium is mildly dilated. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is moderately depressed. anterior, distal septal, apical, distal lateral, and distal infeior akinesis is present. 3. the aortic valve leaflets are mildly thickened. trace aortic regurgitation is seen. 4. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. 5. moderate to severe tricuspid regurgitation is seen. 6. there is moderate pulmonary artery systolic htn. . . cardiac catheterization procedure: right heart catheterization: was performed by percutaneous entry of the right femoral vein, using a 7 french pulmonary wedge pressure catheter, advanced to the pcw position through a 8 french introducing sheath. cardiac output was measured by the fick method. left heart catheterization: was performed by percutaneous entry of the right femoral artery, using a 6 french right catheter, advanced to the ascending aorta through a 6 french introducing sheath. coronary angiography: was performed in multiple projections using a 6 french xblad 3.5 and a 6 french jr4 catheter, with manual contrast injections. visualization of the left coronary artery was repeated after the i.c. administration of 50 mcg of nitroglycerine. percutaneous coronary revascularization was performed using placement of drug-eluting stent(s). conscious sedation: was provided with appropriate monitoring performed by a member of the nursing staff. hemodynamics results body surface area: 1.62 m2 hemoglobin: 10.7 gms % fick **pressures right atrium {a/v/m} 25/26/24 right ventricle {s/ed} 55/25 pulmonary artery {s/d/m} 55/30/41 pulmonary wedge {a/v/m} 32/33/31 aorta {s/d/m} 131/68/94 **cardiac output heart rate {beats/min} 70 rhythm sinus o2 cons. ind {ml/min/m2} 125 a-v o2 difference {ml/ltr} 81 card. op/ind fick {l/mn/m2} 2.5/1.5 **resistances systemic vasc. resistance 2240 pulmonary vasc. resistance 320 **% saturation data (nl) svc low 42 pa main 43 ao 99 other hemodynamic data: the oxygen consumption was assumed. **arteriography results morphology % stenosis collat. from **right coronary 1) proximal rca normal 2) mid rca normal 2a) acute marginal normal 3) distal rca normal 4) r-pda normal 4a) r-post-lat normal **arteriography results morphology % stenosis collat. from **left coronary 5) left main normal 6) proximal lad discrete 100 12) proximal cx normal 13) mid cx normal 13a) distal cx normal 14) obtuse marginal-1 discrete 70 15) obtuse marginal-2 normal 16) obtuse marginal-3 normal **ptca results lad **baseline stenosis pre-ptca 100 **technique ptca sequence 1 guiding cath xblad 3. guidewires choice p initial balloon (mm) 2.5 x 15 final balloon (mm) 2.5 x 24 # inflations 8 max pressure (psi) 270 **result stenosis post-ptca 0 success? (y/n) y ptca comments: we elected to treat the totally occluded proximal lad with ptca/stenting using heparin and integrilin prophylactically. a choice ptxs wire crossed into the lad with significant difficulty (a wizdom ss wire and several pt intermediate wires would not cross). a 2.5 x 15 mm voyager was used to predilate in five inflations at 8-9 atm. an export catheter would not cross beyond the proximal lad, but suctioning of this area resulted in minor improvement in flow. a 2.5 x 24 mm taxus des was deployed proximally and into the mid-lad at 12 atm, and another 2.5 x 24 mm taxus des was deployed in overlapping fashion more distally at 12 atm. the second sds was used to post-dilate the overlap area at 18 atm. there was significant spasm and no-reflow in the , intracoronary nitroglycerin and nitroprusside were adminstered through the guide, and more intracoronary nitroprusside was administered through the lumen of a 2.0 x 30 mm maverick positioned just distal to the second stent. final angiography demonstrated no dissection, no residual stenosis within the stented segments with loss of a major diagonal branch (closed at the start of the case), and timi-3 flow into a diffusely diseased distal lad. technical factors: total time (lidocaine to test complete) = 1 hour 38 minutes. arterial time = 1 hour 34 minutes. fluoro time = 43.1 minutes. contrast: non-ionic low osmolar (isovue, optiray...), vol 175 ml, indications - hemodynamic premedications: asa 325 mg p.o. anesthesia: 1% lidocaine subq. anticoagulation: heparin 1000 units iv other medication: fentanyl 12.5 mcg iv furosemide 80 mg iv integrilin 10 cc iv bolus integrilin 4.5 cc/hr nitroprusside 550 mcg ic plavix 300 mg po cardiac cath supplies used: .014 cordis, wizdom ss 300 .014 , pt , 300cm .014 , pt , 300cm 2.5 guidant, voyager 15 2.0 , maverick, 30 6f cordis, xblad 3.5 2.5 , taxus express 2 otw, 24 2.5 , taxus express 2 otw, 24 3f , export aspiration catheter comments: 1. selective coronary angiography demonstrated a right dominant system with two cad. the left main had mild disease. the lad had a 70% lesion at it's origin and a 100% proximal occlusion. the left circumlfex artery had a 70% lesion in the om1 branch. the rca had mild disease. 2. resting hemodynamics demonstrated markedly elevated right and left sided filling pressures with a mean ra pressure of 24 mm hg and mean pcwp of 31 mm hg. moderate pulmonary hypertension was present. the cardiac index was markedly reduced, based on an assumed oxygen consumption index. central aortic pressure was normal. 3. left ventriculography was not performed. 4. successful pci of the lad with two overlapping taxus des (2.5 x 24 mm and 2.5 x 24 mm). final diagnosis: 1. two coronary artery disease. 2. markedly reduced cardiac index with elevated left and right sided filling pressures but normal central aortic pressure. 3. acute anterior stemi treated with primary pci. . . 10:36pm ck(cpk)-606* 10:36pm ck-mb-58* mb indx-9.6* brief hospital course: the patient is a year old woman with hypertension, hyperlipidemia, and no known cad. she presented to the emergency department with dyspnea. ecg demonstrated anterior stemi. after a discussion with the patient's nephew, the patient was brought to the catheterization laboratory where she was found to have occlusion of the lad with 80% stenosis at om1. she had a cypher stent placed to the lad. she was found to have a low cardiac index with low mvo2 during catheterization. she was diuresed 1 liter over the course of her hospitalization which she tolerated well, and resulted in marked improvement in her oxygenation. hospitalization was complicated by increased bleeding at access site after catheterization, for which hemostasis was eventually obtained but integrellin was discontinued early. her hematocrit remained stable. as post mi echo showed akinesis, pt was started on coumadin for a 6 month course after determining she was not a fall risk with physical therapy and with her pcp. was also found to have a uti for which she was treated with levaquin. medications on admission: zyprexa, lipitor discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 3. sertraline hcl 50 mg tablet sig: 0.5 tablet po daily (daily). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). 7. olanzapine 5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 8. atorvastatin calcium 20 mg tablet sig: two (2) tablet po daily (daily). discharge disposition: extended care facility: for the aged - acute rehab discharge diagnosis: acute myocardial infarction dementia hypertension discharge condition: stable discharge instructions: return to the emergency department if you develop chest pain, shortness of breath, or dizziness. followup instructions: dr. partner will see you while you are at rehab. dr. will see you once you are back at . . you will follow up with a cardiology appointment at out patient clinic with provider: , .d. where: cardiac services phone: date/time: 11:00 . ***** to follow up: 1) patient started on lasix 40mg qd, as well as potassium. please monitor cr levels and potassium levels. at time of discharge, cr is 1.5. 2) patient recently started on coumadin 5mg qd. at time of discharge, inr is 1.4 (after 2 doses of coumadin). she is being discharged on 3mg dose qd. import follow-up instructions follow-up instructions: procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor transfusion of packed cells insertion of drug-eluting coronary artery stent(s) diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute myocardial infarction of other anterior wall, initial episode of care other persistent mental disorders due to conditions classified elsewhere diseases of tricuspid valve kyphosis (acquired) (postural) 

Answer: The patient is high likely exposed to