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: chest pain major surgical or invasive procedure: cardiac catherization central line (cordis) placement with swan-ganz history of present illness: 30 yom with no pmh, p/w to osh on with mid-sternal cp, in severity in the setting of cocaine and alcohol use. he also was taking klonopin (not prescribed to him, obtained from friends) the days prior to presentation. in osh ed, his initial vitals were 38 128 120/67 24 98% on 15l nrb 97.5kg. he was noted to have ste in the anterior leads on the ecg. he had an episode of seizure like activity and went into pea which after cpr converted to torsade/vf. he was given 4g of magnesium and was shocked back to normal rhythm. total time was approx. 15 minutes. he also recieved 6mg ativan, 324 asa, lidocaine bolus, integrillin load and gtt, heparin load and gtt, and was placed on nitro gtt. he has a l tibial osteo-line. fsg was 210. other pertinent labs were: na of 145, k 3.5, hco3 18, ca 9.8, creatinine 1.5, glucose 176, wbc 21.6, hct 47.8, ck 382, mb 3.7, trop 0.01, toxic screen was negative. . on transfer to ed, he was noted to: 103 99/73 16 100% nrb. he was given phentolamine x1, sent to cath lab. he was noted to have a a prox. lad thrombus with complete occlusion that resolved with suction. . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: diabetes (-), dyslipidemia (-), hypertension (-) 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: none. social history: -tobacco history: yes -etoh: yes -illicit drugs: yes family history: + father and sister - protein s deficiency, father had early strokes in his 40's, htn. no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: general: wdwn, in nad. disoriented. heent: ncat, bloody sclera. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. 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. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ . pertinent results: 06:04am blood wbc-10.0 rbc-3.91* hgb-11.9* hct-34.4* mcv-88 mch-30.4 mchc-34.6 rdw-14.2 plt ct-250 04:29am blood neuts-90.0* lymphs-7.2* monos-2.5 eos-0 baso-0.3 06:04am blood pt-18.2* ptt-52.4* inr(pt)-1.6* 06:04am blood glucose-98 urean-19 creat-1.0 na-137 k-4.1 cl-102 hco3-22 angap-17 06:04am blood ck(cpk)-5435* 06:29am blood alt-48* ast-133* ld(ldh)-1103* ck(cpk)-9112* alkphos-37* totbili-0.8 03:02pm blood ck(cpk)-8561* 08:26pm blood ck(cpk)-4287* 08:11am blood alt-128* ast-811* ck(cpk)-* alkphos-46 totbili-1.4 04:29am blood ck(cpk)-7946* 06:04am blood ck-mb-5 01:54am blood ck-mb-11* mb indx-0.2 06:43am blood ck-mb-58* mb indx-1.3 ctropnt-12.07* 03:59pm blood ck-mb-315* mb indx-3.6 04:29am blood ck-mb-493* mb indx-6.2* ctropnt-22.18* 06:04am blood calcium-8.7 phos-4.6* mg-2.2 08:11am blood triglyc-61 hdl-31 chol/hd-4.9 ldlcalc-110 ldlmeas-109 . c cath comments: 1- selective coronary angiography of this right-dominant system demonstrated acute thrombotic occlusion of the proximal lad and timi 0 flow throuhghout the lad system beyong the occlusion. the lcx and rca were free from angiographic disease. 2- limited resting hemodynamic assessment showed markedly elevated left-sided filling pressures (mpcwp 25 mmhg), normal right-sided filling pressures (rvedp 5 mmhg), mild pulmonary htn (36/26 mmhg) and preserved cardiac output (5.3 l/min) and cardiac index (2.5 l/min/m2). 3- successful percutaneous thrombectomy of the lad and diagonal with restoration of timi 3 flow. final angiography showed no stenotic lesions at the thrombus site. no dissection or distal emboli. 4- successful deployment of a 6 french angioseal to the rcfa. . final diagnosis: 1. complete thrombotic occlusion of the proximal lad. 2. successful percutaneous thrombectomy of the lad and diagonal branch 3. successful deployment of a 6 french angioseal closure device . tte the left atrium is mildly dilated. left ventricular wall thicknesses and cavity size are normal. there is severe regional left ventricular systolic dysfunction with akinesis of the mid to distal anterior wall, anterior septum and lateral wall. the basal anterior and anteroseptal, distal inferior and inferolateral segments are hypokinetic. a left ventricular thrombus cannot be excluded. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. . impression: severe focal lv systolic dysfunction consistent with large lad territory infarction. no significant valvular abnormality seen. ef 20% brief hospital course: in brief, this is a 30 year old man with history of cocaine abuse who presented with stemi and found to have a lad thrombus. his stemi was associated with cocaine and etoh use. he is currently s/p thrombectomy. his post cath course was complicated by cardiogenic shock and a swan-ganz was placed for monitoring. his shock improved with furosemide diuresis and afterload reduction with acei. he was also noted to have mild respiratory distress that was atributed to a combination of pulmonary edema and atelectasis. also, the patient experienced two episodes of emesis while hospitalized and there was concern for aspiration pneumonia. he was empirically treated with levofloxacin and metronidazole. his respiratory status improved with these interventions. post catheterization the patient was mantained on therapeutic anticoagulation with heparin gtt and bridged to warfarin. the reason for this intervention was his low ef of 20% with anterior/apical akinesis and subsequent concern for lv thrombosis. of note, upon initial presentation to osh ed, he experienced a cardiac arrest with torsades de pointes/vf, which was treated with defibrillation and magnesium. he remained in sinus rhythm during this hospitalization. given his etoh abuse he was maintained on a diazepam scale for withdrawl symptoms. the medical regimen on discharge includes asa, metoprolol, lisinopril, clopidogrel, atorvastatin, epleronone, furosemide and warfarin. he was strongly advised to abstain from cocaine and alcohol abuse in order to prevent further morbitity. dr. , the patient's pcp, notified via email of this hospitalization. medications on admission: n/a discharge medications: 1. 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:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily): for one month. disp:*30 tablet(s)* refills:*0* 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. eplerenone 50 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. metoprolol succinate 25 mg tablet sustained release 24 hr sig: 0.5 tablet sustained release 24 hr po qam (once a day (in the morning)). disp:*15 tablet sustained release 24 hr(s)* refills:*0* 7. warfarin 1 mg tablet sig: three (3) tablet po once daily at 4 pm. disp:*90 tablet(s)* refills:*0* 8. lisinopril 5 mg tablet sig: three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: - st-elevation myocardial infarction - acute systolic heart failure - cardiogenic shock secondary diagnoses: - substance abuse discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: you were seen at for heart attack complicated by shock and fluid in the lungs. you were hospitalized in the intensive care unit for several days, during which time we were able to improve your breathing and heart function. at discharge, your heart function is at approximately one-third of normal from your heart attack. we believe your heart attack was likely due to your substance abuse. in the future, it is vitally important that you abstain completely from all illicit drugs as well as smoking. you will need to continue to follow up with a cardiologist regularly as well as your primary physician in order to adjust your medications. these medications are very important in order to preserve your remaining heart function. you will need to weigh yourself daily in order to assess for fluid retention. if you gain greater than lbs. suddenly, notify your pcp as this could indicate your heart failure is worsening. the following medications have been changed: added aspirin for your heart added atorvastatin for your heart added plavix for your heart added eplerenone for your heart added furosemide to remove excess fluid added lisinopril for your heart added metoprolol succinate for your heart added warfarin to prevent blood clots please do not take your warfarin today. start tomorrow (). take all other medications as prescribed. if you experience fevers, shortness of breath, chest pain, or any other symptoms that concern you, please contact your pcp or go to the emergency room. followup instructions: you will need to follow up with your primary care physician, . , in one week. at that time, you will need to have your blood checked to see if it is appropriately thinned from the warfarin. this medication may need to be adjusted. you can contact his office at to set up an appointment. you will need to follow up with dr. for your cardiology follow-up. this follow up is being scheduled for you. you will be contact with the date of your appointment. if you are not notified within 3-4 days as to the date of your appointment, please to set up an appointment in weeks. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor pulmonary artery wedge monitoring excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: congestive heart failure, unspecified other pulmonary insufficiency, not elsewhere classified acute myocardial infarction of anterolateral wall, initial episode of care pulmonary collapse pneumonitis due to inhalation of food or vomitus cardiogenic shock fever, unspecified primary hypercoagulable state acute systolic heart failure hematemesis cocaine abuse, continuous acute alcoholic intoxication in alcoholism, continuous 

Answer: The patient is high likely exposed to