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: theophylline acetate attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization history of present illness: mr. is a 75m with a pmh s/f type ii dm, htn, and schizophrenia who presented with a chief complaint of substernal chest pain at 6pm on . the pain started today at about 2pm when the patient was resting. he describes substernal chest discomfort that radiated to his left arm, constant in nature, in severity, assoicated with nausea, and light headedness. he denies any sob, palpitations, or vomiting. he does report that he gets a similar sensation with exertion (walking), which is relieved with "relaxing". ros in notably negative for any orthopnea or lower extremity edema, although the patient does report occasional pnd. . in the ed, his ekg was consistent with an anterior stemi. cks were 111 with an mb fraction of 6, and troponin was 0.07. he recieved 5mg iv morphine, 325mg asa, 0.8mg sl nitroglycerin, and 5mg iv metoprolol. a code stemi was called, and the patient was given a 5000 unit bolus of heparin, 600mg of , eptifibitide drip was started, and he was taken immediately to the cath lab. . in the cath lab, he had an episode of vf vs polymorphic vt for ~13seconds where he was unresponsive and pulseless. this resolved with one shock. the patient was loaded with 100mg of lidocaine followed by a drip at 2mg/hr. cardiac catheterization revealed 99% stenosis at the lad into which a bms was placed. integrillin had to be stopped secondary to gum bleeding. . on review of systems, 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. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for exertional chest pain, and occaisiona pnd. he denies any orthopnea, palpitions, syncope or presyncope. past medical history: 1. cardiac risk factors: diabetes, hypertension 2. cardiac history: none 3. other past medical history: type ii dm htn schizophrenia depression social history: -tobacco history: smokes cigarettes for "many years", although he cannot quantitate this. he also smokes a pipe. he denies any alcohol, or illicits. -etoh: denies -illicit drugs: denies no next of or family in the u.s. pt. is from originally. family history: no family history of early mi, otherwise non-contributory. mother had an mi at the age of 85 physical exam: vs: t=97.8...bp=139/89...hr=59...rr=17...o2 sat=98%ra general: elderly male, appears his stated age, +tarditive dyskynesia heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp ~11cm 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: diffuse bilateral inspiratory and expiratory wheezes. no stridor. 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: chest ct: atherosclerotic calcifications are noted along the thoracic aorta as well as along the coronary arteries. calcifications in the mediastinum and left perihilar region are consistent with calcified lymph nodes. mediastinal lymph nodes measure up to 11 mm in short axis in the ap window. trace pericardial fluid or pericardial thickening is noted anteriorly. there is no evidence of pneumothorax or pleural effusion. the central airways are patent. patchy ground-glass opacities predominantly in the right lower lobe are noted. while the current study is not designed for subdiaphragmatic diagnosis, note is made of splenic artery calcifications. osseous structures: no region of bony destruction is seen concerning for malignancy. multilevel degenerative changes are noted, with predominantly anterior osteophyte formation. impression: right lower lobe patchy infiltrate consistent with pneumonia. c. cath 1. multi-vessel coronary artery disease. 2. acute anterior myocardial infarction treated with ptca and stenting of the mid lad with a bare metal stent. 3. successful closure of the right femoral arteriotomy site with a 6f mynx closure device. cardiac echo: the left atrium is moderately dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild to moderate regional left ventricular systolic dysfunction with severe hypokinesis of the mid- and distal segments of anterior wall and septum, and akinesis of the apex. there is a 2.8 x 0.9 cm echodensity at the lv apex, suspicious for a thrombus (cine loops #40-41), although image quality is poor and this could also be an artifact. transmitral doppler and tissue velocity imaging are consistent with grade ii (moderate) lv diastolic dysfunction. 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. there is no pericardial effusion. estimated pulmonary pressures are normal. impression: mild to moderate regional left ventricular systolic dysfunction, c/w cad. possible lv apical thrombus. 06:31pm blood wbc-7.7 rbc-6.46* hgb-14.8 hct-44.8 mcv-69* mch-22.8* mchc-33.0 rdw-15.4 plt ct-208 06:31pm blood neuts-57.6 lymphs-33.9 monos-6.4 eos-1.5 baso-0.7 06:31pm blood pt-12.3 ptt-26.0 inr(pt)-1.0 07:00pm blood glucose-171* urean-6 creat-1.1 na-132* k-3.2* cl-98 hco3-26 angap-11 02:38am blood alt-42* ast-167* ld(ldh)-391* ck(cpk)-1120* alkphos-56 totbili-1.2 02:38am blood ck-mb-103* mb indx-9.2* ctropnt-4.28* 07:00pm blood %hba1c-6.6* 07:04pm blood glucose-170* lactate-2.6* na-134* k-3.4* brief hospital course: 75 year-old man with a pmh schizophrenia s/p stemi w/ pci to lad. echo demonstrated apical hypokinesis with wall thrombus. . # coronary artery disease: patient presented to ed with chest pain. ecg demonstrated anterior st elevations and a code stemi was called. patient recieved ptca with bare metal stent (bms) to the lad. his ck peaked at 1120 and tropt peaked at 4.28. he was started on asa, plavix and atorvastatin 80mg. he did not have any further chest pain and st elevations began to resolve on night of cath. he was counseled repeatedly for > 4 minutes regarding smoking cessation. . # apical hypokinesis/thrombus: after intervention, trans thoracic echo was obtained and showed apical hypokinesis with wall thrombus. patient started on coumadin with lovonex bridge. can discontinue lovonex when inr therapeutic (). continue anti-couagulation until cardiac follow-up with dr. 3 pm (. echo scheduled for at 10am, results will be followed up with dr. who will decide whether anti-coagulation should be continued or thrombus has resolved. . # rhythm: had a brief episode of polymorphic vt vs. vf in the cath lab, likely ischemia mediated. now revascularized without any more ectopy. b-blocker decreased to toprol 100 mg due to pr prolongation. . # hemoptysis: noted after ptca in setting of gingival bleeding after peri-procedural anticoagulation. this however self resolved. a ppd was placed and was non reactive. chest ct did not show an obvious malignancy. sputum cultures were obtained and were negative and sputum cytology was also negative for malignant cells. no further workup is warranted at this time. no fever or leukocytosis suggestiong pneumonia therefore was not started on antibiotics. .. # agitation / diaphoresis : became extremely agitated with holding antipsychotics. differential diagnosis included serotonin syndrome, alcohol withdrawal and psychotic agitation. patient improved with benzodiazepines and although no clear etiology was elucidated, these episodes did not recurr. . #. schizophrenia: inpatient psychiatry consulted after patient began having episodes of agitation. we proceeded with recommendation to continue aripiprazole per home regimen, although patient refused taking this on a regular basis given concerns for gait instability. at time of discharge, patient agreed to take perphenazine 2 mg tablet sig: one (1) tablet po tid (3 times a day). monitor for worsening tremors or signs of ems. contact outpatient psychiatrist if any questions. . # diabetes: during admission, we maintained glucose control with sliding scale insulin. anjust as needed at rehab, could be started on oral agents. .. # htn: bb and acei. b-blocker decreased to toprol 100 mg due to pr prolongation. .. # schizophrenia: manage as above. contact outpatient psychiatrist. .. # wheezes: copd on chest ct. provided albuterol and ipratropium nebs prn. he will benefit from outpatient pfts to confirm diagnosis. .. # depression - d/c'd citalopram, held trazodone for concern of cardiac side effects. .. medications on admission: aripiprazole 5mg daily citalopram 10mg daily clobetasol 0.05% cream daily to the scalp flucinolone 0.025% cream fluticasone 50mcg spray prn folic acid 1mg daily glipizide 10mg daily hctz 25mg mwf metoprolol succinate 50mg daily angrogel 1.25g per accuation: two accuations daily in am trazodone 300mg daily cyanocobalmin 1000mcg daily guaifenesin prn pyridoxime 50mg daily discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. 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* 3. enoxaparin 80 mg/0.8 ml syringe sig: one (1) syringe subcutaneous (2 times a day) for 4 weeks: can discontinue when inr therapeutic . . disp:*56 syringe* refills:*0* 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 7. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 8. perphenazine 2 mg tablet sig: one (1) tablet po tid (3 times a day). 9. lorazepam 1 mg tablet sig: one (1) tablet po qhs prn () as needed for insomnia. 10. warfarin 5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)): adjust as needed per primary care doctor. have your inr checked. . 11. insulin per sliding scale print-out discharge disposition: extended care facility: - discharge diagnosis: primary: anterior st elevation myocardial infarction left ventricular thrombus secondary diabetes mellitus type ii schizophrenia primary: anterior st elevation myocardial infarction left ventricular thrombus discharge condition: hemodynamically stable, chest pain free discharge instructions: you were admitted to the hospital with a heart attack. you had a blockage of one of your heart blood vessels that was opened with a catheter and treated with a stent. you will need to take aspirin all the time. you will also need to take plavix without skipping doses until your cardiologist tells you to stop. your heart muscle was affected by your heart attack and you developed a blood clot inside your heart. you will need to take coumadin until you see your cardiologist. take "lovenox" until you are told not to. please keep all appointments and take all medications as directed. if you develop any new chest pain, nausea, vomiting, or any symptoms that concern you, please see a doctor immediately. you have the following appointments: 1) thursday 10 am echo, sc clinical ctr, cardiology echo lab 2) 3 pm, dr. sc clinical ctr, cc7 cardiology (sb) 3) have the facility arrange follow-up with your primary care doctor at time of discharge. , r. . 4) , md phone: date/time: 3:45 followup instructions: you have the following appointments: 1) thursday 10 am echo, sc clinical ctr, cardiology echo lab 2) 3 pm, dr. sc clinical ctr, cc7 cardiology (sb) 3) have the facility arrange follow-up with your primary care doctor at time of discharge. , r. . 4) , md phone: date/time: 3:45 md, procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: tobacco use disorder toxic encephalopathy diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute myocardial infarction of other anterior wall, initial episode of care atherosclerosis of aorta paroxysmal ventricular tachycardia ventricular fibrillation anticoagulants causing adverse effects in therapeutic use other vascular complications of medical care, not elsewhere classified phlebitis and thrombophlebitis of superficial veins of upper extremities schizoaffective disorder, unspecified certain sequelae of myocardial infarction, not elsewhere classified, other 

Answer: The patient is high likely exposed to