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 /stemi major surgical or invasive procedure: cardiac catheterization with drug eluting stent to obtuse marginal artery history of present illness: mr. is a 72 year-old male with pmh of cad s/p stemi and stent to the proximal lad in , dm, htn, hl who was admitted from the ed to the cath lab with a stemi s/p des to om1. he presented from home with substernal cp radiating to his left arm. the pain started at rest. denied associated shortness of breath, nausea, or vomiting. not currently on plavix. . in the ed initial vs: t 99 bp 128/63 p 83 rr 18 sat 97%. he was given asa 81 mg, nitro sl x3 without relief. ekg showed inferior st elevations. he was started on a heparin gtt, nitro gtt, and was given 4 mg iv morphine and 5 mg iv metoprolol. no integrillin was given due to his chronic kidney disease/single kidney. got 600 mg of plavix. . he was taken to the cath lab. his inital ck returned normal at 173 and trop was 0.02. cardiac catheterization showed a patent proximal lad stent with proximal edge 40% and 60-70% lesion distal to stent involving diagonal bifurcation. left circ showed 80% large om1. a des was placed in the om1. anomalous rca with significant disease (totally occluded), however chronic as the rv branches were open with good flow. he experienced pain in his left shoulder and arm which he states is chronic of many months duration. his post intervention ekg showed resolution of the st elevations. . on presentation, he denied chest pain, shortness of breath, shoulder pain, or other symptoms. . on review of systems, he denied any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, black stools or red stools. he denied recent fevers, chills or rigors. he did admit to a chronic cough. he did have pain in his knees and left shoulder at baseline. all of the other review of systems were negative. . cardiac review of systems was notable for absence of dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. he stated his exercise ability was limited by knee pain. past medical history: 1. cardiac risk factors: + diabetes, + dyslipidemia, + hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: stemi in s/p ptca at -pacing/icd: none 3. other past medical history: 1)cad s/p stemi and ptca of lad at , presented with lower abd pain and sob 2)hypertension 3)dyslipidemia 4)bph 5)type 2 diabetes with peripheral neuropathy 6)s/p r nephrectomy 5 years ago - pathology benign per patient 7)early parkinsonism-followed by neuro 8)bells'palsy ( htn) s/p valtrex 9)ckd ii baseline 1.1-1.2 10)depression 11)microcytic anemia-stable all his life-?thalassemia. neg, -egd in past. 12)elevated psa 13)urinary frequency and incomplete emptying on uds 14)knee arthritis social history: married, lives with wife. currently retired. denies tobbaco, alcohol, or ivda. he and his wife take care of a 3 year old grandchild. family history: significant for a father with diabetes. no history of cancers or strokes. one child with dm physical exam: general: elderly male lying in bed in nad. alert and appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: no jvd present. cardiac: rrr, 3/6 systolic murmur radiating to his carotids present. lungs: patient is breathing comfortably. he has slight crackles at the sides of his bases bilaterally. abdomen: soft, ntnd. no hsm or tenderness. extremities: no edema present. right femoral area with dressing in place. no active bleeding present. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: femoral 2+ dp 2+ pt 2+ left: femoral 2+ dp 2+ pt 2+ pertinent results: 11:20pm blood wbc-6.1 rbc-4.97 hgb-9.9* hct-32.8* mcv-66* mch-19.9* mchc-30.1* rdw-14.1 plt ct-197 05:50am blood wbc-10.6# rbc-4.45* hgb-9.4* hct-29.6* mcv-67* mch-21.1* mchc-31.7 rdw-14.3 plt ct-184 06:15am blood wbc-7.5 rbc-4.50* hgb-9.5* hct-30.0* mcv-67* mch-21.0* mchc-31.5 rdw-14.1 plt ct-198 06:50am blood pt-12.0 ptt-32.6 inr(pt)-1.0 11:20pm blood glucose-265* urean-21* creat-1.2 na-140 k-3.6 cl-103 hco3-29 angap-12 06:15am blood glucose-135* urean-18 creat-1.2 na-139 k-4.3 cl-102 hco3-30 angap-11 11:20pm blood ck(cpk)-173 11:20pm blood ctropnt-0.02* 05:27am blood ck-mb-9 ctropnt-0.13* 06:50am blood calcium-8.8 phos-3.2 mg-2.0 12:06am blood type-art fio2-2 po2-81* pco2-45 ph-7.40 caltco2-29 base xs-1 intubat-not intuba comment-nasal 12:06am blood glucose-241* lactate-1.0 na-138 k-3.8 12:06am blood hgb-10.0* calchct-30 o2 sat-94 cardiac cath study date of comments: 1. selective coronary angiography in this right dominant system demonstrated 3 vessel cad with likely culprit om. the lmca had no significant stenoses. the lad had a patent stent with a 40% stenosis at the proximal edge and a 60-70% stenosis distal to the stent. the lcx was large and had an 80% stenosis at om1. the rca was small and had diffuse subtotal occlusion with timi 3 flow to the rv branches. 2. ptca and stenting of thr om1 with a 2.5x18 mm promus des with excellent results (see ptca comments). 3. successful closure of the rcf arteriotomy with a 6f angioseal. final diagnosis: 1. three vessel coronary artery disease with likely culprit om. 2. stenting of the om1 with a promus des 3. closure of the r-cf arteriotomy with a 6f angioseal. 4. severely diseased non-dominant rca with patent rv branches 5. anterior take off of the rca that was difficult to selectively engage with ar2 diagnostic catheter 6. asa 325 mg daily and plavix 75 mg daily x 7 days then once daily x minimum of 12 months 7. high dose statin 8. echo on monday 9. ace-inhibitor if renal parameters permit 10. beta blockers 11. consider stress test in few weeks to evaluate the significance of the lad (ostial and mid) lesions tte (complete) done at 10:57:04 am final the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with inferior hypokinesis. the remaining segmetns are hyperdynamic and the lvef is therefore preserved.. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. there is atypical mitral annular calcification (mac) that occurs mainly at the anterior annulus encroaching on the lvot but without evidence for lvot obstruction or sub (aortic) stenosis (lvot diameter is 1.5 cm). ther are small, bland-appearing, mobile elements associated with the mac. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: mr. is a 72 year-old male with pmh of cad s/p stemi and stent to the proximal lad in , dm, htn, hl who was admitted from the ed to the cath lab with a question of stemi s/p des to om1. # coronaries/stemi s/p des to om1: initial ck is normal at 173 and trop of 0.02. ste in the inferior leads, however he was found to have a new occlusion in his lt cx om1 now s/p des. his stes resolved after intervention. his peak ck was 173 and was downtrending afterwards. the patient was continued on aspirin, plavix, metoprolol and simvastatin. a tte was done which showed ef 55%. he was discharged with close follow up with his cardiologist and primary care physician. # hypertension: the patient had elevated blood pressure that was difficult to correct. he was started was eventually maintained on valsartan, metoprolol, hydrochlorothiazide and amlodipine. at discharge his blood pressure was controlled. if he needs further management he may do well with clonidine. he will follow up with his primary care physician in the near future. # hyperlipidemia: the patient was started on simvastatin 80mg daily while an inpatient. gemfibrozil was held. further management was deferred to primary care physician and cardiologist. # diabetes type ii: the patient was continued on his home insulin regimen. # chronic kidney disease: the patient had a history of nephrecomy. he was treated with n-acetylcysteine and fluids per cath protocl. his creatinine remained stable at 1.2. # chronic anemia: the patient was at his baseline and has a chronic microcytic anemia. this will be followed by his primary care physician. # arm pain: chronic in nature. not related to heart. the patient will see orthopedics as an outpatient for further evaluation. # bph: he was continued on his home terazosin and finasteride. # code status: the patient was full code. medications on admission: aspirin 81 mg po daily pravastatin 20 mg po daily terazosin 7mg po qhs valsartan 80 mg po daily gemfibrozil 600 mg po daily finasteride 5 mg po daily atenolol 50 mg po daily omeprazole 20 mg capsule, delayed release(e.c.) po daily insulin nph & regular human 100 unit/ml (70-30), 25 units sq hydrochlorothiazide 12.5 mg po daily discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. terazosin 2 mg capsule sig: 3.5 capsules po hs (at bedtime). 3. pravastatin 80 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 4. valsartan 160 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. gemfibrozil 600 mg tablet sig: one (1) tablet po once a day. 6. finasteride 5 mg tablet sig: one (1) tablet po once a day. 7. metoprolol succinate 200 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*2* 8. omeprazole 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 9. insulin nph & regular human 100 unit/ml (70-30) suspension sig: twenty five (25) units subcutaneous twice a day. 10. clopidogrel 75 mg tablet sig: one (1) tablet po bid (2 times a day) for 4 days. disp:*8 tablet(s)* refills:*0* 11. plavix 75 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 12. amlodipine 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 13. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: st elevation myocardial infarction hypertention diabetes mellitus coronary artery disease chronic kidney disease discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - independent discharge instructions: you had a heart attack and a cardiac catheterization showed a blockage in one of your arteries that was opened with a stent. it is extremely important that you take plavix and aspirin every day for at least one year. don't stop taking plavix unless dr. tells you to. if you stop taking plavix, you could have another more serious heart attack. your blood pressure was high and we made the following changes to your medicines: 1. increase your aspirin to 325 mg 2. increase your pravastatin to 80 mg daily 3. increase your valsartan to 160 mg twice daily 4. stop taking atenolol 5. start taking metoprolol xl daily 6. take plavix twice daily for the next 4 days, then decrease to once daily for one year. followup instructions: primary care: , a. phone: date/time: wednesday at 2:45pm. . cardiology: dr. phone: date/time: thursday at 3:00pm. md, procedure: coronary arteriography using two catheters left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes percutaneous transluminal coronary angioplasty status hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) paralysis agitans urinary frequency old myocardial infarction iron deficiency anemia, unspecified bell's palsy acquired absence of kidney chronic kidney disease, stage ii (mild) 

Answer: The patient is high likely exposed to