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: history of present illness: the patient is a 73 year old female with cardiac risk factors of hypertension, hypercholesterolemia, age and diabetes, without prior history of cardiac events, transferred from hospital. per the patient's husband, she began having nausea, vomiting and substernal chest pain at rest, which would come and go on the day prior to admission, beginning at 11:00 a.m. the patient presented to long hospital where the pain was relieved by two sublingual nitroglycerin. the patient was given a prescription for sublingual nitroglycerin as well as several tablets and sent home. per the patient's husband she continued to have some nausea and diaphoresis, but did not complain of chest pain or shortness of breath that evening. the patient went to bed and awoke at approximately 1:00 a.m. per her husband's description, with her hands on her chest, unable to speak, vomited times one. the ems transported the patient to hospital. in the emergency department at systolic blood pressure was in the 80 range, thought consistent with cardiogenic shock. the patient was taken emergently to the catheterization laboratory where percutaneous transluminal coronary angioplasty and stenting was performed for a totally occluded proximal left anterior descending. in addition, there was noted an occlusion of the right coronary artery, but with adequate collaterals. the patient had an asystolic episode versus complete heart block in the catheterization laboratory. she was given atropine and a temporary pacing wire was placed. an intra-aortic balloon pump was also placed and the patient was on dopamine and also intubated for airway protection. she was transferred to the accompanied by her physician for further management, including possible coronary artery bypass graft evaluation. on arrival the patient had been on repro since approximately 2:00 a.m. with some ooze from the femoral site. the paced sire was not sensing, but was pacing adequately. however, the patient was not noted to have any arrhythmias. she had a couple episodes of bradycardia, with a question of second degree av block. her initial ck at hospital was 525. per the patient's family she had no history of chest pain or chest pressure, no edema, no paroxysmal nocturnal dyspnea, no history of gastrointestinal bleed or ulcer. she has never had a colonoscopy. per family her diabetes and cholesterol were well controlled and she no longer had been requiring blood pressure medications of late. past medical history: 1. hypertension. 2. hypercholesterolemia. 3. hypothyroid. 4. type ii diabetes, controlled with oral agents. admission medications: lescol 20 mg q.d. levoxyl 0.175 mg q.d. avandia 4 mg q.d. allergies: there were no known drug allergies. social history: the patient lives with her husband and is retired, does not smoke or drink alcohol and has four children nearby. the patient is a full code. physical examination: on examination the patient was afebrile. systolic blood pressure was 80 to 120 over 40 to 60, pulse 90 to 110 on dopamine at 3 to 5 mcg per minute, respiratory rate was 10 to 12 and oxygen saturation was 97% and 99% on a 40% fio2 mechanical ventilation. the patient was sedated, but responds to voice and followed commands. sclera were anicteric. pupils are equal, round, and reactive to light and accommodation, neck was without jugulovenous distension. the chest was with few bibasilar crackles. cardiovascular examination was s1, s2 with audible s3, no murmurs or rubs. the abdomen showed bowel sounds present, nontender, nondistended. upper extremities were warm. lower extremities were slightly cool, pulses were doppler, no edema. neurologically the pupils were reactive. the patient follows commands and all extremities and reflexes were intact. laboratory data: white blood cell count was 10.4, hematocrit 30.1, platelet count 210. sodium was 137, potassium 4.1, chloride 107, bicarbonate 17, bun 21, creatinine 1.0. ck was 5730 with an mb of 114, index of 2.0, several hours later index had gone to 8.0. coagulation, ptt was 50.9, inr was 1.2. electrocardiogram at the outside hospital showed a right bundle branch pattern, left axis deviation and st depressions in ii, iii and avf, st elevations in l and v1 through v6 with hyperacute t waves laterally. electrocardiogram on arrival showed sinus bradycardia at approximately 60, left axis deviation, right bundle branch block, q waves in v1 through v3 and st elevations in v1 through v4. chest x-ray revealed cardiomegaly. ett and balloon pump were in place. hospital course: the patient was admitted to the ccu. dopamine drip was weaned. 1. cardiovascular: catheterization studies were reviewed and it was determined the patient did not require further intervention or surgery at that time. dopamine was weaned gradually and replaced with dobutamine, titrated upwards in order to improve the peripheral perfusion on intra-aortic balloon pump. repro was discontinued approximately twelve hours later and the patient was started on heparin per sliding scale, given the presence of the balloon pump. the patient was successfully extubated on the day following admission with additional weaning and was able to have successful weaning of the balloon pump and dobutamine the day after that. aspirin and lasix were continued. cholesterol levels were checked and were within normal limits on the patient's cholesterol lowering medications. the patient began to show signs and symptoms of congestive heart failure, requiring lasix. in addition, echocardiogram showed severe left ventricular hypokinesis of the apical wall anterolaterally, with depressed ejection fraction. she was also begun on captopril, which was titrated upward to 25 three times a day, and ultimately changed to zestril 10 mg daily. blood pressure would not tolerated more than 12.5 twice a day of lopressor, but this can continue to be adjusted as an outpatient. the patient was also loaded on coumadin after discontinuation of intra-aortic balloon pump, given the severe hypokinesis and the need for long term anticoagulation. at the time of discharge heparin will be changed to lovenox and the patient will continue to require coumadin loading at 7.5 mg at hour of sleep. 2. pulmonary: the patient was easily and successfully extubated. oxygen was weaned to room air by the date of discharge and the patient settled to where she eventually required 20 to 40 mg of lasix by mouth daily, continued titration may be necessary. 3. renal: creatinine remained stable throughout admission. 4. gastrointestinal: the patient was noted to have some scant coffee grounds at the time of admission. this was attributed to stress gastritis, also in the setting of her anticoagulation. she was placed on zantac prophylactically and high dose prilosec once taking by mouth medications, with stabilization of her hematocrit and no further evidence of bleeding. prilosec was discontinued prior to discharge. 5. fluids, electrolytes and nutrition: the patient was able to take by mouth. she did not require potassium repletion while in the hospital, however potassium should be checked as an outpatient and repletion added to her medical regimen if needed. 6. hematology: the patient will require prolonged anticoagulation, secondary to severe focal hypokinesis of the septum, apex and the left ventricle, as well as reduced ejection fraction. inr was subtherapeutic at the time of discharge so coumadin loading will continue at 7.5 mg at hour of sleep until the inr is in its goal of 2.0 to 2.5. the patient will continue on subcutaneous lovenox injections at the time of discharge until inr is therapeutic. discharge status: the patient will be discharged to an acute rehabilitation center. condition on discharge: stable. discharge diagnoses: 1. acute myocardial infarction. discharge medications: aspirin 325 mg q.d. plavix 75 mg q.d. times 25 days. lovenox 60 mg subcutaneous b.i.d. until inr greater than 2.0. coumadin 7.5 mg q.h.s. avandia 4 mg q.h.s. zestril 10 mg q.d. lopressor 12.5 mg b.i.d. lasix 40 mg q.d. lescol 20 mg q.d. levoxyl 0.175 q.d. sublingual nitroglycerin as needed. tylenol as needed. discharge instructions: inr should be checked at acute rehabilitation daily. once inr is greater than 2.0, lovenox may be discontinued and coumadin may be titrated for goal inr of 2.0 to 2.5. the patient's potassium level should also be checked and k-dur 10 to 20 meq daily added if potassium proves to decline on lasix therapy. the family has requested the patient follow up with dr. of cardiology at hospital. telephone number is . an appointment will be scheduled for the patient prior to discharge. the patient's primary care physician is . , telephone number . the patient should follow up with him on return from vacation. , m.d. dictated by: medquist36 procedure: removal of external heart assist system(s) or device(s) diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism acute myocardial infarction of other anterior wall, initial episode of care cardiogenic shock other specified gastritis, with hemorrhage 

Answer: The patient is high likely exposed to