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: stemi. major surgical or invasive procedure: cardiac catheterization with angioplasty and stenting (2 x des to om1), . history of present illness: ms. is a generally healthy 54-year-old woman who is admitted to the ccu following emergent cardiac catheterization. on the afternoon prior to admission, the patient had acute onset of a burning substernal cp with a pressure sensation radiating to her left shoulder. she did not have associated symptoms such as nausea, sob or diaphoresis. she thought this might have been indigestion or pain from her neck, and her symptoms did improve with antiacids. the discomfort then waxed and waned over the course of the day; the patient eventually felt well enough to go to sleep. around 1am she was awakened from sleep by an acute worsening of her symptoms. she presented to hospital where her ecg was notable for ste in i, avl, v5 and v6 as well as std in iii and v1 through v4. initial tropi was elevated at 0.51 (initial ck not available). the patient was treated with asa, iv heparin and iv ntg, which resulted in transient resolution of her pain. she was transferred to the ed, where she additionally received integrillin and 600mg plavix. as she was having recurrent discomfort in the ed, she was taken for urgent cardiac cath, performed with radial access, which demonstrated a tight om lesion. this lesion was treated with a des; a small proximal dissection was noted, and this was then treated with a second des. the was excellent flow post-procedure. on arrival to the ccu, the patient reports being pain free and feeling entirely well. on review of systems, she denies any recent fever, chills, change in weight, nausea, vomiting, abdominal pain, change to bowel or bladder habbits, arthalgia, myaglia, dizziness, numbness or weakness. 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. upper back pain, s/p spinal fusion social history: the patient reports being under a moderate amount of psychosocial stress recently. she works in hr for the social security administration. -tobacco history: prior smoker, quit for 14 years, now smoking a few ciggarettes per day. -etoh: rare -illicit drugs: denies family history: the patient's mother suffered an mi in her early 40s, but is now in her 80s and doing well. the patient's father required multi-vessle cardiac bypass surgery in his late 60s. physical exam: gen: well appearing adult female, no acute distress. heent: perrl, eomi. mmm. op clear. conjunctiva well pigmented. neck: supple, without adenopathy or jvd. chest: lungs clear to auscultation with normal respiratory effort. cor: normal s1, s2. rrr. no murmurs appreciated. abdomen: soft, non-tender and non-distended. +bs, no hsm. extremity: small hematoma at right radial access cath site. otherwise warm, without edema. 2+ dp pulses bilaterally. neuro: alert and oriented. cn 2-12 intact. motor strength intact in all extremities. sensation intact grossly. on the day of discharge vital signs were 97.9 f (98.2 f maximum), 93/55 mmhg (range 92/62 to 106/56 mmhg), 56 bpm (range 55 to 72 bpm), rr of 18 and 100 % o2 sat. on room air. physical exam findings were unchanged from those above, except for some resolution of hematoma. pertinent results: laboratory data at admission: 04:45am blood wbc-11.5* rbc-4.55 hgb-14.7 hct-41.6 mcv-91 mch-32.3* mchc-35.4* rdw-12.4 plt ct-224 04:45am blood neuts-72.8* bands-0 lymphs-21.0 monos-3.7 eos-1.8 baso-0.8 04:45am blood hypochr-normal anisocy-normal poiklo-normal macrocy-normal microcy-normal polychr-normal 04:45am blood pt-12.3 ptt-150* inr(pt)-1.0 04:45am blood glucose-117* urean-17 creat-0.7 na-142 k-4.0 cl-108 hco3-23 angap-15 04:45am blood ck(cpk)-176 05:03pm blood ck(cpk)-1690* 04:22am blood ck(cpk)-1142* 04:45am blood ck-mb-15* mb indx-8.5* 04:45am blood ctropnt-0.12* 05:03pm blood ck-mb-166* mb indx-9.8* 04:22am blood ck-mb-65* mb indx-5.7 04:45am blood cholest-69 05:03pm blood %hba1c-5.7 eag-117 04:45am blood triglyc-53 hdl-45 chol/hd-1.5 ldlcalc-13 laboratory data at discharge: 06:40am blood wbc-7.8 rbc-4.49 hgb-14.0 hct-40.1 mcv-89 mch-31.2 mchc-35.0 rdw-13.7 plt ct-212 06:40am blood glucose-98 urean-16 creat-0.8 na-143 k-4.5 cl-105 hco3-29 angap-14 06:40am blood calcium-9.3 phos-3.9 mg-2.1 ekg sinus rhythm. st-t wave configuration consistent with acute ischemic injury (question posterolateral). clinical correlation is suggested. no previous tracing available for comparison. rate pr qrs qt/qtc p qrs t 77 162 84 30 cardiac catheterization (radial) brief history: this 54 year old female with a family history of premature coronary artery disease and current tobacco use presented to hospital with intermittent resting substernal chest pain that started the day prior. the patient awoke on the day of admission at 2am with recurrent chest discomfort and presented to the hospital where ecg revealed anterolateral st elevations and an elevated troponin of 0.52. she was treated with aspirin, heparin, and nitroglycerin with resolution of her pain and st changes. transfer was catheterization was initiated and following arrival to the ed she developed recurrent chest discomfort, was given integrilin and plavix, and taken urgently to the catheterization laboratory. indications for catheterization: stemi. procedure: left heart catheterization: was performed by percutaneous entry of the right radial artery, using a 5 french jacky radial catheter, advanced to the ascending aorta through a 6 french introducing sheath. coronary angiography: was performed in multiple projections using a 5 french jacky radial catheter, with manual contrast injections. percutaneous coronary revascularization was performed using placement of drug-eluting stent(s). hemodynamics results body surface area: 1.84 m2 hemoglobin: 14.7 gms % rest **pressures left ventricle {s/ed} 154/25 aorta {s/d/m} 154/83/113 **cardiac output heart rate {beats/min} 72 rhythm sinus **arteriography results morphology % stenosis collat. from **right coronary 1) proximal rca diffusely diseased 70 2) mid rca diffusely diseased 70 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 normal 6a) septal-1 normal 7) mid-lad discrete 50 8) distal lad normal 9) diagonal-1 normal 12) proximal cx normal 13) mid cx normal 13a) distal cx normal 14) obtuse marginal-1 discrete 100 15) obtuse marginal-2 normal **ptca results cx ptca comments: initial angiography revealed a 100% occlusion in a large om branch. we planned to treat this with ptca and stenting. heparin and integrillin were given prophylactically. a 6f xb3.0 guide provided good support. a bmw wire crossed the stenosis without difficulty. we dottered with a 2.0x12mm sprinter balloon and then predilated at 12 and 14atm. a 2.5x23mm promus des was then deployed at 14atm and post-dilated with a 3.0x15mm quantum maverick at 20atm and a 3.25x12mm quantum maverick at 22atm (mid/distal) and 14atm (proximal). after the final balloon inflation there was a proximal cap dissection that was covered with a 2.5x8mm promus des, deployed at 16atm, and post-dilated to 3.25mm at 20atm. final angiography revealed no residual stenosis, timi 3 flow, and no apparent dissection. technical factors: total time (lidocaine to test complete) = 1 hour 13 minutes. arterial time = 1 hour 8 minutes. fluoro time = 26.6 minutes. contrast injected: non-ionic low osmolar (isovue, optiray...), vol 270 ml premedications: midazolam 1 mg iv fentanyl 25 mcg iv, 50 mcg iv asa 325 mg p.o. clopidogrel 600 mg po anesthesia: 1% lidocaine subq. anticoagulation: heparin 3000 units iv other medication: verapamil 2.5 mg ia integrilin (2mg/ml) 6.8 ml iv bolus, 11.7 ml/hr iv drip nitroglycerin 200 mcg ic x2 cardiac cath supplies used: .035in , magic torque 180cm .014in , bmw universal 300cm 2.0mm , sprinter 12mm 3.0mm , quantum maverick 15mm 3.25mm , quantum maverick 12mm 3.0mm , quantum maverick rx 12mm 3.25mm , quantum maverick rx 08mm 6fr cordis, xb 3.0 - allegiance, custom sterile pack - , left heart kit - , right heart kit 6fr arrow, transradial artery access kit - , priority pack 20/30 2.5mm , promus otw 23mm 2.5mm , promus otw 08mm - terumo, tr band large comments: 1. coronary angiography in this right dominant system demonstrated three vessel disease. the lmca was without angiographically apparent disease. the lad had 50% mid vessel stenosis. the lcx had a 100% occlusion of a large om1. the rca had diffuse disease 60-70% in the proximal and mid vessel and was a large caliber artery. 2. resting hemodynamics revealed mild systemic arterial systolic hypertension with sbp 154 mmhg. the left ventricular filling pressure was elevated at lvedp 25 mmhg. there was no significant pressure gradient across the aortic valve. 3. successful pci of the occluded om with overlapping 2.5x8mm (prox) and 2.5x23mm (distal) promus des. the entire length of stent was post-dilated to 3.25mm. final diagnosis: 1. three vessel coronary artery disease. 2. elevated left ventricular filling pressure. 3. successful pci of the lcx with des. attending physician: , . referring physician: , . cardiology fellow: , a. , m. echocardiography the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is low normal (lvef 50%) secondary to hypokinesis of the posterior and lateral walls. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. there is an anterior space which most likely represents a promient fat pad. cxr comparison: none. portable upright chest radiograph: there is no focal consolidation and no effusion or pneumothorax. the pleural surfaces are smooth. the hilar and cardiomediastinal contours are normal. cervical fixation hardware is incompletely visualized. there is no acute osseous abnormality, and the surrounding soft tissues and upper abdomen are normal. impression: no acute cardiopulmonary process. ekg sinus rhythm. right axis deviation. non-specific st-t wave changes, although ischemia or infarction cannot be excluded. low voltage in the limb leads. compared to the previous tracing st-t wave changes are more diffuse and more marked. rate pr qrs qt/qtc p qrs t 66 164 78 8 135 brief hospital course: coronary artery disease stemi, with ekg concerning enough for activation of the cath lab prior to large enzyme and myocardial damage. enzymes peaked late on the day of admission and were trending down by . pci with two drug-eluting stents placed in om1. posterolateral hypokinesis was noted on echo, resulting from the present event and associated with a mildly depressed left-ventricular ejection fraction of 50%. she was monitored with telemetry without any significant events, except for very occasional ectopy. ecg changes progressed slightly (see above). a1c was not indicative of diabetes as a potential risk factor, nor were lipids particularly abnormal. smoking is likely the primary indentified inciting factor for this patient. however, the patient's mother had early coronary disease, in her 40s, suggesting a genetic predisposition that is as yet unidentified in this pedigree, possibly polygenic. agressive lipid lowering is indicated, along with antiplatelet agents, particularly after drug-eluting stent placement. therefore, her medication regimen includes atorvastatin (80 mg po qd), plavix (75 mg po bid for one week then qd), aspirin (325 mg po qd). a beta-blocker, metoprolol succinate (25 mg po qd) was also added. hypertension mrs. was mildly hypertensive on the first day of admission, with blood pressure range up to 150/89 mmhg. lisinopril was commenced at an introductory dose (2.5 mg po qd). metoprolol, as above, likely also has a mildly anti-hypertensive effect. leukocytosis likely stress demargination in the context of acs. resolved spontaneously during the hospital stay. medications on admission: none. discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po twice a day for 7 days: after 7 days, switch to once daily in the morning. disp:*38 tablet(s)* refills:*5* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*5* 4. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*5* 5. metoprolol succinate 25 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:*5* discharge disposition: home discharge diagnosis: st elevation mi (heart attack) discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with chest pain which was found to be due to a heart attack. your blocked blood vessel was opened using agioplasty and with the placement of two drug coated stents. you are now safe for discharge home. it is very important that you take all of your medications as directed and keep your follow-up appointments. followup instructions: please call to schedule a follow-up appointment with a cardiologist. in the hospital, you have been cared for by dr. . dr. office number is (. procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery tobacco use disorder unspecified essential hypertension hematoma complicating a procedure accidental puncture or laceration during a procedure, not elsewhere classified cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure leukocytosis, unspecified acute myocardial infarction of other lateral wall, initial episode of care 

Answer: The patient is high likely exposed to