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: percocet attending: chief complaint: chest pain major surgical or invasive procedure: balloon angioplasty of distal lad history of present illness: 69 y/o m h/o severe copd on 2-4l home o2, cad (most recent cath showed no obstructive dz), admitted for cp. states was at home, laying in bed watching tv when developed l sided cp radiating to l arm. assoc w/ sob, diaphoresis. took sl ntg at home without relief. . taken to hospital by ems. ecg showed 1-2mm ste v3-v5. he was started on ntg gtt for bp 200/105 and heparin. he received asa 325, plavix 300, and aggrestat and was medflighted to . . also received solumedrol 125mg, ceftriazone and azithromycin for copd flare. . cath showed 90% thrombotic distal lad, 80% lcx, 90% pda. there was diffuse coronary vasospasm that improved w/ 200mg ic tng. poba w/ good result. rhc showed pcwp 39, ra 27, rv 45/18, pa 54/37, received 40 iv lasix in lab. . ros: significant for stable 2 pillow orthopnea, + pnd, + doe. his grown children assist with adls. . past medical history: hypercholesterolemia htn copd (chronic 2l o2) angina gerd esophageal strictures bph h/o colonic polyps s/p appy s/p remote right ankle surgery s/p left hand surgery after traumatic injury social history: widowed, 3 children; prev tobacco (~2 packs/week), quit ~ 5 years ago; denies etoh, denies illicits. family history: + cad physical exam: vs - bp 122/75, hr 105-115, rr 17, o2 96% 2l o2 gen - in bed, comfortable, nad heent - op clr, mmm, jvp difficult to assess as pt supine cv - rrr, distant chest - ctab anteriorly abd - soft, nt, no g/r ext - no edema, 2+ bilat dp pulses pertinent results: labs on admit: wbc 8.4, hct 42.4, mcv 84, plt 400 (diff: neuts-93.6* bands-0 lymphs-5.9* monos-0.5* eos-0.1 baso-0) pt 13.2*, ptt 31.8, inr(pt) 1.2* na 135, k 5.1, cl 99, hco3 26, bun 24, cr 0.9, glu 159 alt 23, ast 14, alkph 86, tbili 0.3 ca 8.8, ph 4.4, mg 1.9, chol 197, tg 46, hdl 51, chol/hdl 3.9, ldl 137* hba1c 6.3 abg: 7.27/290/61 abg: 7.37/84/46 . cardiac enzymes: 05:25am blood ck(cpk)-99 ck-mb-notdone ctropnt-0.09* 11:15am blood ck(cpk)-156 ck-mb-8 ctropnt-0.09* 05:55pm blood ck(cpk)-214* ck-mb-7 ctropnt-0.08* 06:15am blood ck(cpk)-178* ck-mb-6 ctropnt-0.08* . labs on discharge: 05:35am blood wbc-10.0 rbc-4.42* hgb-12.6* hct-37.0* mcv-84 mch-28.4 mchc-33.9 rdw-13.5 plt ct-376 05:35am blood glucose-100 urean-25* creat-0.9 na-138 k-4.1 cl-99 hco3-32 angap-11 05:35am blood calcium-9.2 phos-5.0* mg-2.0 . imaging: cxr - hyperinflation reflects severe emphysema. heart is normal in size, and there is no pulmonary edema. tiny left pleural effusion may be present. no pneumothorax. . cardiac cath - 1. selective coronary angiography of this right dominant vessel revealed 3 vessel coronary artery disease. the lmca had no angiographically apparent flow limiting lesions. the lad had mild proximal disease and a 90% thrombotic lesion in distal vessel?first septal branch (twin lad system). the lcx was a small vessel and had an 80% distal stenosis. the rca was a dominant vessel with mild proximal disease. the pda had a 90% stenosis. the ramus intermedius was a small vessel with mild diffuse disease. 2. resting hemodynamics revealed severely elevated left and right sided filling pressures, moderate pulmonary hypertension, and low cardiac index of 1.6 l/min/m2. 3. left ventriculography was deferred. 4. after ic administration of nitroglycerin, flow through the ramus intermedius and the lcx improved dramatically suggesting a componenet of vasoconstriction. 5. successful poba of the distal lad with a 2.0x15mm balloon with excellent results (see ptca comments). . final diagnosis: 1. three vessel coronary artery disease. 2. severely elevated right and left sided filling pressures. 3. moderate pulmonary hypertension. 4. low cardiac index . 5. acute anterior mi. . ekg - sinus tachycardia with left axis deviation and late transition. since previous tracing, no significant change intervals axes rate pr qrs qt/qtc p qrs t 107 164 90 346/408.85 77 -48 91 . echo - the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef 60%). 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 ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. there is no pericardial effusion. brief hospital course: 69 yo m w/ pmh of copd, cad, htn and hypercholesterolemia, who was admitted for stemi and was found to have coronary vasospasm and elevated filling pressures on cardiac catheterization. . # ischemia: mr. had an st elevation mi and went to the cath lab for poba to lad. the most notable finding on his catheterization was that his coronaries appeared to be diffusely spastic and could be dilated with the administration of iv nitro. his cardiac enzymes peaked at ck of 214, ck mb of 8, and trop of 0.08 on . he was continued on aggrestat, since he had been started on it at the osh, for a total of 18 hours post-cath. he was on a nitro gtt on arrival to the ccu, but was able to be weaned to po meds shortly thereafter. he was started on aspirin, plavix, and atorvastatin for his acute coronary syndrome, an ace-inhibitor for aid in cardiac remodeling, and diltiazem and isosorbide mononitrate for relief of coronary vasospasm. given his pulmonary disease, no beta-blocker was given. he tolerated these medications well, with no side effects. . # pump: mr. had markedly elevated filling pressures by r heart catheterization and received iv lasix during the procedure. however, he had an echo on which showed a normal ef of 60%. he appeared euvolemic on exam with minimal diuresis on po lasix, so it was felt that his respiratory symptoms and dyspnea were most likely due to his underlying pulmonary disease. prior to discharge, mr. had an episode of hypotension after getting his po lasix dose. he was given additional po fluids and his bp responded well, so his po lasix was discontinued since it was felt that he was euvolemic, perhaps even hypovolemic, and his echo appeared to have a preserved ef (though likely has diastolic dysfunction). he was advised to follow-up with his cardiologist, dr. , who can decide if he needs to be restarted on lasix. . # rhythm: mr. was monitored on telemetry and remained in nsr through the majority of his stay. . # copd: at the osh, he was given iv steroids, ceftriaxone and azithromycin for a copd flare. however, on admission to the ccu, he had no evidence of a copd exacerbation (no wheezing, his o2 sats were stable on his home o2 requirement, and had no dyspnea), so he was not continued on steroids or antibiotics. he was continued on his home copd regimen (inhaled steroids, long acting anticholinergic, and albuterol). once his cardiac enzymes had peaked and he was transferred to the stepdown unit, he was able to ambulate w/ pt and maintain stable oxygen saturations. he was discharged home with home pt to help improve his functional status. . # fen: he was put on a low sodium, heart healthy diet. he was not given any additional ivf after his post-cath hydration. his electrolytes were checked daily and were repleted to keep his k >4 and mg >2. . # ppx: he received sc heparin for dvt ppx, protonix for gi ppx, and colace/senna for a bowel regimen. . # dispo: he was discharged home with services (pt and vna). he will follow-up with his pcp and with dr. within 2-4 weeks. medications on admission: dilt 360 qd spiriva imdur 180 qd buspirone 10 tid guaifenesin 600 qid citalopram 20 qd lactase pantoprazole 40 ativan 0.5 discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*90 tablet, delayed release (e.c.)(s)* refills:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. lorazepam 0.5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. disp:*30 tablet(s)* refills:*0* 6. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 7. buspirone 10 mg tablet sig: one (1) tablet po tid (3 times a day). tablet(s) 8. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: three (3) tablet sustained release 24hr po daily (daily). disp:*90 tablet sustained release 24hr(s)* refills:*2* 9. diltiazem hcl 180 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). disp:*30 capsule, sustained release(s)* refills:*2* 10. atorvastatin 80 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 11. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 12. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: st elevation mi s/p balloon angioplasty to distal lad . secondary diagnosis: copd hypercholesterolemia htn gerd esophageal strictures bph discharge condition: good. afebrile, bp 92-139/50-81, hr 101, rr 20, sats 97% on 2l o2. discharge instructions: 1. please call your pcp or go to the nearest er if you develop any of the following symptoms: fever, chills, chest pain, shortness of breath, jaw or arm pain, nausea, vomiting, leg pain, leg swelling, numbness or tingling in your legs, or any other worrisome symptoms. 2. please continue taking all your medications as prescribed. 3. please follow-up with your cardiologist, dr. , in weeks. he will help determine if you are eligible for cardiac rehab and should be able to help you find services in your area. followup instructions: 1. please follow up with dr. and dr. in weeks for follow-up after your hospitalization. you have been started on several new medications so your creatinine and your potassium levels should be monitored. 2. please follow up with dr. in weeks. you likely need to have a stress test before you can begin cardiac rehab and he will help facilitate that for you. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor angiocardiography of right heart structures excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension acute myocardial infarction of other anterior wall, initial episode of care chronic airway obstruction, not elsewhere classified other chronic pulmonary heart diseases hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other and unspecified angina pectoris hypovolemia stricture and stenosis of esophagus 

Answer: The patient is high likely exposed to