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: no known allergies / adverse drug reactions attending: chief complaint: throat and arm pain major surgical or invasive procedure: cardiac catheterization with thrombectomy of stent and promus drug eluting stent to the mid right coronary artery history of present illness: 78 year old female with history of niddm, mi x 3, and copd who presents who presents with chest pain found to have ekg changes concerning for stemi. . the patient was in her usual state of health until about two weeks ago when she developed intermittent throat and arm pain. this happened a few times but has increased in frequency over the last three days, which is when she noted the developed of chest pain as well. at around 1300 today, the pain became constant, rated at an , which was very concerning to the patient so she called ems at 1800 and was brought to ed for further evaluation. of note, the patient reports poor compliance with her home medications of late, which include po antihyperglycemics, aspirin, and plavix. . she received asa 325mg in the ambulance and rated her pain at on arrival to the ed. she denied any sob and reports the pain was different than the pain she experienced with her prior mi. in the ed, ekg was concerning for stemi and cardiology was notified. she received heparin gtt, plavix 600mg, and integrillin and was sent for urgent cardiac catheterization. during the cath, she was found to have a in-stent thrombosis in the rca, which was suctioned and angioplastied. per report, "successful primary angioplasty for inferior stemi with 80% thrombotic stenosis in the mid portion of previously placed stent; this was treated with pci and stenting utilizing 3.5x23mm promus des, post-dilated to 3.75mm with excellent result." the patient tolerated the procedure well and is being admitted to the ccu for further monitoring. . on arrival to the ccu, vital signs were t- 97.6, hr- 90, bp- 103/77, rr- 19, sao2- 88% on ra. the patient denies chest pain, shortness of breath or headache. she remains hemodynamically stable. . on review of systems, she 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. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems, at this time, is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: . cardiac risk factors: (+)diabetes, (+)dyslipidemia, (-)hypertension 2. cardiac history: - cabg: n/a - percutaneous coronary interventions: ami in - tpa followed by ptca/pci of rca and lcx. she has had two other interventions with a total of four stents placed - pacing/icd: n/a 3. other past medical history: 1. coronary artery disease status post multiple pcis. 2. diabetes mellitus- non-insulin dependant, with peripheral neuropathy 3. hyperlipidemia. 4. copd from smoking 5. status post hysterectomy. 6. status post right common femoral arterial thrombectomy in . social history: #social history: patients husband died at age 41, she has worked as a waitress all of her life. until recently worked as a cashier at cvs. lives at home with her daughter , son-in-law and grand children. able to complete all adls/iadls. no etoh or iv drugs family history: #family history: mom mi son died mi brother died mi aunt mi dad bone cancer died 92 physical exam: on admission: vs: t- 97.6, hr- 90, bp- 103/77, rr- 19, sao2- 88% on ra general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with normal jvp. cardiac: regular rate and rhythm, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: bibasilar crackles with no wheezes or rhonchi. no accessory muscle use. abdomen: soft, ntnd. no hsm or tenderness. no abdominial bruits. extremities: no c/c/e. no femoral bruits. pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ . on discharge: vitals - tm/tc: 97.8/97.1 hr: 73-76 bp:102-123/48-51 rr:20 02 sat: 96% ra in/out: last 24h: last 8h: weight: 66.2 (68.5) . tele: sr, few pvc's . fs: 273/211/191 . general: 78 yo f in no acute distress, lying flat in bed heent: no pharyngeal erythemia, mucous membs moist, no lymphadenopathy, jvp non elevated chest: crackles right base, bs on left cv: s1 s2 normal in quality and intensity rrr no murmurs rubs or gallops abd: soft, non-tender, obese, bs normoactive. no rebound/guarding. ext: wwp, no edema. dps, pts 2+. neuro: a/o, pleasant and conversant, mae, good memory of recent events skin: no rash pertinent results: on admission: 07:10pm blood wbc-6.1 rbc-4.21 hgb-12.4 hct-40.0 mcv-95 mch-29.5 mchc-31.1 rdw-12.4 plt ct-242 04:03am blood glucose-284* urean-13 creat-0.7 na-138 k-4.1 cl-102 hco3-31 angap-9 04:03am blood ck(cpk)-213* 06:20pm blood ck-mb-10 mb indx-7.8* ctropnt-0.17* 12:02pm blood ck(cpk)-187 06:20pm blood ck(cpk)-129 04:03am blood calcium-8.1* phos-3.8 mg-2.0 . on discharge: 06:55am blood wbc-6.1 rbc-3.92* hgb-11.8* hct-36.6 mcv-93 mch-30.0 mchc-32.1 rdw-12.7 plt ct-225 06:55am blood glucose-222* urean-20 creat-0.7 na-138 k-4.2 cl-101 hco3-32 angap-9 04:03am blood ck-mb-22* mb indx-10.3* ctropnt-0.39* 12:02pm blood ck-mb-16* mb indx-8.6* ctropnt-0.25* 06:20pm blood ck-mb-10 mb indx-7.8* ctropnt-0.17* . cardiac catheterization: 1. selected coronary angiography in this right dominant system demonstrated 2 vessel coronary artery disease. the lmca had no angiographically apparent disease. the lad had a 30-40% mid vessel stenosis slightly worsened from . the lcx in known to have a total flush occlusion. the mid rca is diffulsely disease with an 80% in stent restenosis and possible thrombus suggestive of very late isrs. there is a focal 50% lesion at the distal rca bifurcation worsened from . the rplv (very substantive vessel) stent placed in is widely patient. 2. limited resting hemodynamics revealed a normotensive central systemic arterial pressure of 124/71 mm hg. 3. successful thrombectomy and pci to the mrca using 3.5x23mm promus des. 4. no complications. final diagnosis: 1. 2 vessel coronary artery disease with in stent restenosis of rca. 2. successful pci to the mrca with promus des. 3. no complications. . echo : preliminary only brief hospital course: # right coronary artery st elevation myocardial infarction: s/p rca stemi with succesful des to site of in-stent thrombosis and early resolution of ekg abnormalities. no further chest pain, ck's have downtrended. on bb, acei, statin, plavix and asa. echo with poor windows and no wma, preserved ef on first read, reviewed by dr. who felt there was an inferior wall motion abnormality with ef 45%. appears euvolemic. plan to continue clopidogrel for 1 year/month for des and likely forever. np and sw saw pt for her history of medicaton non-complience. she is able to afford her medicines, just stated she was "stubborn" and didn't feel that she needed the medicine anymore. her diabetes regimen is also onerous to her and she wishes it could be simplified. she states she now realizes that she needs to take her medications daily. . # rhythm: sr, no vea . # hyperlipidemia- high dose atorvastatin for now, change back to rosuvastatin at discharge because of her history of myalgias on high dose statin. she has tolerating 20 mg of rosuvastatin so far. . # diabetes mellitus- on glypizide and onglyza at home, struggling to do fingersticks 4 times per day and take her meds. last a1c in was 10.5. followed by dr. from in . her home po meds were restarted at discharge and she has a f/u appt with dr. at the end of the week. . transitional issues: 1. vna at home to monitor for medication compliance and to do diabetic teaching 2. asa and plavix for one year at least 3. f/u with dr. in 2 weeks. 4. vna to check bp and hr on new lisinopril and metoprolol medications on admission: home medications: confirmed with 1. glipizide xl 10 mg daily 2. onglyza 5 mg daily 3. crestor 20 mg daily 4. aspirin 81mg daily 5. plavix 75mg daily (did not fill for one month) 6. amytripiline- 25mg qhs 7. omeprazole 20 mg daily 8. hydrocodone/acetaminophen 7.5/750mg tid as needed discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 3. amitriptyline 25 mg tablet sig: one (1) tablet po hs (at bedtime). 4. glipizide 10 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po once a day. 5. onglyza 5 mg tablet sig: one (1) tablet po once a day. 6. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. metoprolol succinate 50 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). disp:*30 tablet extended release 24 hr(s)* refills:*2* 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*2* 9. crestor 20 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: st elevation myocardial infarction diabetes mellitus type 2 coronary artery disease dyslipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure caring for you at . you had a heart attack that was caused by a clot in an earlier stent from being off your plavix. the clot was removed and another drug eluting stent was placed over the previous stent. you will need to take a full aspirin (325mg) and plavix 75 mg every day for the next year and likely longer. do not stop taking plavix or miss unless dr. tells you to. this is very important to prevent another heart attack or possibly death. an echocardiogram showed that your heart function is good. . we made the following changes to your medicines: 1. increase aspirin to 325 mg for the next year 2. continue crestor at 20 mg daily 3. stop taking omeprazole (prilosec), take ranitidine instead for your heartburn 4. start lisinopril to lower your blood pressure 5. start metoprolol to lower your heart rate and help your heart recover from the heart attack. followup instructions: dr. on monday , the office will call you at home with an appt. dr. on friday as previously scheduled. 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: coronary atherosclerosis of native coronary artery tobacco use disorder chronic airway obstruction, not elsewhere classified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia acute myocardial infarction of other inferior wall, initial episode of care 

Answer: The patient is high likely exposed to