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: chest pain major surgical or invasive procedure: cardiac catheterization with bms to rca history of present illness: mr. is a 69 y/o male with a history of hypertension, hypercholesterolemia who presented to his pcp's office with chest pain since saturday. pt has no history of cad or angina. he reports starting two days prior to admission he developed heartburn which was not relieved with otc antacids so he made a pcp . he denied any worsening with position, activity or associated nausea,vomiting, diaphoresis, shortness of breath, lightheadedness. he reports it felt like his last episode of acid reflux so made the pcp appointment to get a prescription medication for it. at his pcp's office he was found to have st elevations in ii and iii and was taken by ambulance to the ed. in the ed repeat ekg showed q waves already present with some st elevation in ii and iii, his troponin was elevated at 1.39 and his cr was 0.9. he had received a full dose aspirin at his pcps office and was placed on a heparin drip in the ed and taken to the cath lab from there. in the cath lab, he received prasugril and bivalirudin and underwent left heart cath via the right femoral artery and was found to have total occlusion of the rca, and he had a bms placed in it. he was to be transferred to the service, however he was noted to be in 2nd degree heart block on post intervention ekg, so he was admitted to the ccu. he denies any history of cardiac problems or arrythmia in the past. his brother had a history of rheumatic heart disease but he had no problems. on arrival to the ccu, the patient has no complaints and reports feeling well. . review of systems on review of systems, s/he 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. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . 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. cardiac risk factors: - diabetes, + dyslipidemia, + hypertension 2. cardiac history: n/a -cabg: n/a -percutaneous coronary interventions: n/a 3. other past medical history: bph pud s/p hernia repair when 21 yo s/p bladder repair post rupture in a car accident social history: he works as a mechanic. he lives with his second wife. has two children from his first wife who are grown and in the 40s. he has four grandchildren. distant tobacco use, no alcohol or other drugs. is able to walk miles without pain or shortness of breath. family history: his father died at age 56 of stomach cancer. his mother age 79 died of an unknown type of cancer. he has five brothers and four sisters. one brother has rheumatic heart disease. there is no diabetes, coronary artery disease, colon, breast or prostate cancer. physical exam: admission physical exam: vs: 98.5, 65, 136/85, 95%ra general: well appearing white male in nad, lying in bed. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, neck: supple with no elevated jvp. cardiac: pmi located in 5th space. rrr, no mrg appreciated. lungs: assessed anteriorly due to recently out of right groin catheterization- clear to auscultation bilaterally. speaking in full sentences, in no acute distress. abdomen: soft, ntnd. normoactive bowel sounds. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+, hematoma present with slight bruit, popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ . discharge physical exam: afebrile, bp 100-120s/70s, hr 70s, saturations 100% ra exam unchanged pertinent results: admission labs: 04:50pm blood wbc-17.7*# rbc-4.53* hgb-13.9* hct-42.8 mcv-94 mch-30.6 mchc-32.5 rdw-12.9 plt ct-263 04:50pm blood neuts-79.0* lymphs-13.8* monos-6.3 eos-0.3 baso-0.7 04:50pm blood glucose-87 urean-12 creat-0.9 na-131* k-4.4 cl-94* hco3-27 angap-14 04:50pm blood ck(cpk)-753* 04:50pm blood cholest-157 04:50pm blood triglyc-69 hdl-44 chol/hd-3.6 ldlcalc-99 troponin trend: 04:50pm blood ck-mb-33* mb indx-4.4 04:50pm blood ctropnt-1.39* 06:08am blood ck-mb-21* ctropnt-3.13* studies: radiology chest (portable ap) mild vascular prominence which could be seen with pulmonary venous hypertension or slight congestion. cardiac cath: 1. selective coronary angiography in this right dominant system demonstrated single vessel coronary artery disease. the lmca is normal. the lad and lcx are without obstructive disease. the rca was totally occluded in the mid vessel. 2. limited resting hemodynamics revealed normal systemic arterial pressure with central aortic pressure 134/68 with a mean of 81 mmhg. final diagnosis: 1. one vessel coronary artery disease. echo: left atrium: elongated la. right atrium/interatrial septum: normal ra size. no asd by 2d or color doppler. normal ivc diameter (<=2.1cm) with >50% decrease with sniff (estimated ra pressure (0-5 mmhg). left ventricle: mild symmetric lvh with normal cavity size. moderate regional lv systolic dysfunction. no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: mildy dilated aortic root. mildly dilated ascending aorta. normal aortic arch diameter. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. normal pa systolic pressure. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. conclusions the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 0-5 mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is moderate regional left ventricular systolic dysfunction with akinesis of the basal inferior, inferolateral and inferoseptal segments and hypokinesis of the rest of the inferior wall. the remaining segments contract normally (lvef = 40%). there is some echogenicity of the basal inferior/inferolateral endocardium, consistent with myocardial edema. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. 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 structurally normal. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: mild regional left ventricular dysfunction, c/w recent inferoposterior infarction. mild mitral regurgitation. no echocardiographic evidence of right ventricular infarction or mechanical complications of lv infarction. vascular ultrasound right groin: right femoral vein and artery demonstrate appropriate waveforms and are patent. there is a 1.7 x 1.3 cm partially thrombosed saccular pseudoaneurysm arising from the right common femoral artery with a measuring approximately 6 mm. there is no evidence of av fistula. brief hospital course: principle reason for admission 69 year old male with history of hypertension but no coronary artery disease or anginal symptoms who presented with heartburn and found to have q waves in inferior mi who is now s/p left heart cath with bms to the rca. he developed mobitz type i secondary heart block which spontaneously resolved. # st elevation myocardial infarction (stemi): pt had symptoms of heartburn as his anginal equivalent beginning 2 days prior to admission and already had q waves on his ekg at the time of presentation. he had st elevations in leads ii and iii consistent with an inferior mi. troponin elevated at 1.39 with ck-mb of 39. he received a full dose aspirin at his pcps office and was placed on a heparin drip in the ed. he was then taken to the cath lab where bivalirudin was started and he was loaded on prasugrel. he was found to have total occlusion of the rca and is now s/p bare metal stent (bms) placement to the right coronary artery (rca). he was transferred to the ccu due to transient mobitz i heart block following catheterization. on admission to the ccu, he was started on atorvastatin 80 mg daily, asa 325 daily, prasugrel 10mg daily, and lisinopril 10mg daily. metoprolol was initially held due to heart block but was restarted on at 50mg daily (half his home dose). repeat tte showed lvef of 40% with moderate regional left ventricular systolic dysfunction with akinesis of the basal inferior, inferolateral and inferoseptal segments and hypokinesis of the rest of the inferior wall. # right groin pseudoaneurysm: after his groin access for cardiac cath, he was noted to have a hematoma. an ultrasound was performed which showed a 1.7 x 1.3 cm partially thrombosed saccular pseudoaneurysm arising from the right common femoral artery with a measuring approximately 6 mm. this remained stable after several days of observation and e should have a repeat ultrasound of his right groin in 2 months to follow-up for resolution, this has been scheduled. # heart block: patient was in asymptomatic second degree mobitz i heart block after his cardiac catheterization which resolved spontaneously. he did not receive any interventions or have pacer wires placed following the procedure. on admission to the ccu he denied any palpitations, light headedness or chest pain. all nodal agents including bblockers were held on admission. the following day he was restarted on metoprolol 50 mg daily and he was monitored on tele which showed normal sinus rhythm. # leukocytosis- patient has elevated wbc on arrival to the ed at 17.7 with only 70% pmns and no bands. he denied infectious symptoms and this was thought possibly stress reaction to his stemi. he was afebrile during admission and his cxr showed no evidence of pulmonary process. urinalysis was not indicative of occult infection. wbc on discharge were 10.9. #hypertension (htn)- normotensive on admission to ccu. we continued home lisinopril 10mg daily but initially held his home metoprolol (as above). on discharge his regimen included lisinopril 10 mg daily and metoprolol 50 mg daily. # history of peptic ulcer disease: he did not have any symptoms during admission and his hematocrit remained stable despite being loaded with bivalirudin and prasugrel administered for 3 days. he was continued on his home omperazole 40 mg and told to monitor for melena and blood stools. #benign prostatic hypertrophy (bph)- asymptomatic and patient not currently on any medications. transitional issues: - his metoprolol can be uptitrated as an outpatient as long as repeat ekgs show continued resolution of heart block - monitor for symptoms of gi blood loss medications on admission: hydrocholorothiazide 25mg daily lisinopril 10mg daily metoprolol 100mg daily omeprazole 40mg discharge medications: 1. aspirin ec 81 mg po daily rx *aspirin 81 mg daily disp #*30 tablet refills:*0 2. atorvastatin 80 mg po daily rx *atorvastatin 80 mg daily disp #*30 tablet refills:*0 3. lisinopril 10 mg po daily start: in am hold if sbp<100 4. omeprazole 40 mg po bid 5. prasugrel 10 mg po daily rx *effient 10 mg daily disp #*30 tablet refills:*0 6. metoprolol succinate xl 50 mg po daily rx *metoprolol succinate 50 mg daily disp #*30 tablet refills:*0 discharge disposition: home discharge diagnosis: inferior st elevation myocardial infarction discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you were admitted to the hospital because you were having chest pain. we found that you were having a heart attack caused by a blockage in one of the arteries in your heart. we started you on several medications and performed a cardiac catheterization, where a stent was placed in the blocked artery. you tolerated the procedure very well. please note the following changes to your medications: start taking: prasugrel 10 mg daily to keep the stent in your artery open aspirin 81 mg daily (baby aspirin) to keep your stent open atorvastatin (lipitor) 80 mg daily for high cholesterol decrease your metoprolol succinate to 50 mg daily for your heart you will also need to follow up with your doctors as we have scheduled below. you should bring all your medications to each appointment so your doctors update their records and adjust the doses as needed. it has been a pleasure taking care of you in the hospital! followup instructions: department: when: thursday at 11:10 am with: , md building: (, ma) campus: off campus best parking: free parking on site department: adult specialties when: monday at 9:00 am with: , md building: (, ma) campus: off campus best parking: free parking on site procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters left heart cardiac catheterization 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 pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension cardiac complications, not elsewhere classified hematoma complicating a procedure hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) peripheral vascular complications, not elsewhere classified acute myocardial infarction of other inferior wall, initial episode of care cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure leukocytosis, unspecified other second degree atrioventricular block personal history of peptic ulcer disease aneurysm of artery of lower extremity 

Answer: The patient is high likely exposed to