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: cc: major surgical or invasive procedure: cardiac catheterization history of present illness: hpi:55 y/o male with no cardiac hx, risk factors of former smoker and hypercholesterolemia who had been in usual state of excellent health when he collapsed today at mile 7 of a marathon. emt on scene immediately with ?vf/vt. shocked at 200 j x 1, intubated and given bolus of 100 mg lidocaine and 2 mg gtt started. cpr initiated < 5 minutes before the patient became combative. he was extubated in the field and a&o x4. in ed, received asa, morphine 2mg, anzemet x1. ros: no complaints of cp, sob, palpitations, presyncope or syncope in past or present. recent r calf pain for 2 weeks (in area of insertion of achilles tendon after achilles tendon injury following marathon in ). no orthopnea, pnd, lightheadedness. slight nausea. no headache, slight neck and chest soreness now. no abdominal pain. no black or bloody stools, no urinary changes. past medical history: pmh: no diabetes, hypertension + hypercholesterolemia social history: sh: he works in human resources. quit smoking in . occasional alcohol use. no drug use. family history: no history of cad or sudden cardiac death, no hypercoagulable d/o, mother passed away with liver cancer in 50s, father passed away with lung cancer in 50s, gm with dm physical exam: t 96 hr 51 bp 107/74 rr 14 98% ra, 6'1", 190 lbs. gen: wdwn man lying in bed in nad heent: perrla, eomi, op clear, mmm neck: jvp 7 cm cv: rrr, nl s1, s2, no m/g/r lungs: ctab, no w/r/r abd: bs+, soft, nt, nd, no organomegaly ext: no c/c/e, 2+ femoral pulses, no femoral bruits, 2+ dp, pt bilaterally, no warmth, swelling, tenderness of bilateral les neuro: cn 2-12 intact, moving all 4 extremities pertinent results: stress test - protocol for 9 minutes stopping b/c of ankle pain and fatigue. no cp. resting hr 46 increased to peak hr of 101 bpm (62% of mphr), baseline bp increased from 116/80 to 170/90 with exercise. baseline ekg reveals sinus brady 46 bpm with baseline anterolateral st-t wave abnormalitiies and possible prior septal infarction. ekg tracings throughout exercise and at maximal heart rate are negative for ischemic st segment shifts at the achieved submaximal work load. no signficant arrhtymias, although occasional isolated pcvs were noted. conclusions: poor exercise tolerance with submaximal stress test (62% predicted). stress test negative for chest pain and for definite electrocardiographic evidence of ischemia at the achieved submaximal work load. ct head w/o contrast 12:12 pm findings: no hemorrhage is seen. no mass lesion, hydrocephalus, shift of normally midline structures, minor or infarct is apparent. the density values of the brain parenchyma are within normal limits. the surrounding osseous and soft tissue structures are unremarkable. there is minimal mucosal thickening in the maxillary and ethmoid sinuses. impression: paranasal sinus mucosal thickening, otherwise normal study. chest (portable ap) 10:15 am semi-upright ap view of the chest: the heart is at the upper limits of normal size. the mediastinal and hilar contours are within normal limits. the pulmonary vascularity is normal. patchy bibasilar opacities are present less likely representing atelectasis. no definite pleural effusions are seen, however, the left costophrenic angle was excluded from the study. there is no pneumothorax. the osseous structures are unremarkable. impression: bibasilar atelectasis. no evidence of congestive heart failure. 3:46:48 pm atrial fibrillation rate 61 anteroseptal myocardial infarct, age indeterminate - possible acute/recent/in evolution left ventricular hypertrophy since previous tracing of the same date, no significant change tte on admission the left atrium is mildly dilated. the inferior vena cava is dilated (>2.5 cm). left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with hypokinesis of the distal half of the anterior septum and anterior wall. the remaining left ventricular segments contract normally and overall systolic function is low normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. mild to moderate (+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. imperssion: mild left ventricular systolic dysfunction. mild-moderate mitral regurgitation. c.cath study date of *** not signed out *** brief history: 55 yr old male with no prior cardiac history presented following a witnessed cardiac arrest while running a road race. ems treated pt in the field with cpr and defibrillator (200j x 1). no history of sudden cardiac in family. indications for catheterization: coronary artery disease, stable. prior q wave anterior mi, date unknown. procedure: left heart catheterization: was performed by percutaneous entry of the right femoral artery, using a 5 french angled pigtail catheter, advanced to the left ventricle through a 5 french introducing sheath. coronary angiography: was performed in multiple projections using a 5 french jl4 and a 6 french jr4 catheter, with manual contrast injections. left ventriculography: was performed in the 30 degrees projection, using 39 ml of contrast injected at 13 ml/sec, through the angled pigtail catheter. percutaneous coronary revascularization was performed using placement of drug-eluting stent(s). conscious sedation: was provided with appropriate monitoring performed by a member of the nursing staff. hemodynamics results body surface area: 2.1 m2 hemoglobin: 14 gms % fick **pressures left ventricle {s/ed} 117/16 aorta {s/d/m} 115/68/82 **cardiac output heart rate {beats/min} 45 rhythm atrial fibrillation other hemodynamic data: the oxygen consumption was assumed. left ventriculography: volumetric data: lv end diastolic volume index (nl 50-90 ml/m2). 67 lv end systolic volume index (nl 15-30 ml/m2). 31 lv stroke volume index (nl 35-75 ml/m2). 36 lv ejection fraction (nl 50%-80%). 54 qualitative wall motion: : 1. antero basal - normal 2. antero lateral - normal 3. apical - normal 4. inferior - normal 5. postero basal - normal other findings: mitral valve was normal. aortic valve was normal. **arteriography results morphology % stenosis collat. from **right coronary 1) proximal rca normal 2) mid rca normal 2a) acute marginal normal 3) distal rca normal **arteriography results morphology % stenosis collat. from **left coronary 5) left main normal 6) proximal lad normal 6a) septal-1 normal 7) mid-lad diffusely diseased 100 8) distal lad normal 9) diagonal-1 normal 10) diagonal-2 normal 12) proximal cx normal 13) mid cx normal 13a) distal cx normal 14) obtuse marginal-1 normal 15) obtuse marginal-2 normal 17) left pda normal 17a) posterior lv normal **ptca results lad **baseline stenosis pre-ptca 100 collateral grade (0-2) 0 **technique ptca sequence 1 guiding cath 6f xblad guidewires shinobi initial balloon (mm) 2.0x15mm final balloon (mm) 3.0x15mm # inflations 4 max pressure (psi) 260 **result stenosis post-ptca 0 dissection (0-4) 0 success? (y/n) y ptca comments: initial angiography revealed a totally occluded mid lad lesion. we planned to treat this lesion with ptca/stenting. heparin/integrilin combination was used. a 6f xblad 3.5 guide provided good support. after using a pt int. and a pilot 50 wire, a shinobi wire finally made it through the lesion. then a 2.0x15mm maverick balloon was used to dotter through the lesion and to confirm intraluminal position. then the wire was switched for a asahi prowater wire and predilation was performed at 10 atm x 2. stenting was with a 2.5x23mm cypher des at 18 atms posted with a 3.0x15mm quantum maverick balloon at 18 atms x 2. final angiography revealed no residual stenosis, no dissection and normal flow. technical factors: total time (lidocaine to test complete) = 0 hour53 minutes. arterial time = 0 hour51 minutes. fluoro time = 22 minutes. contrast: non-ionic low osmolar (isovue, optiray...), vol 215 ml premedications: asa 325 mg p.o. heparin anesthesia: 1% lidocaine subq. anticoagulation: other medication: fentanyl 25 mcg iv heparin 3500 unit bolus integrellin 15.8 cc bolus followed by 14 cc/hr gtt plavix 300 mg po midazolam 0.5 mg iv nitroglycerine 200 mcg ic cardiac cath supplies used: .014 , pt , 300cm .014 , asahi prowater, 300 .014 , asahi soft, 300 .014 , asahi soft, 300 .014 , asahi soft, 300 2.0 , maverick, 15 3.0 , quantum maverick, 15 6f cordis, xblad 3.5 150cc mallincrodt, optiray 150cc 100cc mallincrodt, optiray 100cc 2.5 cordis, cypher otw, 23 comments: 1. selected coronary angiography of this left dominant system demonstrated single vessel coronary artery disease. specifically the right coronary artery was a small nondominant vessel without any evidence of any flow limiting lesions. the right provided collaterals to the distal portion of the lad. the left main demonstrated no significant disease. the lad demonstrated a total occlusion in the mid portion of the vessel at the bifurcation of the 2nd and 3rd septal branches. the distal portion of the vessel filled slowly via collaterals from the rca. the lcx was a large dominant vessel with timi iii flow throughout. 2. lv ventriculography demonstrated a preserved lv ejection fraction with an ejection fraction of approximately 55% with normal wall motion. there was no evidence of mitral regurgitation. there was no pressure gradient across the aortic valve upon pullback from the left ventricle to the aorta. 3. successful stenting of the mid lad with a 2.5x23mm cypher des posted to 3.0 with excellent results (see ptca comments). final diagnosis: 1. one vessel coronary artery disease. 2. normal lv systolic function. 3. pci of the mid lad. conclusions: the left atrium is mildly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with focal hypokinesis of the distal septum. the remaining left ventricular segments contract normally. right ventricular chamber size and free wall motion are normal. the aortic arch is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with very mild regional left ventricular systolic dysfunction c/w cad (distal lad lesion). mild pulmonary artery systolic hypertension. dilated aortic arch. compared with the prior study of (images reviewed), left ventricular systolic function has improved. based on aha endocarditis prophylaxis recommendations, the echo findings indicate a low risk (prophylaxis not recommended). clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. resting data ekg: afib, prwp heart rate: 48 blood pressure: 140/92 protocol - treadmill stage time speed elevation heart blood rpp (min) (mph) (%) rate pressure 1 0-3 1.7 10 81 2 2.5 12 103 170/90 3 3.4 14 116 180/90 4 4.2 16 142 182/90 total exercise time: 10 % max hrt rate achieved: 86 symptoms: none st depression: none interpretation: this 55 yo male s/p stent was referred to the lab for evaluation of arrhythmias. the patient exercised for 10 minutes on protocol and stopped due to fatigue. this represents a good functional capacity for age. the patient denied any arm, neck, back or chest discomfort throughout the study. there were no significant st segment changes noted. the rhythm was atrial fibrillation with occas. vpb's and rare vent. couplets. there was an appropriate blood pressure response. impression: no anginal symptoms or ischemic ekg changes noted. ventricular ectopy as noted above. 10:08am lactate 4.6 10:00am tsh-4.5* 06:09pm free t4-1.3 10:00am caltibc-278 ferritin-230 trf-214 10:00am iron-122 10:00am ck-mb-notdone 10:00am ctropnt-<0.01 10:00am ck(cpk)-98 amylase-43 06:09pm ck(cpk)-118 06:09pm ck-mb-7 ctropnt-0.15* 1:40 pm ck-mb-not done ctropnt-0.04 1:40 pm ck (cpk)-88 brief hospital course: 55 y/o male with hypercholesterolemia p/w sudden cardiac death likely ischemic vt/vf s/p pci of 95% stenosed mid-lad with 1 des. . cardiac - follow-up will be with dr. . #. ischemia - patient with osh ett with history of baseline anterolateral st-twave abnormalities and possible prior septal infarction. has risk factor of hypercholesterolemia and distant history of smoking. cath showed 95% mid-lad lesion which was stented with 2.5x23mm cypher des. peak ck 118 and trop 0.15 - thought to be due to electrical defibrillation in field. patient unable to tolerate beta-blockade given baseline athletic bradycardia. tolerated 10 minutes on an exercise treadmill test prior to discharge without recurrence of ventricular fibrillation or ventricular tachycardia. - asa, plavix indefinitely - lipitor increased to 80 qd - heart healthy diet . #. pump - + mr, lvef 50-55% and mild regional left ventricular systolic dysfunction with hypokinesis of the distal half of the anterior septum and anterior wall on tte from admission improved on repeat tte with normalized ef, continued mild regional lv systolic dysfunction and only trivial mr. - initial wall motion abnormality likely secondary to defibrillation at time of syncope vs. ischemia . #. rhythm - recent ischmeic vt/vf, now in atrial fibrillation following defibrillation at scene of syncope. no history of atrial fibrillation. patient will be placed on coumadin, and after attaining a therapeutic inr for at least 3 weeks, he will be cardioverted. ep evaluated him and felt that an icd was not warranted given that his vt/vf was likely induced by ischemia. - lovenox bridge until coumadin therapeutic - coumadin 5 mg qd - will follow-up with pcp's office for inr checks - will be called by ep office to schedule cardioversion in weeks after at least 3 weeks of a therapeutic inr . #. prophylaxis - the patient will take omeprazole for gi prophylaxis given his multiple blood thinners medications on admission: lipitor 20 qd discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for 7 days. disp:*10 tablet(s)* refills:*0* 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. warfarin 5 mg tablet sig: one (1) tablet po at bedtime: this dose will be adjusted by your doctor based on your levels. disp:*30 tablet(s)* refills:*2* 5. atorvastatin 80 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*2* 6. enoxaparin 100 mg/ml syringe sig: ninety (90) mg subcutaneous every twelve (12) hours for 7 days: discontinue this medication once your inr (coumadin level) is therapeutic. disp:*1300 mg* refills:*0* 7. inr check sig: one (1) check every 3 days: until inr reaches 2.0-3.0. disp:*1 check* refills:*0* 8. prilosec (omeprazole) 20 mg once a day 30 minutes before breakfast (called and discussed with family) discharge disposition: home discharge diagnosis: sudden cardiac death ischemic ventricular fibrillation/tachycardia coronary artery disease - left anterior descending 95% stenosis atrial fibrillation discharge condition: good discharge instructions: 1. no heavy lifting for 2 weeks. please talk to your cardiologist before beginning an exercise regimen. no driving for 3 days. 2. please take all medications as prescribed. 3. please keep all follow-up appointments. 4. please seek medical attention if you develop chest pain, shortness of breath, nausea, vomiting, increased groin pain or bleeding, or have any other concerning symptoms. 5. always take your aspirin and plavix - if you do not take these, you could die. (called and discussed with patient) followup instructions: please go to dr. office to get your inr (coumadin level) checked within the next 2 days. you will need follow-up checks every few days initially until your levels stabilize. please make a follow-up appointment with dr. for within the next 1-2 weeks at . please ask him to follow your inr (coumadin levels), and to make sure they are therapeutic (between ) for at least 3 weeks prior cardioversion. you have a follow-up appointment with dr. () at 2 pm on in the building of on the . provider: , m.d. phone: date/time: 2:00 you will be called in weeks by () to be cardioverted (to get you out of atrial fibrillation and back into a normal heart rhythm). he will call your doctor, dr. , to make sure that your inr (coumadin levels) are therapeutic for 3 weeks prior to the procedure. procedure: angiocardiography of left heart structures injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter 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 pure hypercholesterolemia mitral valve disorders atrial fibrillation paroxysmal ventricular tachycardia cardiac arrest ventricular fibrillation 

Answer: The patient is high likely exposed to