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: penicillins / bactrim ds attending: chief complaint: angina (transfer from for interventional cath) major surgical or invasive procedure: cardiac catheterization with drug eluting stent x1 and bare metal stents x2 to right coronary artery history of present illness: mrs. is a 66 year old woman with copd and pvd transfered from for interventional cath after worsening cp x 4 days. over the past 3-4 months, she endorses recurrent non-exertional substernal chest pressure. these last 4 days the chest pressure worsened, increasing in intensity and frequency. she called 911 and was taken to by ambulance. in the ed she reported same chest pain- ecg revealed no ischemic changes. sx were relieved with sl nitroglycerine. patient was admitted to where she received nitro and heparin gtt, asa, plavix, metoprolol, and lipitor. she had no cp since receving nitro in . troponin t peaked at 0.2. diagnostic cardiac catheterization at revealed: 1.severe single vessel cad, with a focal 90% stenosis of the distal rca involving the origin of the pda. diffuse calcification and mild-to-moderate disease of all three coronary arteries 2.normal lv systolic function. 3. mild lv diastolic dysfunction 4.no evidence of valvular disease. she was transferred to this am for interventional catheterization. . at , she underwent cardiac catheterization with identification of significant rca disease. she received a des to the distal rca and bms x 2 to the mid rca. the procedure was complicated by closure of the pda. the patient also experienced significant oozing with a drop in hematocrit from 29.8 to 22.9. . following the procedure, the patient was transfered from the cath lab to the ccu for close overnight monitoring. . 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 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: cad 2. cardiac history: - percutaneous coronary interventions: des to distal rca and bms x 2 to mid rca 3. other past medical history: copd, glaucoma, anemia social history: - tobacco history: 80 pack-years, now pack per day - etoh: history of etoh abuse, quit 15 years ago - illicit drugs: none family history: - no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. brother passed at age 58 from cad brother and sister with htn/hld brother and sister with arrhythmias sister with breast and colon cancer father and brother with alcoholism physical exam: admission exam: general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, loud p2. left 2nd intercostal 2/6 systolic murmur. no thrills, lifts. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. prolonged expiratory phase. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no edema. no femoral bruits. cath site without bruit or oozing. skin: no stasis dermatitis, ulcers, or xanthomas. pulses: right: carotid 2+ femoral 2+ pt 2+ left: carotid 2+ femoral 2+ pt 2+ . discharge exam: t 97.8 hr 74-78 rr 18 bp 112-145/61-68 o2 sat 100% ra wt 57.5kg general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, loud p2. 1/6 systolic murmur best heart at the l upper sternal border. no thrills, lifts. lungs: ctab, no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. prolonged expiratory phase. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no edema. no femoral bruits, cath site with moderately sized hematoma, not pulsatile, not expanding. pulses 2+ bilaterally. pertinent results: admission labs: 08:00pm blood hct-25.1* 12:56am blood glucose-110* urean-6 creat-0.5 na-137 k-3.6 cl-106 hco3-20* angap-15 12:56am blood ck-mb-7 ctropnt-0.11* 05:26am blood ck-mb-15* 06:00pm blood ck-mb-14* ctropnt-0.25* 12:56am blood calcium-8.3* phos-4.2 mg-1.5* . discharge labs: 06:35am blood wbc-7.6 rbc-3.72* hgb-11.1* hct-31.8* mcv-86 mch-30.0 mchc-35.0 rdw-15.9* plt ct-267 06:35am blood plt ct-267 06:35am blood glucose-106* urean-8 creat-0.7 na-144 k-4.1 cl-109* hco3-27 angap-12 06:35am blood ck-mb-8 06:35am blood calcium-9.1 phos-3.9 mg-2.0 . cardiac cath (): 1. limited coronary angiography in this right-dominant system demonstrated one-vessel disease. the rca had a 30% proximal stenosis, diffuse stenosis in the mid-rca to 60% with a question of thrombus and a distal rca 95% stenosis and an ostial rpda 99% stenosis. 2. successful ptca and stenting of the distal rca into the pl system with a 2.75 x 15 mm promus to 3.5 distally and 3.0 proximally complicated by loss of the rpda (see ptca comments). 3. successful ptca and stenting of the mid-rca with overlapping 2.75 x 12 mm (distally) and 3.0 x 26 mm integrity (proximally) stents postdilated to 3.0 (see ptca comments). . tte (): the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. 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 leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. brief hospital course: primary reason for admission: 66 year-old woman with copd and worsening cp/ transferred from osh for interventional cath now status post pci with stent x 3 to rca. . active diagnoses: . # cad: cardiac cath showed significant rca disease now s/p pci with stent x3. she had bms x2 placed to the mid rca (2.75 x 12 mm (distally) and 3.0 x 26 mm integrity (proximally) stents postdilated to 3.0) and des x1 to the distal rca (2.75 x 15 mm promus to 3.5 distally and 3.0 proximally). pci was c/b jailing of the rpda which resulted in cessation of flow to the pda that was confirmed by angiography. she had a slight bump in ckmb post procedure consistent with this finding, but ckmb was downtrending at the time of discharge. post-cath echo showed normal rv size and wall motion. . # post procedure hct drop: cardiac cath was c/b significant oozing at the femoral insertion site and the pt's hct dropped to 23 immediately post cath. she was transfused 2u prbcs with an appropriate response, and her hct at the time of discharge was stable at 32. she was admitted to the ccu for monitoring overnight and remained hemodynamically stable throughout her course. there was no evidence of femoral bruit or expaning hematoma at the femoral sheath site, but there was moderate superficial ecchymoses. . chronic diagnoses: . # copd: she has a ~80 year smoking history and was maintained on her home medications while hospatilized. a nicotine patch was provided. she was counseled on the importance of smoking cessation. pt was never sob after cardiac cath and never had any signs of symptoms of copd exacerbation. . # anxiety: pt was continued on her home citalopram and had no problems with anxiety during her course. . transitional issues: pt was discahrged home with asa 325, plavix 75, metoprolol, nitro, lipitor 80mg and nicotine patches as well as her existing copd meds. she was instructed on the importance of continuing asa/plavix and was counseled extensively on smoking cessation. she will follow up with cardiology and her pcp. medications on admission: ipratropium bromide 17- 2inh by mouth qid prn fluticasone 110 mcg/actuation- 2 inh budesonide-formoterol (symbicort)- 160-4.5- 2inh citalopram 10mg qam 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. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*2* 5. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation qid (4 times a day) as needed for shortness of breath or wheezing. 6. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 7. symbicort 160-4.5 mcg/actuation hfa aerosol inhaler sig: two (2) puffs inhalation twice a day. 8. citalopram 10 mg tablet sig: one (1) tablet po once a day. 9. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily) for 6 weeks. disp:*45 patch 24 hr(s)* refills:*0* 10. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet sublingual as directed as needed for chest pain. disp:*25 tablets* refills:*0* 11. outpatient lab work please check labs at on friday discharge disposition: home discharge diagnosis: non st elevation myocardial infarction chronic obstructive pulmonary disease s/p bunion surgery discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had a heart attack and blockages were found in your right coronary artery at hospital. you were transferred to for a procedure to open the blocked artery and you had one drug eluting stent and two bare metal stents placed in your right coronary artery. it is crucially important that you take aspirin and plavix every day to prevent the stents from clotting off and causing another heart attack. do not miss or stop taking aspirin and plavix for any reason unless dr. tells you it is ok. you had some bleeding from the catheterization site and required two units of blood to replace the blood that was lost. you are recovering well and have had no further chest pain. during the catheterization, you received a lot of contrast (dye) and we will check your kidney blood tests on friday to make sure that your kidneys are functioning well. it is very important that you quit smoking in order to prevent the arteries from developing blockages and causing another heart attack. you have been given a prescription for a nicotine patch to help with the cravings. please get your blood checked on friday at in . . we made the following changes to your medicines: 1. start taking aspirin 325 mg and plavix 75 mg every day for at least one year to prevent the stents from clotting off. 2. start taking metoprolol to lower your heart rate and help your heart recover from the heart attack. 3. start taking a high dose of lipitor (atorvastatin) to lower your cholesterol and help your heart recover. 4. use nitroglycerin under your tongue as needed for chest pain. please take one pill, wait 5 minutes and you can take one more pill if the chest pain is still there. please call dr. if you have any chest pain and take nitroglycerin. 5. start nicotine patches daily to help you quit smoking. followup instructions: primary care: ,mahmooda . date/time: at 1:40pm. . cardiology: you will have an appt with dr. in about a month, her office will call you at home with an appt. procedure: insertion of non-drug-eluting coronary artery stent(s) insertion of drug-eluting coronary artery stent(s) excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents diagnoses: subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery chronic airway obstruction, not elsewhere classified peripheral vascular disease, unspecified unspecified glaucoma 

Answer: The patient is high likely exposed to