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: celebrex attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with pci history of present illness: 34m w/ pmh sig for hypercholesterolemia and positive family history who presents from an osh after experiencing acute substernal chest pain, shortness of breath and diaphoresis. . his history begins about two years ago when he was admitted with chest pain but was ruled out for mi by enzymes and exercise mibi. he had intermittent "indigestion". on the day of admission, he developed sudden-onset substernal chest pain while he was speaking to a customer at work. he excused himself from worked and presented to an osh where he was found to have ste v2-v6 and hyperacute t waves. thrombolysis with tnk was attempted but failed to relieve his pain. he was therefore transferred to for emergent percutaneous coronary intervention. . coronary angiography revelead a total occlusion of his distal rca which appeared old and a fresh thrombus in his mid-lad. lcx showed mild disease and lm was clean. a 3.5 cypher stent was placed to the lad and the patient was transferred to the ccu on integrellin and an iabp. past medical history: anxiety hypercholesterolemia social history: he does not smoke cigarettes has one or two drinks in a month family history: mother and father both have early cad. physical exam: 98.6 98 101/50 18 97% ra gen - alert, no acute distress heent - perrl, extraocular motions intact, anicteric, mucous membranes moist neck - no jvd, no cervical lymphadenopathy chest - clear to auscultation bilaterally cv - normal s1/s2, rrr, no murmurs, rubs, or gallops abd - soft, nontender, nondistended, with normoactive bowel sounds back - no costovertebral angle tendernes extr - no clubbing, cyanosis, or edema. 2+ dp pulses bilaterally neuro - alert and oriented x 3, cranial nerves intact, upper and lower extremity strength 5/5 bilaterally, sensation grossly intact skin - no rash pertinent results: 08:58pm glucose-126* urea n-19 creat-0.9 sodium-143 potassium-4.2 chloride-107 total co2-27 anion gap-13 08:58pm alt(sgpt)-82* ast(sgot)-411* ld(ldh)-689* ck(cpk)-4224* alk phos-75 amylase-70 tot bili-0.2 08:58pm lipase-25 08:58pm ck-mb-444* mb indx-10.5* ctropnt-9.51* 08:58pm albumin-4.1 calcium-8.7 phosphate-3.7 magnesium-2.0 cholest-213* 08:58pm triglycer-334* hdl chol-45 chol/hdl-4.7 ldl(calc)-101 08:58pm wbc-17.9* rbc-3.75* hgb-12.1* hct-32.0* mcv-85 mch-32.2* mchc-37.7* rdw-12.5 08:58pm plt count-252 08:58pm pt-13.6 ptt-64.4* inr(pt)-1.2 07:36pm type-art rates-/18 o2-100 o2 flow-15 po2-278* pco2-32* ph-7.43 total co2-22 base xs--1 intubated-not intuba comments-nasal 07:36pm hgb-13.6* calchct-41 o2 sat-98 06:40pm wbc-19.7*# rbc-4.66 hgb-14.2 hct-39.7* mcv-85 mch-30.4 mchc-35.7* rdw-12.5 06:40pm neuts-81.4* bands-0 lymphs-15.0* monos-2.9 eos-0.4 basos-0.4 06:40pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 06:40pm plt smr-normal plt count-321 06:40pm pt-13.9* ptt-68.4* inr(pt)-1.2 cardiac catheterization: 1. selective coronary angiography demonstrated two vessel coronary artery disease. the lmca was without flow limiting disease. the lad was totally occluded in the mid vessel. the diagonal branch was without flow limiting disease. the lcx and its two om branches were without flow limiting disease. the rca was a dominant vessel that had diffuse disease in the mid and distal vessel with a total occlusion in the distal rca. 2. right heart catheterization demonstrated elevated right and left sided filling pressures with rvedp of 20 mmhg and mean pcwp of 33 mmhg. cardiac output and index were 4.6 l/min and 2.3 l/min/m2 respectively. 3. left ventriculogram deferred to reduce contrast load. 4. successful primary pci with stenting of the mid lad with a 3.0x33mm cypher des at 16 atms (see ptca comments). 5. successful placement of intra-aortic balloon pump in right common femoral artery. echocardiogram: 1. the left ventricular cavity size is normal. overall left ventricular systolic function is severely depressed. anterior, septal, apical, distal lateral, and distal inferior severe hypokinesis to akinesis iis present. lvef 30% 2. there is a trivial/physiologic pericardial effusion. brief hospital course: ## cardiac: a) ischemia: cardiac catheterization demonstrated two vessel coronary artery disease. the lmca was without flow limiting disease. the lad was totally occluded in the mid vessel. the diagonal branch was without flow limiting disease. the lcx and its two om branches were without flow limiting disease. the rca was a dominant vessel that had diffuse disease in the mid and distal vessel with a total occlusion in the distal rca. there was successful primary pci with stenting of the mid lad with a 3.0x33mm cypher des at 16 atms and successful placement of intra-aortic balloon pump in right common femoral artery. the pt did have some cp after pci but this was attributed to debris post-cath and it resolved by the second day post-cath. his peak ce: ck 5297 trop 11.11. he was monitored closely in the ccu and iabp was removed without incident. he was started on asa, plavix, and metoprolol. acei was added when his blood pressure tolerated. prior to admission he was on zocor 40 and this was increased to 80 and zetia was added given his cholesterol panel. he was also started on folate given his young age early coronary disease. the pt should undergo a complete workup for hypercoaguability given his early onset cad and positive family history. . b) pump: pt was initially supported with an iabp for afterload reduction. following its removal he was started on lisinopril 2.5. echo showed an ef of 30% and thus he was anticoagulated with coumadin and heparin gtt was used as a bridge. he was discharged with an inr of 1.9 and will follow up on with dr. office to make sure his inr is therapeutic. he will follow up with dr. and is currently searching for a new pcp. . c) rhythm: pt was slightly tachycardic with hr's in the 90's even 3 days after his mi. this was felt to be secondary to adrenergic drive. he was asymptomatic. up-titration of his beta blocker was restricted by his low bp. he was discharged with metoprolol 37.5 twice daily with instructions that if he felt dizzy he would only take 25mg twice daily. his pcp and cardiologist may increase this medication further as tolerated. the pt was also scheduled for an outpatient ep visit for evaluation for an icd given his low ef. he had a few pvc's but no other events on telemetry in the days following his mi. . ## pt did spike a fever to 101 . however, ua was negative, lungs remained clear, and ucx and bcx showed no growth. after this one spike he remained afebrile and had no symptoms. . medications on admission: zocor 40 mg daily zolpidem 10mg qhs mvt discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. warfarin sodium 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day): if you develop dizziness or extreme tiredness, only take one tablet twice a day and discuss with your pcp or cardiologist. disp:*90 tablet(s)* refills:*2* 8. zolpidem tartrate 10 mg tablet sig: 1-2 tablets po at bedtime. disp:*60 tablet(s)* refills:*2* 9. outpatient physical therapy outpatient cardiac rehabilitation 10. outpatient lab work please collect pt and inr. 11. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 12. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet sublingual q 5 minutes x 3 as needed for chest pain. disp:*30 tablets* refills:*2* discharge disposition: home discharge diagnosis: st-elevation myocardial infarction congestive heart failure hypercholesterolemia discharge condition: stable discharge instructions: if you have chest pain or shortness of breath, you may try taking nitroglycerin, but if your symptoms do not resolve after 3 sublingual pills, call ems or come to the er immediately. please take all medications as prescribed. followup instructions: --dr. assistant should call you regarding an appointment in his clinic for this , . his office telephone # is . --provider: , md where: cardiac services phone: date/time: 2:00 --please follow-up with primary care physician 2 weeks. if you would like to have dr. as your new pcp, call to make an appointment. --please follow-up with cardiac rehabilitation procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor implant of pulsation balloon insertion of drug-eluting coronary artery stent(s) diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified 

Answer: The patient is high likely exposed to