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: history of present illness: the patient is a 47-year old male with multiple cardiac risk factors including hypertension, hyperlipidemia, tobacco and a family history who presented to an outside hospital on the morning of after experiencing the onset of "" chest pain beginning at rest at 3 a.m. with associated nausea and diaphoresis. the patient states that he developed upper respiratory tract infection symptoms approximately two days prior to this presentation which included sputum and fevers. later that same evening, he developed severe chest pain at 1 in the morning which was "heavy" and occurred in bursts of minutes diminishing spontaneously. the patient was able to sleep comfortably that evening however on the following morning, at 3 a.m., he woke up with severe chest pain. he subsequently presented to hospital emergency department there. there he was found to have a temperature of 101. ekg revealed an extreme right axis pole, r waves in v1 through v3, st segment depressions in v1 through v3 and st segment elevations of approximately 0.5 millimeters in v5 to v6, i and l. he had his ck checked which was greater than 3000 with an mb of 185, a troponin was greater than 50. he was started on iv nitroglycerin, iv heparin, however he still continued to have 4/10 chest pain at which time, integrilin was added. the patient's chest pain persisted. a stat echocardiogram was done which revealed an ejection fraction of 40%, lateral wall akinesis, posterolateral hypokinesis. the patient was transferred to the hospital for emergent cardiac catheterization. past medical history: 1. hyperlipidemia. 2. hypertension. 3. cervical disk herniations status post surgery x4. 4. status post right orbit reconstruction. 5. status post left total knee replacement. medications on presentation to outside hospital: 1. pravachol, dose unknown. 2. hydrochlorothiazide, dose unknown. 3. percocet, dose unknown. 4. atenolol, dose unknown. family history: the patient had a father who had a coronary artery bypass graft at age 56, had a brother who died age 42 of a cardiac arrest/myocardial infarction. allergies: no known drug allergies. social history: the patient is unemployed and lives on disability. he lives with his family and has two children. he is currently a smoker, smoking one per pack day times over 30 years. he denies intravenous drug use or alcohol use. physical examination: on presentation, vitals - temperature 97, blood pressure 108/58, pulse 97, respiration 16, saturating 100% on 2 liters. the patient was 6'7" tall. general - he was a tall, middle-aged male lying in bed in no apparent distress. heent - normocephalic, atraumatic, mucous membranes moist. neck - supple without lymphadenopathy. jugular venous distention was flat at 180 degrees. cardiovascular - regular rate and rhythm, normal s1, s2, plus s3, no murmurs, gallops, rubs. chest - clear to auscultation bilaterally. abdomen - soft, nontender, nondistended with normal active bowel sounds. extremities - without lower extremity edema, 2+ dorsalis pedis pulses bilaterally, right groin sheath is in place, clean, dry and intact. neurologically, alert and oriented x3, cranial nerves iii-xii intact. laboratory: on presentation, wbc 17.9, hematocrit 37.6, platelets 232, mcv 100. sma-7 - sodium 138, potassium 3.8, chloride 101, bicarbonate 26, bun 16, creatinine .9, glucose 112. pt/inr 1.3, ptt 57.3. ck - 3049. abg - 7.3/941/113. ekg - pre-catheterization showed sinus with a rate 75 and extreme right axis, normal intervals, millimeter st segment depressions in i, l. tall r's in v1 through v4, q's in i, l, v5 and v6. post stent ekg - sinus tach with a rate of 100, right axis deviation, normal intervals, tall r's in v1 through v4 and q's in v5 and v6. brief hospital course: the patient was emergently transferred to the hospital from hospital with evidence of an evolving acute lateral wall myocardial infarction. he was noted to be hemodynamically stable however. the patient emergently presented to the cardiac catheterization lab where he was noted to have a normal left main and lad with 90% small d1, left circ with 100% occlusion of a large om1 which was noted to have thrombus in distal extension. his coronary artery had less than 40% luminal stenosis. the patient underwent angio-jet percutaneous transluminal coronary angioplasty and stent of his large om1. he was noted to have elevated pressures in the catheterization lab which included a ra pressure of 20, a pa pressure of 65/30, a wedge of 32 and a rv pressure of 45/20. the patient was transferred to the ccu service following his intervention. he was maintained on integrilin x18 hours, iv nitroglycerin for blood pressure control, iv heparin and plavix. he also received aspirin, small doses of lopressor which were titrated as he was weaned from the iv nitroglycerin, and small doses of an ace inhibitor. he was aggressively diuresed on the first two hospital days given his elevated left heart filling pressures during catheterization. he was monitored on telemetry without evident. his ck's peaked at 3225 with an mb of 118 and an index of 3.7. this index was down from his first ck which was 3049 with an mb of 158 and an index of 5.2. in addition, the patient had a fasting lipid panel checked. he was noted to have a normal cholesterol and ldh of 95 and hdl of 34. since his normal outpatient anti-hyperlipidemic was not on formulary, he was transiently put on lipitor throughout his hospitalization. after the patient was felt to be stable from a cardiac standpoint, he was transferred from the ccu to 11 where he continued to be monitored. he had serial ekg's performed which revealed persistent tall r waves in v1 through v2, q. waves in i, l, v5 and v6 and mild st segment elevations of to 1.5 millimeters in v2through v6. an echocardiogram was performed on the morning of hospital day #4, revealed an ejection fraction of 35%, bilateral atrial enlargement, mild global rv hypokinesis, lvh with a dilated lv cavity, and segmental lv wall motion abnormalities specifically akinesis in the inferoposterior lateral segments. the hospital course was somewhat complicated by intermittent episodes of chest pain which occurred 1-2x a day both at rest and with exertion. the symptoms were often quite nebulous in presentation and were never corresponding to the pain which brought him to hospital. they were occasionally associated with shortness of breath but there was never associated nausea, vomiting, or diaphoresis. the episodes were never associated with ekg changes and were never relieved with sublingual nitroglycerin. iv morphine sulfate was the only medication which seemed to relieve the symptoms. after long discussions with the cardiology team involved in this patient's care, it was decided that these were highly unlikely to represent post myocardial infarction angina or acute ischemic events. the patient's normal doses of pain medications specifically percocet which he takes for low back pain was titrated for improved relief and he subsequently remained symptom free. the patient also had multiple other issues arise throughout his hospital course. first off, the patient was noted to have a leukocytosis, cough and sputum production on presentation. repeat chest x-rays never revealed evolution of infiltrates, consolidations or effusions. his sputum was sent for culture however the sample was noted to have greater than 10 epithelial cells in addition to greater than 25 pmn's. there was no one predominant organism cultured from his sputum. his symptoms were perceived to be most likely consistent with a tracheobronchitis in this known smoker. he was treated with levaquin x5 days with slow resolution of his symptoms. the patient was also noted to have a somewhat low hematocrit on presentation which dropped from the mid 30's to 31 following his catheterization. it remained stable in the mid to low 30's. he was noted to have a borderline macrocytosis on presentation with an mcv of 99. b12 and folate studies were sent off but both came back normal. a full iron panel was also sent off and other than a low serum iron of 27, the rest of his serum iron panel was within normal limits. the patient's low hematocrit was believed to be most likely secondary to blood loss associated with his cardiac catheterization and he was subsequently started on a multivitamin for dietary supplementation. the patient was also noted to have a mild transaminitis upon presentation to the hospital with an ast of 288, and an alt of 63. his alkaline phosphatase was normal, however his total bilirubin was mildly elevated at 1.4 on presentation. his levels were monitored every day following admission and were noted to decrease, however on the day of discharge, they had still not normalized and remained mildly elevated at an ast of 76, and an alt of 81. a hepatitis panel was sent and was negative for hepatitis b and c. an acetaminophen level was also checked given this patient's known use of chronic percocet at baseline. however this level also came back negative. the patient was noted to take a statin chronically at baseline and it was reported that his transaminases might be mildly elevated in the setting of an hmg coa reductase inhibitor. it was recommended that he follow up with these studies with his outpatient physician. was discharged to home on the morning of hospital day #5 with plans to follow up with his primary care physician. much discussion with the patient, it was decided that he would preferentially seek cardiology care in the area near his home. it was decided that he would talk with his primary care physician in order to adequately choose a primary care physician. was told to follow up in weeks time with his primary care physician as well as his new cardiologist. medications on discharge: 1. aspirin 325 milligrams p.o. q.d. 2. plavix 75 milligrams p.o. q.d. 3. pravachol as previously prescribed. 4. plavix 75 milligrams p.o. q.d. x30 days. 5. lopressor 25 milligrams p.o. b.i.d. 6. zestril 2.5 milligrams p.o. b.i.d. discharge diagnoses: 1. acute lateral myocardial infarction. 2. ischemic cardiomyopathy, ejection fraction 35%. 3. hyperlipidemia. 4. hypertension. 5. cigarette smoker. 6. chronic back pain. condition on discharge: stable. , m.d. dictated by: medquist36 procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters intraoperative cardiac pacemaker injection or infusion of platelet inhibitor diagnoses: pneumonia, organism unspecified anemia, unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome tobacco use disorder other and unspecified hyperlipidemia acute myocardial infarction of other lateral wall, initial episode of care 

Answer: The patient is high likely exposed to