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 63 year-old woman with known coronary artery disease (st myocardial infarction in with percutaneous transluminal coronary angioplasty in , to obtuse marginal one, lcx obtuse marginal one) with acute onset of right sided chest discomfort afternoon of presentation, which waxed and waned for 30 minutes. onset of pain was at rest and associated with diaphoresis, nausea. no vomiting and no radiations. the patient states had chills over the last week with a red swollen right second toe, but no fevers. in review of systems she also notes shortness of breath, two pillow orthopnea and dyspnea on exertion with about ten steps. in the emergency department she was found to have 2 to elevations in her inferior leads (lead 2, 3 and avf) and was taken to catheterization, which showed a 99% stenosis at the origin of the right posterior descending coronary artery. this lesion was stented with a 2.25 times 20 mm pixel stent with resultant 0% residual stenosis and brisk flow. left ventriculography showed posterior basal severe hk, no mitral regurgitation and left ventricular hypertrophy of approximately 65%. her hemodynamics showed pa pressures of 56/35, wedge of 31, cardiac output of 3.88 and index of 1.86. during the procedure the patient had transient hypotension and bradycardia, which responded to atropine and dopamine transiently. she was transferred to the coronary care unit for further management. past medical history: 1. coronary artery disease status post st myocardial infarction in treated with lytics and percutaneous transluminal coronary angioplasty times two and . 2. hypertension. 3. psoriasis. 4. arthritis. 5. gastroesophageal reflux disease. 6. irritable bowel syndrome. 7. obesity. 8. status post appendectomy. outpatient medications: 1. remicade. 2. hydrochlorothiazide. 3. diltiazem. 4. folic acid. 5. tylenol #3 prn. allergies: penicillin, which gives a rash. social history: the patient lives alone and is single. tobacco one to two packs per day times 20 years. quit 15 years ago. etoh quit 31 years ago. family history: mother died of coronary artery disease at the age of 77. brother in mid 50s. father with diabetes. physical examination on admission: weight 108.9 kilograms, blood pressure 134/73. pulse 72. respirations 17. oxygen saturation 98% 5 liters nasal cannula. general, obese female appearing fatigued and in no acute distress. heent slightly dry mucous membranes. neck no jvp. no bruits. lungs faint rales at bases, distant breath sounds bilaterally. cardiovascular normal s1 and s2. no murmurs, rubs or gallops appreciated. abdomen obese, normoactive bowel sounds, soft, nontender, nondistended. skin psoriatic patches with erythema on trunk although on extremities, left wrist/dorsum hand with swelling/warmth. also noted in thenar eminence. right second metatarsal and length of second toe with erythema, edema and warmth, tender to movement, but no skin breakdown seen. electrocardiogram normal sinus rhythm at 75 beats per minute, st elevations of 2 to 3 mm in leads 2, 3 and avf with st depressions of 1 to 2 mm in lead v2. laboratory data on admission: ck 94, mb of less then 0.01 rising to ck of 589 with an mb of 11 and index of 8.3%. chemistries notable for creatinine of 1.1, white blood cell count of 20 with 88% neutrophils, 7% lymphocytes, 2 monocytes, hematocrit 35.7, platelets 481. tte in showed normal ef, no wall motion abnormalities. cardiac catheterization as per history of present illness, also noted left anterior descending coronary artery, left circumflex with mild luminal irregularities. right coronary artery with right posterior descending coronary artery pixel stent 2.25 times 20 mm, ra mean 25, wedge 34, pa 60/36, lvef 60% with severe hk of posterior basal wall. hospital course: 1. coronary artery disease/ischemia/st myocardial infarction: the patient was taken to the catheterization laboratory and stent placed with normalization of electrocardiogram. her ck peaked at 1040 with mb of 149 (14.3% mb index) and troponin t of 3.71. the patient was medically managed also with aspirin, plavix, high dose statin, beta-blocker and ace inhibitor. during her recovery period she experienced reinfarction of this area with in stent rethrombosis. this was documented by repeat catheterization showing 100% occlusion of the placed stent in the right posterior descending coronary artery. she had repeat cks cycled, which peaked at about 300. at the time of her repeat infarction that she noted chest pain associated with elevations in 2, 3 and avf, but became chest pain free about 30 minutes after. there was no further intervention made during her second catheterization given that the patient was chest pain free and likely had finished infarcting the area. 2. pump issues: the patient had a tte on , which showed ef of 40%, normal left ventricular wall thickness cavity size and hypokinesis of the inferior, posterior and lateral walls. she had mild av and mv thickening, but no aortic regurgitation or mitral regurgitation. she was gently diuresed initially given her elevated wedge pressures, but maintained euvolemic throughout the remainder of her admission. 3. rhythm: immediately after her infarction she was noted o have several runs of nonsustained ventricular tachycardia, which were note noted in the subsequent days of her admission. 4. blood pressure issues: her blood pressure tolerated her new cardiac regimen with systolics running 110s to 120s. 5. arthritis: the patient was seen by rheumatology who tapped her left wrist. no crystals were seen. it was determined that she likely had psoriatic arthritis, but wrist/foot films are pending. she was started on low dose vioxx with decrease in the signs and symptoms of inflammation, but with residual tenderness. she will follow up with her outpatient rheumatologist at discharge. per rheumatology team her psoriasis was flaring at this time and this could be the reason for her arthritis on admission. 6. psoriasis: dermatology was consulted given the patient's severe pruritus all over her body. she was started on steroid ointment with clobetasol and dovonex though this was not available by pharmacy. she will need close follow up with outpatient dermatologist and was recommended not to continue the steroid cream for greater then one month without evaluation as this could lead to skin breakdown and superinfection. 7. gastroesophageal reflux disease: the patient was continued on pantoprazole. disposition: the patient will be discharged to home with primary care physician to set up cardiac rehab. discharge condition: stable. discharge status: to home. discharge diagnoses: 1. myocardial infarction. 2. coronary artery disease. 3. hypertension. 4. gastroesophageal reflux disease. 5. psoriasis. 6. arthritis likely psoriatic. discharge medications: 1. aspirin 325 mg po q.d. 2. plavix 75 mg po q.d. 3. acetaminophen prn. 4. sarna lotion prn. 5. atorvastatin 80 mg po q.d. 6. pantoprazole 40 mg po q.d. 7. toprol xl 50 mg po q.d. 8. sublingual nitroglycerin 0.3 mg prn up to three tablets at a time. 9. vioxx 12.5 mg po q.d. 10. clobetasol 0.05% ointment applied b.i.d. 11. calcipotriene 0.005% cream b.i.d. 12. lisinopril 5 mg po q.d. follow up plans: the patient will call primary care physician . for appointment in the next week. she has an appointment with him also on and an appointment has been made for her to see dr. on at 8:30 a.m. she will need to follow up with dermatologist in the next three to four weeks and outpatient rheumatologist as well. , m.d. dictated by: medquist36 procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization combined right and left heart cardiac catheterization coronary arteriography using two catheters coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor arthrocentesis diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension acute myocardial infarction of other inferior wall, initial episode of care primary pulmonary hypertension other complications due to other cardiac device, implant, and graft psoriatic arthropathy 

Answer: The patient is high likely exposed to