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: this is a 69-year-old male with a past medical history significant for hypertension, disease who is status post a large anterior myocardial infarction, status post cardiac catheterization, who is being admitted to the coronary care unit for observation and management. the patient was in his usual state of health until he stopped his aspirin for approximately one week in order to receive a the sudden onset of substernal chest pain at 12:45. it was rated a , and it radiated to his left arm. it was associated with shortness of breath. there was no nausea or vomiting. the patient immediately presented to the emergency department at the . an electrocardiogram done in the emergency room showed marked st elevations in the precordial leads, in i, and with corresponding st depressions inferiorly. he was given aspirin, sublingual nitroglycerin, lopressor intravenously, and he was placed on a nitroglycerin drip. he was started on tenecteplase and transferred to for cardiac catheterization. immediate catheterization upon arrival to revealed a 60% left anterior descending artery lesion which received successful percutaneous transluminal coronary angioplasty. no left ventriculogram was performed. there were no arrhythmias, and hypotension was not seen. pressures on entering were pulmonary artery pressures of 51/20, with a wedge pressure of 22, cardiac output of 6.45, and a cardiac index of 3.15. post catheterization, he was transferred to the coronary care unit for further care. upon arrival at the coronary care unit, his blood pressure and heart rate were normal, and the patient denied any chest pain. he did acknowledge some discomfort in his chest and graded it a . there was no radiation, shortness of breath, nausea or vomiting. he also noted some groin discomfort. past medical history: 1. hypertension. 2. paroxysmal atrial fibrillation since for which he was not treated with coumadin. 3. the patient had a colonoscopy last week; the results of which were pending at that point in time. medications on admission: the patient takes atenolol 50 mg p.o. q.d., he takes procardia 90 mg p.o. q.d., and aspirin 81 mg p.o. q.d. allergies: he has no known drug allergies. social history: he is married with children. he denies any tobacco use ever, and he drink two to three beers per week. family history: his brother had a myocardial infarction at approximately the age of 65. there is no other history of heart disease. physical examination on presentation: on arrival to the coronary care unit, physical examination revealed vital signs with temperature of 97.9, blood pressure 134/80, heart rate 63, respiratory rate 16, oxygen saturation 98% on 4 liters nasal cannula oxygen. in general, he was lying flat, resting comfortably, breathing easily. he was obese, in no acute distress. head, ears, nose, eyes and throat examination revealed normocephalic and atraumatic. pupils were equal, round, and reactive to light. mucous membranes were dry without lesions. neck revealed he had jugular venous pulse to approximately 11 cm. cardiovascular examination revealed a regular rate and rhythm. normal first heart sound and second heart sound. no murmurs, gallops or rubs. lungs were clear to auscultation bilaterally with slightly decreased breath sounds at the bases. abdominal examination revealed he was obese, soft, nontender, and nondistended, positive bowel sounds. groin was in the femoral clamp post catheterization and discontinuation of the femoral sheath. extremities revealed his distal pulses were 2+ in all four extremities without any edema. pertinent laboratory data on presentation: white blood cell count of 12.2, hematocrit of 39.6, platelets of 334. blood urea nitrogen 14, creatinine 0.8; the remainder of his laboratory results were pending. the differential on his white blood cell count was 92 neutrophils, 1 band, 5 lymphocytes, 1 monocyte. radiology/imaging: a creatine kinase was 2584, mb 112, for an index of 4.3. the catheterization results showed pressures with pulmonary artery of 51/20, wedge 23, cardiac output 6.45, cardiac index of 3.15. the left main had a mild tapering left anterior descending artery with 60% proximal lesion, 90% ulcerated lesion after the first diagonal split off, moderate diffuse disease distally, a nondominant left circumflex, and a right coronary artery with mild disease. he was bolused with heparin, nitroglycerin, and diltiazem during the procedure. electrocardiogram prior to procedure showed sinus rhythm at 75, st elevations in precordial leads i and , depressions in iii and avf, poor r wave progression, and a q wave in v1 through v4. electrocardiogram post procedure showed normal sinus rhythm at 60, improved st elevations in v1 through v4, i, and . no st depressions in the inferior leads and the poor r wave progression previously seen. impression: this is a 69-year-old male with a history of hypertension, atrial fibrillation, and no known coronary artery disease who presented with large anterior myocardial infarction, status post percutaneous transluminal coronary angioplasty to the left anterior descending artery and stenting, who was admitted to the coronary care unit for observation. plan/cardiovascular: serial electrocardiograms will be obtained each day. creatine kinases will be followed until they are trending down for two consecutive creatine kinases. the patient will not be placed on a 2b3a inhibitor since he received thrombolytics at an outside hospital prior to catheterization. aspirin will be continued, plavix 300 mg was given, and then he will be continued on plavix 75 mg p.o. q.d. times 30 days. the patient will be continued on a heparin drip for 48 hours. the patient will be started on a statin, and an ace inhibitor and a beta blocker will be as the heart rate and blood pressure tolerate it. a transthoracic echocardiogram will be obtained prior to discharge. if the patient has apical akinesis, the patient will be anticoagulated for approximately three months with coumadin. he will be maintained on heparin until he receives his echocardiogram. hospital course: on hospital day two, the patient was started on low-dose lopressor and captopril; these will be slowly increased over the next few days. his creatine kinases peaked at 3824 with a mb fraction of 268 on the evening of . the patient was given one dose of lasix for diuresis. other than that, he was comfortable and in good condition, and he was transferred to the floor. he was also started on coumadin 5 mg in the evening for likely apical akinesis and 3-month anticoagulation. on hospital day three, the patient's heart rate went up to 150. an electrocardiogram was obtained which showed that the patient was in atrial fibrillation. the patient was given lopressor intravenously which controlled the ventricular response, and the patient returned to sinus rhythm a few hours after this event. also on hospital day two, a large groin hematoma was noted. an ultrasound was obtained that showed no pseudoaneurysm. hematocrit was checked which was unchanged from prior. on hospital day four, a physical therapy consultation was obtained, and the patient ambulated down the hallway and up stairs without any significant problems, and he was deemed safe for discharge. an echocardiogram was also obtained that showed an ejection fraction of approximately 30%. it showed severely depressed left ventricular function, hypokinesis of the anterior free wall, anterior septum, and apical hypokinesis and akinesis. there was also 1+ mitral regurgitation and borderline pulmonary hypertension. on hospital day five, the patient's inr was still 1.2. his coumadin was increased to 7.5 mg the night before. the patient was continued on the heparin. he will be discharged on on lovenox until his inr becomes therapeutic. discharge plan: the current plan is for him to be discharged to the residence in , . will give him his lovenox for four doses, and he will go home to , and follow up with dr. (telephone number ) for an inr check on friday, and he was to follow up with the cardiologist on tuesday, , at 3:40 p.m. this information was given to the patient and his wife. medications on discharge: 1. zestril 5 mg p.o. q.d. 2. atenolol 50 mg p.o. q.d. 3. coumadin 7.5 mg p.o. q.d. 4. aspirin 325 mg p.o. q.d. 5. plavix 75 mg p.o. q.d. times 30 days. 6. lipitor 10 mg p.o. q.d. 7. lovenox 80 mg subcutaneous b.i.d. times four doses. discharge diagnoses: 1. hypertension. 2. history of paroxysmal atrial fibrillation. 3. anterior myocardial infarction with an ejection fraction of 30%. 4. hematoma condition at discharge: he was discharged in stable condition and with the previously dictated follow-up arrangements. , m.d. dictated by: medquist36 d: 16:45 t: 15:58 job#: procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation hematoma complicating a procedure other chronic pulmonary heart diseases 

Answer: The patient is high likely exposed to