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: no known allergies / adverse drug reactions attending: chief complaint: stemi major surgical or invasive procedure: cardiac catheterization with des to pda of lcx history of present illness: 45m with history of htn presented to on morning of with cc of buring sensation in his chest. symptoms started while eating a large meal and continued with exertion while eating in his garden as the morning progressed. also endorsed bilateral arm heaviness and pain radiating to his jaw. there was conern for acs/ua vs aortic disection. he underwent cta which showed no evidence of thoracic or abdominal aortic dissection. was awaiting transfer to for further work up of possible ua when he had an increase in chest pain and a subsequent ekg showed ste in ii,iii and avf. his transfer was expedited to . prior to transfer he received asa, heparin bolus and gtt. integrillin gtt was started and he received prasurgrel in the cath lab. . he was taken to the cath lab where he was found to have 2 vessel disease in l dominant system. the lcx had large bifurcating ramus intermedius with 80% occlusion, an om1 with 60% occlusion at the origin and a totally occluded lesion to the l pda a des was deployed across the lesion. he was also found to have an 80% occlusi9on of the lad. . he tolerated the procedure well and is currently chest pain free. on review of systems, s/he 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. s/he denies recent fevers, chills or rigors. s/he 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: hypertension 2. cardiac history: - cabg: none - percutaneous coronary interventions: none prior - pacing/icd: 3. other past medical history: social history: - tobacco history: none family history: - no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission physical examination: vs:57 126/74 o2 sat 100% 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. neck: supple with no obvious lvd cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: aaox3, cnii-xii intact, no focal deficits discharge exam: tm/tc:98.3/98.2 hr:50-68 bp:110-127/71-85 rr:18 02 sat:98% ra general: 57 yo m in no acute distress heent: mucous membs moist, no lymphadenopathy, jvp non elevated chest: ctabl no wheezes, no rales, no rhonchi cv: s1 s2 normal in quality and intensity rrr no murmurs rubs or gallops abd: soft, non-tender, non-distended, bs normoactive. ext: wwp, no edema. dps, pts 2+. right radial site without bruising or tenderness. neuro: 5/5 strength in u/l extremities. pertinent results: admission labs: 12:48pm blood wbc-8.0 rbc-4.72 hgb-14.8 hct-43.6 mcv-92 mch-31.3 mchc-33.8 rdw-12.9 plt ct-219 12:48pm blood pt-12.6* ptt-103.0* inr(pt)-1.2* 12:48pm blood fibrino-211 12:48pm blood glucose-133* urean-14 creat-0.9 na-138 k-4.5 cl-101 hco3-23 angap-19 12:48pm blood ck(cpk)-292 12:48pm blood lipase-33 12:48pm blood ck-mb-10 mb indx-3.4 pertinent interval labs: 08:59pm blood ck-mb-102* 05:13am blood ck-mb-69* 08:59pm blood %hba1c-5.3 eag-105 08:59pm blood triglyc-102 hdl-42 chol/hd-3.5 ldlcalc-85 studies: cardiac catheterization (): comments: 1. selective coronary angiography of this left dominant system demonstrated two vessel coronary artery disease. the lmca was free of any angiographically-apparent flow-limiting stenoses. the lad had a proximal 80% lesion. the large bifurcating ramus intermedius had an 80% stenosis. the om1 had a 60% lesion at the origin. the l pda was notable for a total occlusion. the rca was a nondominant vessel with no significant lesions. 2. limited resting hemodynamics revealed normal systemic arterial pressures, with central aortic pressure of 121/70, mean 80 mmhg. 3. successful pci of total occlusion of left pda branch using promus element 2.5 x 20 mm drug eluting stent, post-dilated toe 2.75 mm. 4. hemostasis at right radial arterial access site using tr band. final diagnosis: 1. 2 vessel coronary artery disease in a left dominant system with presentation as acute inferior stemi. 2. systemic arterial normotension. 3. successful pci of occluded left pda artery using promus element 2.5 x 20 mm des. excellent result. 4. aspirin daily. prasugrel 10 mgs daily. 5. continue integrilin infusion for 4 hours. echo (): the left atrium is moderately dilated. the right atrium is moderately dilated. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with basal to mid inferolateral hypokinesis. the right ventricular cavity is mildly dilated with borderline normal free wall function. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: mild regional systolic function c/w cad with involvement of the rv free wall. no significant valvular abnormality seen. biatrial dilation. discharge labs: 08:55am blood wbc-3.3* rbc-4.66 hgb-14.5 hct-44.1 mcv-95 mch-31.2 mchc-32.9 rdw-13.2 plt ct-202 08:55am blood glucose-113* urean-13 creat-0.9 na-141 k-4.0 cl-102 hco3-29 angap-14 08:55am blood calcium-9.3 phos-3.1 mg-1.9 brief hospital course: brief patient summary: 45 yom with history of transferred from for inferior stemi now s/p pci of l pda, with unremarkable course in ccu for post-procedural monitoring. issues: # cad: patient presented with chest pain and e/o inferior stemi. s/p pci of pda off lcx in left dominant system with resolution of chest pain and ste changes. new qwaves suggest transmural infarct of tissue. ha1c 5.3, ldl 85, hdl 42. patient was placed on prasugrel, 10mg every day. also placed on asa 81, lisinopril 2.5mg qd, atorvastatin 80mg qd. started very lose dose beta blocker with metoprolol succinate 12.5mg daily. pt was bradycardic in 50-60s prior to beta blocker therapy and remained stable with hr in 50-60s after starting bb. he had a few episodes of atrial tachycardia followed by pauses but was asymptomatic during these episodes so bb was continued. echo two days after cardiac cath demonstrated mild regional systolic function c/w cad with involvement of the rv free wall. no significant valvular abnormality seen. biatrial dilation. pt had significant lad disease that was not stented - he was instructed to call cardiologist or go to ed if chest pain returns. if he remains stable, lad disease should be graded with outpatient stress test/work up and possible elective stenting. # rhythm: sinus bradycardia and nsr on telemetry for post-procedural monitoring. a few episodes of atrial tachycardia as above, asymptomatic and self-terminated. # htn: normotensive during admission. initiated low-dose ace-inhibitor, with titration up as an outpatient if pressures tolerate. transitional issues: 1. stop cialis/viagra unless instructed otherwise by cardiologist 2. outpatient follow-up with cardiologist: will likely need stress test in future if symptoms absent. 3. consider up-titrating lisinopril if blood pressure allows medications on admission: - lisinopril 10mg qd - cialis prn discharge medications: 1. prasugrel 10 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*11* 2. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 4. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. metoprolol succinate 25 mg tablet extended release 24 hr sig: 0.5 tablet extended release 24 hr po daily (daily). disp:*15 tablet extended release 24 hr(s)* refills:*2* 6. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet sublingual as directed as needed for chest pain: take 1 tab for chest pain, wait 5 min, take 1 more tab. call 911 if you still have chest pain after 2 tabs. . disp:*25 tablets* refills:*0* discharge disposition: home discharge diagnosis: st elevation myocardial infarction hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you were admitted to the hospital because you had a heart attack. you underwent cardiac catheterization and had a stent placed in one of your coronary arteries. there are other blockages in your coronary arteries that were not severe enough to open and the medicines that help your heart recover from the heart attack may help to prevent the blockages from getting worse. an echocardiogram showed that your heart is somewhat weaker after the heart attack. you will get another echocardiogram in about a month to check to see if some of the function has returned. your new cardiologist, dr. , recommend a cardiac rehabilitation program nearby that will be very helpful in your recovery and preventing another heart attack. . we made the following changes to your medicines: 1. decrease the lisinopril to 2.5 mg daily as your blood pressure is lower 2. start taking aspirin 81 mg and prasugrel 10 mg daily to prevent the stent from clotting off and causing another heart attack. do not miss or stop taking this medicine unless dr. tells you it is ok. 3. start taking metoprolol xl to slow your heart rate and help your heart recover from the heart attack. 4. start taking nitroglycerin to treat any chest pain that is similar to the pain you had when you had the heart attack. 5. start taking atorvastatin to lower your cholesterol and help your heart recover fromt the heart attack. 6. please also stop your cialis for now and discuss with your cardiologist when you may restart it. this medicine interacts with the nitroglycerin so do not take cialis if you have taken the nitroglycerin within the last 24 hours. followup instructions: please be sure to keep all of your followup appointments as listed below: name: , d do location: medical -cardiology address: ., ste 3a, , phone: appt: at 11:30am procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension acute myocardial infarction of other inferior wall, initial episode of care 

Answer: The patient is high likely exposed to