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 an 80-year-old woman with a history of arthritis, chronic renal insufficiency, and no known cardiovascular risk factors who presented after onset of middle scapular pain. she felt like she was unable to get comfortable. she had some associated nausea and vomiting but no shortness of breath. the pain radiated to her shoulders bilaterally. she took an aspirin and maalox without significant relief. she denies hematemesis or diaphoresis. she has never experienced anything like this in the past. on arrival to the emergency room, her initial electrocardiogram showed st elevations of 2 mm to 3 mm in v1 through v5 with poor r wave progression anteriorly consistent with anterior wave myocardial infarction. symptoms resolved completely with sublingual nitroglycerin. because she was symptom free, the decision was made not to proceed with acute intervention and she was treated with heparin, and integrilin, and aspirin. a follow-up electrocardiogram was consistent with completion of anterior wave myocardial infarction, and she had creatine kinase elevation to 304, with a mb of 29, and troponin of 33, mb index of 10%. a bedside echocardiogram in the emergency room showed anterior wall motion deficit. of note, her glucose in the emergency room was 462 without a prior history of diabetes. past medical history: 1. osteoporosis. 2. arthritis, left foot valgus with use of a brace. 3. status post hysterectomy 20 years ago. 4. no diabetes, no history of hypertension. medications on admission: medications at home include aleve and os-cal. allergies: codeine causes nausea and vomiting. family history: no cardiovascular disease. no diabetes mellitus. social history: no smoking, rare alcohol use. review of systems: the patient denied fever, chills, weight loss, blurry vision, polyuria, diarrhea, constipation, bright red blood per rectum, melena, dysuria, hematuria, paroxysmal nocturnal dyspnea or lower extremity edema. she sleeps on one pillow and did report some recent polydipsia. physical examination on presentation: vital signs were pulse of 97, blood pressure 142/60, respiratory rate 18, afebrile, oxygen saturation 96% on 3 liters nasal cannula. in general, an elderly pleasant woman in no apparent distress. heent revealed pupils were equal, round, and reactive to light. extraocular muscles were intact. the oropharynx with bleeding left upper palate. positive arcus. cardiovascular revealed jugular venous pressure 7 cm. no carotid bruits heard. neck was supple with full range of motion. a regular rate and rhythm. no murmurs, gallops or rubs. pulmonary had crackles at the left lower base; otherwise clear to auscultation bilaterally. the abdomen was soft, nondistended, normal active bowel sounds, and nontender. extremities were positive for degenerative joint disease, trace bilateral edema, faint but palpable pulses bilaterally. neurologically, cranial nerves were intact. no focal findings. normal sensory examination. rectal examination was guaiac-negative per emergency room. pertinent laboratory data on admission: complete blood count with a white blood cell count 9.7, hematocrit 45, platelets 146. sodium 134, potassium 4, chloride 98, bicarbonate 21, bun 12, creatinine 0.7, glucose 462. normal differential. normal pt, ptt, and inr; inr 1.1, ptt 23. creatine kinase #1 was 304, creatine kinase #2 was 779, creatine kinase #3 was 552. mb #1 was 29, mb #2 was 98, mb #3 was 62. mb index #1 was 10, mb index #2 was 12.7, mb index #3 was 11.2. albumin 3.4, calcium 9.2. troponin 33. triglycerides 85, hdl 77, ldl 100. phosphorous 2.8, magnesium 1.8. acetone negative. urinalysis had small blood,, greater than 1000 glucose, 15 ketones, ph of 6, 1 red blood cell, 2 white blood cells, occasional bacteria, specific gravity of 1.03. radiology/imaging: initial electrocardiogram revealed sinus rate 100, normal axis, intervals 0.129/0.76/0.408. st elevations of 2 mm to 3 mm in v1 through v5. no comparison electrocardiogram. electrocardiogram # elevations but not at baseline, t wave inversions anteriorly, and q waves anteriorly. electrocardiogram #3 with sinus rate of 80, normal axis, 0.14/0.8/0.47, q wave in v1 through v4, 0.5-mm st elevations in v2 with resolution of other st elevations. t wave inversions in v1 through v5. chest x-ray on admission revealed no infiltrates, no pneumothorax, widened mediastinum. impression: an 80-year-old woman with no known cardiac risk factors but newly found diabetes mellitus and anterior st elevations likely anterior myocardial infarction in evolution with positive creatine kinases and troponin. by the time the cardiology team admitted the patient she was pain free and repeat electrocardiogram showed improvement in her st elevations. hospital course: 1. cardiovascular: the patient's creatine kinases and troponin levels were followed until they peaked and then decreased. she was placed on aspirin, heparin drip, and integrilin drip. she was started on a beta blocker to control her moderately elevated blood pressure on admission. she was also started on an ace inhibitor. the patient was not taken for an urgent catheterization immediately. on hospital day two, the patient's integrilin drip was discontinued as her creatine kinases decreased and she was asymptomatic. she was continued on the heparin drip for a total of 48 hours. her beta blocker, lopressor, and ace inhibitor were increased to control her heart rate and blood pressure, and lipitor was also started. on hospital day two, the patient was also transferred from the coronary care unit to the floor because she was stable and asymptomatic. her anterior wave myocardial infarction was completed at this point without any complications such as congestive heart failure. the patient's official echocardiogram was an ejection fraction of 35% to 40% with basal anterior, middle anterior, and middle anterior septal, anterior apex, septal apex, akinetic, and basal anterior septal hypokinesis. on the morning of the patient underwent a persantine mibi given the difficulty of exercising with her severe arthritis. her stress electrocardiogram showed no st changes and she experienced no anginal symptoms. the nuclear report reported an ejection fraction of 49% and a partial reversible defect in lateral wall. after discussion with the family it was decided that the patient would undergo cardiac catheterization on . on catheterization the following pressures were found: left ventricle 143/12, aortic 143/70, with a mean of 100, left ventricular end-diastolic pressure of 9, ejection fraction of 47%, akinetic anterolateral hypokinesis, hypokinetic apical, hypokinetic inferior, and normal mitral valve. the middle right coronary artery showed discrete 50% lesion, middle left anterior descending artery with diffuse disease of 80%, distal left anterior descending artery with diffuse disease of 80% after second diagonal. right-dominant coronaries, 1-vessel disease, mild systolic ventricular dysfunction, and a percutaneous transluminal coronary angioplasty and stent were done of the middle left anterior descending artery stenosis. post catheterization, the patient did well. she was continued on aspirin and lipitor, and she was placed on integrilin overnight. she was also continued on her metoprolol and captopril. 2. endocrine: the patient had a high blood glucose on admission with no prior history of diabetes. a hemoglobin a1c was checked, and she was placed on a sliding-scale regular insulin for blood glucose control, q.i.d. fingersticks were checked. the goal was to keep her blood sugars less than 150 ideally in this post infarction time period. consultation was called on the patient given her new diagnosis of diabetes. the team recommended starting glucotrol 2.5 mg p.o. b.i.d. after her catheterization which was done. a diabetes teaching nurse also came to teach the patient how to use the glucometer, and it was determined that she would follow up with dr. in the clinic two weeks after discharge. while starting the oral hypoglycemics she was continued on the regular insulin sliding-scale. prior to discharge, her glucotrol was increased to 5 mg p.o. q.a.m. and 2.5 mg p.o. q.p.m. the patient's hemoglobin a1c came back at 11.8. 3. gastrointestinal: the patient was placed on protonix and colace for prophylaxis. 4. renal: the patient's renal function was at baseline and remained stable. 5. rheumatology: the patient has a history of arthritis. she was placed on p.r.n. tylenol. 6. hematology: the patient's coagulations were followed on the heparin drip and integrilin drip and remained stable. 7. prophylaxis: the patient was on protonix and heparin. she was also eating a regular diabetic diet when she was not undergoing tests. she was also seen by physical therapy while she was in the hospital. 8. code status: full. 9. discharge disposition: on hospital day two the patient was hemodynamically stable without recurrent anginal symptoms or chest pain, and she was transferred to the regular floor but continued to be followed by the coronary care unit team. the patient was seen by physical therapy on , who noted some balance impairments; although the patient denied this. they determined that she was unsafe to go home and that she may require some rehabilitation. however, the patient lives with her daughter and refused any rehabilitation placement. she was seen once more by physical therapy prior to discharge, and this time did better ambulating. condition at discharge: condition on discharge was stable. discharge status: home with daughter. medications on discharge: 1. lipitor 20 mg p.o. q.p.m. 2. zestril 10 mg p.o. q.d. 3. atenolol 25 mg 3 tablets p.o. q.d. 4. aspirin 325 mg p.o. q.d. 5. plavix 75 mg p.o. q.d. for 30 days. 6. glucotrol 5 mg 1 tablet p.o. every morning and half tablet p.o. every afternoon. discharge instructions: 1. the patient was instructed to call the clinic to make an appointment with dr. in two weeks after discharge and to make an appointment with healthy you and food for thought for diabetic counseling. 2. the patient was asked to see her primary care physician within one to two weeks after discharge and to have her cholesterol rechecked three weeks after discharge. discharge diagnoses: 1. status post acute anterior myocardial infarction with a percutaneous transluminal coronary angioplasty and stent of left anterior descending artery. 2. diabetes mellitus, newly diagnosed. 3. arthritis. 4. osteoporosis. , m.d. dictated by: medquist36 d: 15:28 t: 06:33 job#: procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor left heart cardiac catheterization diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation osteoporosis, unspecified osteoarthrosis, unspecified whether generalized or localized, site unspecified 

Answer: The patient is high likely exposed to