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: sulfa (sulfonamide antibiotics) / indocin / minocycline attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization history of present illness: 85 y/o m with pmh of copd, htn and recent admission to with chest pressure (negative stress test) who presents after 3-4 days of recurrent intermittent chest tightness/pressure. the patient had returned home following his prior admission and initially did well. over the past week, he has noted recurrence of his symptoms, along with some dizziniess, lightheadedness and nausea associated with some of these episodes. saw his new cardiologist, dr. , who repeated a nuclear stress test and echo which were reportedly negative and given ntg for the chest pressure. the chest pressure is associated with mild sob and nausea. previously relieved by the ntg, although not entirely responsive on the day of admission. went to , spoke to dr. , was transfered to for catheterization. . on arrival to , the patient had vitals temp: 97.8 hr: 63 bp: 137/79 resp: 18 o(2)sat: 98. was still c/o intermittent chest discomfort. troponin was negative. cbc and chem-7 unremarkable. ecg with prolonged pr but no e/o ischemia otherwise. seen by cardiology in the ed and sent for cath. pt was having chest pressure during and after the cath and was started on nitro gtt during and post-cath. . patient cath revealed 2-vessel disease. no interventions at that time. ct made aware and will decide whether patient is a surgical candidate. transferred to the floor on a nitro drip and still with intermittent chest pressure. pt was continuing to have ongoing chest pain, initially that increased to despite treatment with imdur and iv morphine. he was also given iv lopressor and started on heparin gtt. it was unclear if the pt was going to have a cabg in the future as his pcp wanted him to be evaluated by csurg first. . prior to arrival to the ccu, pt was chest-pain free. however, within ~ 15min of being on the floor, pt became acutely diaphoretic w/ chest pain and hypotensive with sbp 56-60s. his nitro gtt was shut off, he was put in trendelenberg and given a liter of fluid, run wide open. his bps responded immediately. his oxygen saturation went to its lowest at 91% on room air, increased to 95%, but then was put on a nrb, and had 100% saturations. bs checked at 119. ekg was unchanged from prior. after a few minutes, sbp increased to 120s, pt regained color in his face and his chest pain was much relieved. unclear as to the etiology of the acute hypotensive episode, but perhaps likely nitro gtt. past medical history: 1. cardiac risk factors: - diabetes, - dyslipidemia, +hypertension 2. cardiac history: - cabg: - percutaneous coronary interventions: - pacing/icd: 3. other past medical history: copd angina (30 years ago, normal stress test, never had cardiac cath) bph osteoarthritis kidney stone bronchiectasis herniorrhaphy in appendectomy cataract surgery social history: lives with wife, worked as machinist. -tobacco: quit 30 yrs ago, 50 pack year history -etoh: rare -illicit drugs: denies family history: - no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. -father: passed away from stroke at age 75 -mother: htn, colon ca -brother: htn physical exam: admission physical exam: heent- perrla, eomi, anicteric, mmm, op clear neck- supple, no jvp cardiac- rrr, s1 and s2, no r/g. i-ii/vi systolic murmur lung- good air entry b/l. crackle sounds diffusely throughout lungs. abdomen- soft nt/nd, bsx4 extremity- no gross deformity or edema neuro- awake, alert and oriented. moving all extremeties. . discharge physical exam: tm/tc:98.2/97.3 hr:60-86 bp: 97-153/60-86 rr: 18 02 sat: 96% ra general: 85 yo m in no acute distress heent: mucous membs moist, no lymphadenopathy, jvp non elevated chest: ctab no wheezes, no rales, no rhonchi cv: s1 s2 rrr no murmurs abd: soft, non-tender, obese, bs normoactive. no rebound/guarding. ext: wwp, no edema. dps, pts 2+. right and left groin without echymosis or hematoma. neuro: cns ii-xii intact. 5/5 strength in u/l extremities. gait wnl. skin: no rash psych: a/o pleasant pertinent results: on admission: 07:10pm blood wbc-9.1 rbc-4.60 hgb-13.9* hct-41.2 mcv-90 mch-30.3 mchc-33.8 rdw-12.3 plt ct-233 05:15am blood pt-13.5* ptt-26.6 inr(pt)-1.1 07:10pm blood glucose-100 urean-16 creat-0.7 na-132* k-4.2 cl-96 hco3-27 angap-13 05:05am blood alt-16 ast-17 ck(cpk)-56 alkphos-58 totbili-0.9 05:30pm blood ck-mb-4 ctropnt-<0.01 09:28pm blood ck-mb-3 ctropnt-<0.01 01:00am blood ck-mb-3 ctropnt-<0.01 05:30pm blood calcium-9.1 phos-3.4 mg-1.8 05:05am blood %hba1c-5.8 eag-120 on discharge: 06:21am blood wbc-11.9* rbc-4.52* hgb-13.8* hct-39.7* mcv-88 mch-30.6 mchc-34.8 rdw-12.5 plt ct-244 06:21am blood glucose-117* urean-11 creat-0.9 na-134 k-4.1 cl-97 hco3-29 angap-12 05:05am blood %hba1c-5.8 eag-120 05:05am blood triglyc-89 hdl-53 chol/hd-2.5 ldlcalc-61 studies: cardiac cath - 1. selective coronary angiography in this right dominant system demonstrates two vessel disease. there is an 80% lesion at the ostium of the left anterior descending, and an 80% lesion in the right coronary artery involving the bifurcation of the posterior descending artery. the left main and circumflex contain mild disease only. 2. limited resting hemodynamics demonstrate normal systemic blood pressure. echo - left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. impression: normal global and regional biventricular systolic function. mild aortic and mitral regurgitation. cta chest w&w/o c&recons, non-coronary - the lungs feature bilateral dependent atelectasis with possible emphysematous changes, although extensive motion artifact limits evaluation. there are no concerning lung nodules or diffuse opacities identified. there is no pleural or pericardial effusion. the airways are patent to the segmental level bilaterally. there is a left periaortic mediastinal lymph node which does not meet ct size criteria for enlargement. no axillary, mediastinal, or hilar lymphadenopathy identified. there is minimal fusiform dilation of the ascending aorta, with a maximal diameter of 4.44 cm x 3.69 cm occurring just proximal to the origin of the innominate artery (series :image 7682). this is stable from the prior studies. there is no dissection flap identified. scattered atherosclerotic calcifications are seen in the aorta with more extensive disease of the imaged coronary arteries. the main thoracic branches of the aorta are patent with incidental note of a tortuous innominate artery that has a 180 degree hairpin turn (401b:24). there is no pulmonary embolism. the imaged upper abdomen is unremarkable. there are degenerative changes of the thoracic spine but otherwise the imaged axial skeleton is unremarkable. cardiac cath : final report is pending. a des was placed in the 80% rca lesion. brief hospital course: mr. is an 85 year-old male with pmh of copd, htn and recent admission to with chest pressure (negative stress test)who presented after 3-4 days of recurrent intermittent chest tightness/pressure and found to have lad and rca 80% stenosis. . #. cad - mr. presented following 3-4 days of chest pressure as above. in the ed, his vital signs were stable. initial laboratory studies including cbc, chem-7 and troponin were largely unremarkable. an ecg showed prolonged pr but no other evidence of ischemia. given the patient's symptoms he was taken to cardiac cath and was found to have an 80% lesion at the ostium of the left anterior descending, and an 80% lesion in the right coronary artery involving the bifurcation of the posterior descending artery. during the procedure the patient described chest pressure. no intervention was done and ct surgery consulted. the patient returned to the floor. on the floor, the patient continued to describe chest pressure/pain. no ecg changes. started on a nitro drip which initially improved his symptoms however the pain did not resolve. the nitro drip was uptitrated to 200mcg however the patient still described pain. given lopressor, morphine and started on a heparin drip. the pain did not improve and the decision was made to transfer the patient to the ccu. his vs were otherwise stable and he did not have remarkable ecg changes. in the ccu, pt continued to have transient episodes of chest pain, but that improved upon administration of a ppi and maalox/lidocaine. he was taken for catheterization after the pt decided he would like to have stents placed, rather than go through a cabg. in the cath lab, a des was placed in the 80% rca lesion. he initially had ongoing chest pain without ecg changes, but by morning of discharge he felt the best he has felt in a long time. he was started on aspirin, plavix, and atorvastatin, and continued on his home atenolol. #. copd - pt was switched from albuterol to atrovent so as not to irritate/aggravate the heart with beta agonist activity. he was continued on his home flovent. . #. htn - held home anti-hyprtensives in the setting of being on the nitro gtt, but then re-initiated on his home atenolol as the drip was shut off and his blood pressure could tolerate it. benefit from lisinopril as an outpatient. . #. anxiety - pt was continued on his home lorazepam and ambien prn. . #. bph - pt was continued on his home tamsulosin. transitional issues -- he may benefit from further bp control. an acei would be reasonable, but we did not start in house dye load from catheterizations. consider starting acei in outpatient setting. medications on admission: albuterol sulfate inhaler daily albuterol sulfate nebulization daily flovent diskus mucinex daily ativan 0.5mg prn ambien hs atenolol 25 mg tablet 1 tablet by mouth tamsulosin 0.4 mg capsule, ext release 24 hr 1 capsule by mouth once a day ascorbic acid dosage uncertain b complex vitamins dosage uncertain calcium dosage uncertain cholecalciferol (vitamin d3) dosage uncertain fish oil-dha-epa dosage uncertain vitamin e dosage uncertain plavix - last dose:600 mg discharge medications: 1. outpatient lab work please check chem-7 and cbc on tuesday with results to dr. at phone: fax: 2. atrovent hfa 17 mcg/actuation hfa aerosol inhaler sig: one (1) inhalation every six (6) hours as needed for shortness of breath or wheezing. disp:*3 inhalers* refills:*2* 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. flovent diskus 100 mcg/actuation disk with device sig: one (1) inhalation twice a day. 6. lorazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety. 7. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 8. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). 9. atenolol 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. pantoprazole 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 11. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: angina secondary to multi-vessel disease 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 for chest pain. a cardiac catheterization showed that you have multiple blockages in the blood vessels that feed your heart. a second cardiac catheterization was done, in which a stent was placed in one of these blockages that was thought to be the cause of most of your pain. this provided you with substantial relief from your chest pain. of note, you still have a blockage in one of the main vessels to the heart, and should see your cardiologist regarding possible further intervetion. because you now have a stent, it is extremely important that you take all medications as prescribed. failure to do so can result in acute blockage of the stent, which can be life threatening. please note the following changes to your medications: **stop taking albuterol inhaler **start taking atrovent inhaler instead. it will not interact with your heart medications as much as albuterol ** start plavix 75mg by mouth once daily. this keeps your heart stent open and is extremely important to take as prescribed. only your cardiologist can tell you to stop this, no one else, including other doctors. ** start aspiring 325mg by mouth once daily. this also keeps your heart stent open. ** start atorvastatin 80mg by mouth daily. this lowers cholesterol and is important for heart health. ** start pantoprazole 20mg by mouth daily, to protect your stomach while you are taking aspirin. followup instructions: name: , address: ,, , phone: when: thursday, , 3:30pm name: , address: ,ste 7c, , phone: when: thursday, , 2pm department: nutrition when: saturday at 9:00 am with: , rd building: ra (/ complex) campus: east best parking: main garage procedure: coronary arteriography using two catheters coronary arteriography using two catheters left heart cardiac catheterization 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: other iatrogenic hypotension coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified essential hypertension chronic airway obstruction, not elsewhere classified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) anxiety state, unspecified osteoarthrosis, unspecified whether generalized or localized, site unspecified 

Answer: The patient is high likely exposed to