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: penicillins / sulfa (sulfonamides) attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization history of present illness: 59 yr old male with history of htn, hyperlipidemia, type 2 dm presented to this am with sharp, substernal chest pain. found there to have to ii, iii and avf, v5, v6 with reciprocal depressions in v1-v2, avl, avr. transferred directly to cath lab here where he was found to have 80% proximal lcx thought to be culprit that was stented but initially had no re-flow. this flow was restored after intracoronary ntg, adenosine, diltiazem, and reopro. also had chronically occluded proximal rca which was also stented. patient had pcwp of 25. he was administered 40 mg iv lasix in lab and transferred to ccu for observation after complicated intervention and elevated pcwp. past medical history: 1. severe gerd 2. htn 3. hyperlipidemia 4. anxiety 5. prostatitis 1 year ago, on flomax 6. oa, on bextra. 7. h/o rib fx after falling off of horse. social history: married. dentist. 100 pack year history of smoking but quit in . 1 drink per month. no drug use. family history: father died at age 75 of mi. mother healthy at age 85. no other knowledge of dm, htn, cad. physical exam: hr 59, bp 110/51, rr 15, so2 98% on 2l nc gen: in nad heent: mm slightly dry, op clear. cv: rrr, no murmurs, rubs. +s4 lungs: cta b abd: s/nt/nd, + bs ext: trace edema bilaterally le's. pulses 2+ dp bilaterally. neuro: a&ox3. pertinent results: 01:50pm glucose-222* urea n-16 creat-0.8 sodium-138 potassium-5.0 chloride-105 total co2-22 anion gap-16 01:50pm ck(cpk)-105 01:50pm ck-mb-4 ctropnt-0.01 01:50pm wbc-13.8* rbc-5.18 hgb-14.2 hct-40.7 mcv-79* mch-27.4 mchc-34.9 rdw-12.9 01:50pm neuts-84.7* lymphs-11.4* monos-3.1 eos-0.5 basos-0.3 01:50pm microcyt-1+ 01:50pm plt count-261 01:50pm pt-17.3* ptt-150* inr(pt)-1.9 echo (): 1. the left ventricular cavity size is normal. overall left ventricular systolic function is mildly depressed (ef 45-50%). inferior hypokinesis is present. 2. the aortic valve leaflets are mildly thickened. 3. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. cardiac catheterization () 1. selective coronary angiography demonstrated two vessel coronary artery disease in this right dominant circulation. the lmca was without angiographically apparent flow limiting disease. the lad and its diagonal branches had mild disease without significant obstruction. the lcx had an 80% proximal stenosis and was totally occluded in the mid vessel. the rca was a dominant vessel and was occluded proximally with a chronic total occlusion. 2. resting hemodynamics from right heart catheterization demonstrated elevated right and left sided filling pressures with prominent v-waves on the pcwp tracing. cardiac output and index were 4.9 l/min and 2.1 l/min/m2 respectively. 3. no left ventriculogram performed in order to reduce contrast load. 4. successful pci of the rca with a 2.5 x 28 mm cypher des. 5. successful pci of the lcx with two overlapping cypher des (3.5 x 13 mm and 3.0 x 33 mm, post-dilated with a 3.25 mm balloon). severe no-reflow in the lcx was successfully treated with intracoronary vasodilators and abciximab. 6. successful closure of the rfa arteriotomy with a 6 french angioseal device. final diagnosis: 1. two vessel coronary artery disease. 2. acute inferoposterior myocardial infarction, treated with primary pci of the rca and lcx. 3. angioseal deployment in right common femoral artery. brief hospital course: a/p: 59 yo m with h/o dm, htn, hypercholesterolemia who p/w stemi now s/p stents to rca and lcx: . ## cardiac: a. cad: the pt received stents to rca and lcx as described above. pt was started on asa, plavix, and metoprolol. he was continued on valsartan and atorvastatin was increased to 80mg daily. his cardiac enzymes peaked at a ck of 3098, mb of 344, and index of 9.1 and trended down. he had no further chest pain or shortness of breath and was ambulating without difficulties. metoprolol was changed to toprol xl on discharge and the pt was informed that if he felt dizzy or extremely tired this medication may need to be titrated down. he was advised to stagger taking the valsartan and toprol xl to try to prevent this. he will follow up with dr. in cardiology as well as his pcp. was encouraged to follow a heart healthy diet and to pursue cardiac rehabilitation. . b. pump: in the cath lab pt's pa diastolic was 23, pcwp was 25. it was felt that he likely had some stiffness from infarction and slight volume overload. he was diuresed with iv lasix and had good uop. echo showed an ef of 45-50% . c. rhythm: pt had many pvc's on telemetry but was asymptomatic. . ## dm: pt was continued on his outpt oral meds as well as an insulin sliding scale. his hgba1c was 7.1%. he was encouraged to talk about how he might achieve slightly better control of blood glucoses as an outpatient. . ##htn: -pt received bb and valsartan as above. sbp remained between 100 and 120. . ## gerd: -pt was kept on protonix while an inpatient since nexium was not on the formulary. on discharge he was given a prescription for nexium since he states this is more helpful for his gerd than protonix. . ##h/o prostatitis: -pt was continued on flomax. he had some trauma when his foley was removed and subsequently experienced pain on urination, but this resolved after one evening and he was able to urinate without difficulty. . ## diarrhea s/p trip to : states pcp did stool cx's that were negative for parasites but diarrhea has improved greatly after flagyl and imodium. he had no further diarrhea while in house and remained afebrile. . ## joint aches: the pt stated he had been taking bextra and this was very helpful for his joint complaints. however, this medication was recently taken off of the market due to studies showing its link to increased cardiovascular mortality. the pt was instructed to stop taking this medication and to talk with his pcp regarding other medications that may be substituted. medications on admission: flomax 0.4mg daily nexium 40mg twice daily ambien 10mg qhs prn diovan 80mg once daily lipitor 20mg once daily glipizide er 20mg once daily actos 15mg qhs valium 5mg q4-6 prn imodium prn bextra 20mg daily discharge medications: 1. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). tablet(s) 2. tamsulosin hcl 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po hs (at bedtime). 3. zolpidem tartrate 5 mg tablet sig: 1-2 tablets po hs (at bedtime) as needed. 4. atorvastatin calcium 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. pioglitazone hcl 15 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 6. glipizide 10 mg tab, sust release osmotic push sig: two (2) tab, sust release osmotic push po daily (daily). 7. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q3 days (). 8. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 9. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. metoprolol succinate 50 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 12. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet sublingual q5 mins x 3 as needed for chest pain. disp:*30 tablets* refills:*0* 13. cardiac rehabilitation please complete a course of cardiac rehabilitation. discharge disposition: home discharge diagnosis: primary: mi s/p pci to rca and lcx secondary: hyperlipidemia dm htn discharge condition: stable discharge instructions: please find a cardiologist asap and follow up with that physician in the next few weeks. please follow up with your pcp before returning to work. if you develop chest pain, take one sublingual nitroglycerin. if the pain does not resolve, you may take up to 3 tablets, 5 minutes apart. if the pain still has not resolved, call 911 or come to the er immediately. please follow a heart healthy diet consisting of low-fat, low-cholesterol, low-salt foods with plenty of fiber. also please follow your diabetic restrictions as well and discuss how you can improve your glycemic control further with your pcp. take all medications as prescribed. aspirin and plavix are especially important to prevent re-stenosis of your cardiac stents which could cause another heart attack. you are advised to stop taking bextra due to its links with increased cardiac and stroke mortality. please discuss alternative medications with your pcp. followup instructions: provider: , . follow-up appointment should be in 2 weeks. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor angiocardiography of right heart structures insertion of drug-eluting coronary artery stent(s) diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other and unspecified hyperlipidemia acute myocardial infarction of inferoposterior wall, initial episode of care 

Answer: The patient is high likely exposed to