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: / zocor attending: chief complaint: desensitization and elective cardiac catheterization. major surgical or invasive procedure: cardiac catheterization history of present illness: this 64 year old woman with hypertension, hyperlipidemia and prior stroke x 2 underwent elective cardiac catheterization at in due to chest pain and an abnormal stress test. this was significant for a 70% lad lesion and no other significant cad. her ef was 65%. she reports that the pain occurs approximately once per week, both at rest and with exertion. she take nitroglycerin with relief of her symptoms after 1 tablet. she has slight dyspnea with exertion that occurs when she walks quickly or climbs stairs. she denies any dizziness, lower extremity edema, orthopnea or pnd. she does report leg discomfort with ambulation. . she is being admitted this evening for desensitization for an allergy noted to be skin itching. . on review of systems, she denies any prior history of deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she 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: (-)diabetes, (+)dyslipidemia, (+)hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: hypertension hyperlipidemia cva with left sided hemiparesis and decrease in left eye peripheral vision cva renal calculi cad s/p cath at lgh in s/p left great toe osteotomy aaa repair at lgh tubal ligation social history: -tobacco history: 40 pack year quit smoking: quit -etoh: no etoh -illicit drugs: no drugs family history: father died of a stroke at age 78. sister had pacemaker placed at age 45. physical exam: vs t97.1f bp 179/76, hr 44, 96% ra general appearance: middle-aged female lying in bed in nad. alert and mostly spanish-speaking ent - supple, jvd not distended, supraorbital erythema (unchanged for years) cardiovascular: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. respiratory / chest: ctab abdominal: soft, non-tender, bowel sounds present extremities: no edema present, 2+dp b/l pulses: 2+ throughout les. on day of discharge: vs 98.3f, bp 152/72, hr 52, rr 18 94-98%ra. ent - as above. cv s1,2 nl, rr, no m/g/r pulm: cta b/l. ext - warm, dry no edema, r groin ttp no bruit, 2+ femoral pulse and 2+dp. pertinent results: laboratory studies: . 07:53pm blood wbc-7.3 rbc-4.33 hgb-11.8* hct-35.0* mcv-81* mch-27.3 mchc-33.8 rdw-13.7 plt ct-228 06:25am blood wbc-6.9 rbc-4.56 hgb-12.4 hct-37.1 mcv-82 mch-27.2 mchc-33.4 rdw-14.6 plt ct-209 07:53pm blood pt-12.8 ptt-27.8 inr(pt)-1.1 07:53pm blood glucose-113* urean-21* creat-1.1 na-137 k-4.1 cl-101 hco3-28 angap-12 06:25am blood glucose-96 urean-15 creat-1.3* cl-99 hco3-32 07:53pm blood calcium-9.6 phos-3.1 mg-2.0 06:25am blood calcium-9.2 phos-2.9 mg-2.0 studies/imaging: sinus bradycardia. possible left ventricular hypertrophy with secondary repolarization abnormalities. no previous tracing available for comparison. read by: , intervals axes rate pr qrs qt/qtc p qrs t 44 166 102 546/518 51 55 106 cardiac catheterization: 1. planned pci with access via rfa. patient had mid lad 80% long stenosis with no flow limiting disease in other vessels. 2. limited hemodynamics with bp 162/74 with hr 55 in sinus. 3. stenting of mid lad with cypher 3x23mm stetn. 4. successful groin closure with mynx device. final diagnosis: 1. one vessel coronary artery disease. 2. stenting of mid lad. brief hospital course: 64 yo female with htn, hyperlipidemia, cva x 2, found to have cad with 70% lad lesion at osh on diagnostic cath admitted here for densitization prior to catheterization. . # desensitization. pt. completed a desensitization procedure per protocol w/ starting dose of 0.025mg escalated to 75mg over 12 doses. she tolerated this well, w/o complications. there was no angioedema, bronchospasm, hives. she was given benadryl prn for pruritis. pt. had an episode of pruritis on day of discharge, lasting 6hrs, w minimal erythema around left neck region which resolved w/o treatment. pt. underwent cardiac catheterization on as described below. . # coronaries. pt. had a diagnostic cath with 70% lad lesion from osh. she was continued on her home medications with exception of aggrenox, including asa, statin, bbk, acei at home doses. after she completed desensitization, she underwent a catheterization. this showed a mid lad 80% stenosis with no flow limiting disease in other vessels. she received a stent to mid lad with cypher 3x23mm. her groin was successfully closed w/ mynx device. there were no complications, she received ivf and nabicarbonate pre/post hydration as well as 18hr course of integrillin. patient was continued on above regimen as well as 75mg. post catheterization at time of discharge she did not have cp, sob or other angina equivalents with ambulation. . # pump. no echo in system and no evidence of heart failure on exam . # rhythm. pt. was bradycardic in nsr throughout her stay w/ hr in the 50s on telemetry. pr interval was 160. she was on atenolol for bp control at 50mg qd. . # hypertension. on multiple medications at home including a prn minoxidil for sbp > 170. sbps ranged between 125 - 161 during admission. her regimen included felodipine 10mg qd, clonidine 0.2mg , enalapril 40mg qd, chlorthalidone 25mg qd and atenolol 50mg qd. due to hypertension, her felodipine was increased to 20mg qd. she was advised to schedule follow up with her cardiologist within a week to optimize antihypertensive regimen given over 4 antihypertensive medications. . # arf. elevated cr to 1.3, baseline unknown, but 1.1 on admission. pt. likely w/ baseline ckd given long standing htn. this was likely pre-renal etiology vs. contrast induced nephropathy. pt. did receive iv fluid prehydration with nabicarbonate. pt. was advised to increase po fluid intake at home and obtain f/u labs. . # hx of cva. pt. w/ hx of previous cvas x2 admitted on aggrenox. this was stopped as pt was started on asa 325 and for her des. pt. denied having a neurologist and her cva secondary ppx is reportedly managed by pcp. alone is a sufficient as secondary stroke prevention regimen per guidelines, however patient required asa in addition for . given increased incidence of bleeding in patients receiving asa and for secondary stroke prevention, pt was started on omeprazole 20mg ec qd. . # hyperlipidemia. pt. was continued on home statin. . fen: regular cardiac diet, no ivf. . prophylaxis: -dvt ppx with hep sc -pain management with acetaminophen -bowel regimen . patient was discharged home in hemodynamically stable condition, w/o new rash, cp or sob. her new medication regimen was explained to her at length through a spanish translator and her undrestanding checked. she was advised to f/u w/ pcp and cardiologist within 1-2 weeks and check her laboratory studies by to be called in to pcp and cardiologist. medications on admission: enalapril 40mg felodipine 10mg daily clonidine 0.2mg aggrenox 200/25mg aspirin 81mg daily chlorthalidone 25mg daily mvi daily minoxidil 2.5mg daily prn for systolic bp over 170mmhg atenolol 50mg daily ferrous sulfate 325mg 1 tablet daily calcium nitroglycerin prn discharge medications: 1. chlorthalidone 25 mg tablet sig: one (1) tablet po daily (daily). 2. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 5. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 6. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 7. clonidine 0.1 mg tablet sig: two (2) tablet po bid (2 times a day). 8. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. felodipine 10 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po once a day. disp:*60 tablet sustained release 24 hr(s)* refills:*2* 11. enalapril maleate 20 mg tablet sig: two (2) tablet po twice a day. 12. minoxidil 2.5 mg tablet sig: one (1) tablet po once a day as needed for for systolic blood pressure > 170mmhg. 13. benadryl 25 mg capsule sig: one (1) capsule po every hours as needed for itching. 14. outpatient lab work please check chem 7 blood work by and report results to dr. at ( and dr. at . 15. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day for 90 days. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* discharge disposition: home discharge diagnosis: 1. allergy s/p desensitization 2. coronary artery disease 3. hypertesion 4. hyperlipidemia discharge condition: afebrile, hemodynamically stable discharge instructions: you were admitted to the hospital for desensitization due to your allergy to and a cardiac catheterization. you completed this and had a cardiac catheterization on . you had a stent placed to one of your coronary arteries that supplies your heart (left anterior descending artery now with drug eluting stent). the following changes were made to your medications: start 75mg by mouth once a day. stop aggrenox start aspirin at higher dose of 325mg daily increase felodipine to 20mg daily it is important that you take all your medications as prescribed. you should call your doctor or come to the emergency room with any fevers > 100.4, chills, night sweats, chest pain, shortness of breath, palpitations, skin rash, swelling or other symptoms that concern you. you will also need to have your blood work checked by wednesday, and call in results to you pcp and your cardiologist. followup instructions: please see your primary care doctor, dr. in weeks after discharge, please call to make an appointment. please see your cardiologist, , b. within 2 weeks of discharge, please call to make an appointment. please obtain blood work as prescribed by and call in results to your dr. and cardiologist. procedure: coronary arteriography using two catheters insertion of drug-eluting coronary artery stent(s) immunization for allergy 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 kidney failure, unspecified need for desensitization to allergens other and unspecified hyperlipidemia unspecified pruritic disorder 

Answer: The patient is high likely exposed to