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: patient recorded as having no known allergies to drugs attending: chief complaint: chest pain major surgical or invasive procedure: cardiac cath history of present illness: mr. is a 27 yo m with adhd who presented with sscp while doing judo. he describes being in his usual state of health until today at 7pm at which time he had acute substernal chest pain. he felt as though he'd been punched in the chest with the pain a 12 out of 10 in severity. the pain was not improved with resting and associated with nausea and dizziness. when the pain persisted until 1 am, he called his mother and then went to the er. he does not recall having previous episodes of pain such as this and has had no exertional symptoms ever. . upon arrival the patient had vitals of 96.9 164/81 71 16 100 % ra. he had an ecg which showed a stemi. aspirin 324 mg was given as well as plavix 600 mg x 1, heparin bolus (6000), integrillin bolus and nitro gtt. . while in the lab the patient was found to have a nonocclusive thrombus in the lad which was intervened upon with thrombectomy and ic reapro, nicardipine. the angiojet thrombectomy was complicated by a vagal episode that resolved spontaneously. . on review of systems, 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 ?dyspnea on exertion but the absence of paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: adhd intermittent hematuria ureterocoeles s/p excision obstructive sleep apnea social history: patient lives with 2 roommates in . he is unemployed and recently graduated americorps. he had never smoked, drank or used ivdrugs family history: no family history of early mi, or scdotherwise non-contributory physical exam: date and time of exam: 6:00 general appearance: alert and oriented x 3 height: 70 inch, 178 cm bp right arm: 127 / 88 mmhg t current: 97.6 c hr: 74 bpm rr: 15 insp/min o2 sat: 98 % eyes: (conjunctiva and lids: wnl) ears, nose, mouth and throat: (oral mucosa: wnl), (teeth, gums and palette: wnl) neck: (right carotid artery: no bruit), (left carotid artery: no bruit), (jugular veins: not visible), (thyroid: wnl) respiratory: (effort: wnl), (auscultation: wnl) cardiac: (rhythm: regular), (palpation / pmi: wnl), (auscultation: s1: wnl, s2: physiologically split, s3: absent, s4: absent) abdominal / gastrointestinal: (bowel sounds: wnl), (bruits: no), (pulsatile mass: no), (hepatosplenomegaly: no) genitourinary: (wnl) femoral artery: (right femoral artery: mild tenderness medially with small area of blood on gauze, no bruit), (left femoral artery: no bruit) extremities / musculoskeletal: (digits and nails: wnl), (muscle strength and tone: wnl), (dorsalis pedis artery: right: 2+, left: 2+), (posterior tibial artery: right: 2+, left: 2+), (edema: right: 0, left: 0) skin: ( wnl) pertinent results: labs on admission: . 01:50am wbc-8.9# rbc-5.24 hgb-15.2 hct-44.0 mcv-84 mch-29.0 mchc-34.5 rdw-14.0 01:50am neuts-82.6* lymphs-13.3* monos-3.1 eos-0.6 basos-0.3 01:50am glucose-98 urea n-13 creat-1.2 sodium-138 potassium-4.4 chloride-104 total co2-25 anion gap-13 . cardiac enzymes: 01:50am blood ctropnt-0.04* ck(cpk)-398* 05:38am blood ctropnt-0.27* ck(cpk)-751* ck-mb-38* mb indx-5.1 11:13am blood ck(cpk)-1257* ck-mb-86* mb indx-6.8* 09:15pm blood ck(cpk)-1210* 06:25am blood ctropnt-1.12* ck(cpk)-889* ck-mb-41* mb indx-4.6 05:41am blood ctropnt-1.03* ck(cpk)-440* ck-mb-8 . hypercoagulability workup: 03:49pm blood anticardiolipin igg-2.5 anticardiolipin igm-9.5 (normal) 09:49am blood protein c - 98, protein s - 82 (normal) 05:38am blood factor v leiden - negative 05:38am blood -negative dsdna-negative 12:40pm blood prothrombin mutation analysis- pending . tox: 05:38am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 08:55am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-neg 08:55am urine bnzodzp-neg barbitr-neg opiates-pos cocaine-neg amphetm-neg mthdone-neg . urine benzoylecgonine (cocaine metabolite) - pending . labs on discharge: 06:40am blood wbc-5.8 rbc-4.83 hgb-13.6* hct-40.9 mcv-85 mch-28.3 mchc-33.4 rdw-14.3 plt ct-494* 06:20am blood pt-14.6* ptt-33.0 inr(pt)-1.3* 06:40am blood glucose-85 urean-13 creat-1.2 na-138 k-4.8 cl-102 hco3-30 angap-11 . ekg: sinus rhythm. inferior q waves with st segment elevation and lateral precordial st segment elevation. consider inferolateral infarction. no previous tracing available for comparison. clinical correlation is suggested. . echo: the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with mild apical hypokinesis. the remaining segments contract normally (lvef = 55%). no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: mild regional left ventricular systolic dysfunction, c/w cad. no intracardiac thrombus seen. . . . cardiac: . cath () comments: 1. coronary angiography of this left dominant system revealed single vessel thrombus without visualized coronary artery stenoses. the lmca appeared normal. the lad had a significant amount of nonocclusive thrombus in the first third of the vessel with slow flow throughout the vessel. the lcx had no significant disease. the rca was a small, nondominant vessel without significant disease. 2. limited resting hemodynamics revealed normal systemic arterial blood pressure (sbp 123 mm hg). 3. left ventriculography was deferred. 4. successful thrombectomy with both the export catheter and the angiojet device. final angiography revealed some residual thrombus which was improved and improved distal flow. 5. right femoral arteriotomy was closed with a 6 french angioseal device. final diagnosis: 1. one vessel coronary artery disease. 2. normal ventricular function. 3. successful thrombectomy of the lad thrombus. . . cat () comments: 1- selective angiography of the left coronary artery reevaled short but patent lmca. the thrombotus in the proximal lad hasd largely resolved with mild non-obstructive residual mural thrombus. the lad is a large vessel that wraps around teh apex and supplies the inferior wall. contrary to the completion angiogram (performed ), the apical lad is now patent with timi iii flow but significant residual thrombus burden seen. the lcx was a dominant vessel without angiographic lesions. the rca was not injected (known to be small non-dominant vessel). 2- limited hemodynamic assessment revealed normal systemic aretrial pressure (105/72 mmhg). final diagnosis: 1. one vessel coronary artery disease. 2. patent lad throughout with very mild mural thrombus proximally (was near occluded on the initial angiogram) and significant non-occlusive thrombus at the apical lad with timi iii flow down taht segment (had no flow on the previous angiogram). brief hospital course: mr is a 27 yo m with adhd (on methylphenidate before), admitted w acute coronary thrombosis causing stemi now s/p thrombectomy. . # stemi: patient presented with chest pain and was found to have an st-elevation myocardial infarction. he went to the cath lab where he was found to have an lad thrombus that was thrombectomized. he had no other sign of atherosclerotic coronary disease. medical therapy was undertaken including integrilin and heparin drips, aspirin, plavix, atorvastatin, and beta blocker titrated to heart rate of 60. repeat cath showed a distal lad thrombus, separate from the previous one. hence pt was started on coumadin (w lovenox as a bridge). goal is to keep coumadin for mos. . regarding the cause of the event, his only risk factor was obesity and obstructive sleep apnea. tox screen was negative, though urine benzoylecgonine (cocaine metabolite) is pending on discharge. methylphenidate use was also considered as a potential cause, given case reports of its association with mi. lipid panel was normal (ldl 116). hypercoagulable and autoimmune workup were negative, though prothrombin mutation analysis is pending on discharge. . # pump: patient was euvolemic on exam. echo demonstrated lv ejection fraction of 55% with mild regional left ventricular systolic dysfunction and mild apical hypokinesis. . # rhythm: rhythm was sinus. . # adhd: methylphenidate was discontinued out of concern for causing myocardial infarction. he was no treatment for now, can follow up with psych as outpatient, no outpatient psych at this time. . # obstructive sleep apnea: untreated at this point per patient . medications on admission: methylphenidate 54 mg qday discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. clopidogrel 75 mg tablet sig: two (2) tablet po daily (daily) for 6 months. disp:*60 tablet(s)* refills:*0* 3. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily) for 6 months. disp:*30 tablet, delayed release (e.c.)(s)* refills:*1* 4. lisinopril 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 5. warfarin 2 mg tablet sig: 2.5 tablets po once a day. disp:*30 tablet(s)* refills:*0* 6. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*0* 7. outpatient lab work please check inr. please fax results to : 8. enoxaparin 100 mg/ml syringe sig: one (1) syringe subcutaneous q12h (every 12 hours). disp:*14 syringe* refills:*0* 9. outpatient lab work please have your inr checked on friday, , and fax the results to anticoagulation management services @ (. discharge disposition: home discharge diagnosis: primary: st-elevation myocardial infarction secondary: attention deficit hyperactivity disorder, obstructive sleep apnea discharge condition: stable, free of chest pain discharge instructions: you came to the hospital because you had chest pain, and you were found to have had a heart attack. you were given medications to help open up the arteries to your heart. several medications were started that you will need to continue at home for your heart. your methylphenidate was stopped because it may have contributed to the heart attack. you should talk with your doctor about whether this medication can be restarted or whether there might be another option for your adhd. . because you will need to be taking a blood thinner (warfarin) for 3-6 months, you will need to have your blood tested periodically. please go to the outpatient lab with the attached prescription on thursday, . the anticoagulation nurses will then call you to tell you if you need to adjust your warfarin dose. . please return to the emergency room if you have recurrent chest pain, shortness of breath, high fevers and chills, or other symptoms that are concerning to you. followup instructions: please follow up with your primary care physician: , md phone: date/time: 10:30 . you also have an appointment to follow up with a cardiologist: , md phone: date/time: 1:00 procedure: coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor injection or infusion of platelet inhibitor left heart cardiac catheterization left heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery acute myocardial infarction of anterolateral wall, initial episode of care paroxysmal ventricular tachycardia acute myocardial infarction of inferolateral wall, initial episode of care attention deficit disorder with hyperactivity 

Answer: The patient is high likely exposed to