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 a 69-year-old woman with known coronary artery disease status post persantin mibi on showing a moderate reversible inferior defect at which time she had refused cardiac catheterization. three days prior to admission, she developed four out of 10 substernal chest pain which continued through the night prior to admission actually preventing her from sleeping. she was brought to the emergency department by ambulance where on arrival she had 2/10 chest pain with ekg showing biphasic t waves in iii and avf, 0.5 to elevations in ii and iii, 0.5 mm depressions in i and avl. labs are notable on admission for a ck of 267, troponin of 12 with a mb fraction of 47, index of 17.6. she was initially hypertensive to a systolic blood pressure of 170 in the emergency department. she received lopressor iv times three. she was started on a heparin drip and iv nitroglycerin with relief of her chest pain. in addition, she was started on aspirin, plavix and integrilin. she was initially admitted to the service, but transferred to the ccu for closure monitoring and anticipation of cardiac catheterization. past medical history: 1. coronary artery disease as above. 2. hypertension. 3. congestive heart failure with an ejection fraction of 50%. 4. paranoid schizophrenia. 5. high cholesterol. 6. history of tia. 7. osteoarthritis. 8. status post total abdominal hysterectomy. 9. hypothyroidism. medications at home: 1. klor-con 10 mg. 2. mavik 1 mg q. day. 3. levoxyl 25 mcg q. day. 4. lasix 60 mg q. day. 5. isosorbide mononitrate 30 mg q. day. 6. haldol 1 mg q. day. allergies: 1. penicillin. 2. codeine. both of which lead to rash. social history: the patient lives alone. denies any history of smoking or alcohol use. physical examination: on admission to the ccu, patient was afebrile with a temperature of 98.5 f, blood pressure 113/37, heart rate 76, respiratory rate 18, pulse oximetry 97% on two liters. in general, she was alert and oriented. she was pain free. her carotids were 1+ bilaterally without bruit. lungs were clear to auscultation. heart was regular, rate and rhythm without any audible extra heart sounds. her abdomen was benign with normal bowel sounds, no hepatosplenomegaly. her extremities revealed no edema with faint distal pulses. her skin findings were significant for psoriasis. laboratory data on admission: cbc revealed a white count of 7.4, hematocrit 35.8, platelets of 177. coags were within normal limits. chem-7 was unremarkable except for bun and creatinine of 44 and 1.2 respectively. at the time of admission to the ccu, a second set of cardiac enzymes had been obtained which showed a ck of 356, mb of 65, troponin at that time was 43. ekg on admission to the ccu revealed sinus rhythm at 73 beats per minute, normal axis, qtc of 453, elevations in ii, iii and avf, q waves were now present in ii, iii and avf as well with t wave inversions in i and avl. hospital course: 1. cardiovascular: a. coronary artery disease: the patient was continued on heparin and integrilin drips, aspirin, beta blocker, lipitor, plavix and her ace inhibitor in anticipation of cardiac catheterization. cardiac catheterization was performed on . hemodynamics from cardiac catheterization revealed a cardiac output of 5.32 and a cardiac index of 3.04 by the fick method. wedge pressure was 8. pa pressure 32/13 with a mean of 22. left heart cath revealed mild lv diastolic dysfunction with mild to moderate aortic stenosis. lv gram showed ejection fraction of approximately 60%. angiography revealed right dominant system with 50 to 60% left main coronary artery lesion. lad had an 80% distal lesion. left circumflex had an 80% stenosis at the origin and right coronary artery had a 95% osteo stenosis and 70% mid vessel stenosis with timi-ii flow into the distal av groove. following cath, she was continued on aspirin and integrilin to be on for 18 hours. plavix was not continued as the patient did not have any intervention. it was recommended based on the cath results of left main disease with three vessel disease, that the patient undergo coronary artery bypass grafting. cardiothoracic surgery was consulted to evaluate the patient for surgery. initially patient refused coronary artery bypass and a question was raised of the patient's competence to make medical decisions given her history of paranoid schizophrenia and occasional episodes of confusion. psychiatry was consulted who deemed her competent to make her own decisions. ct surgery saw her and explained the procedure, risks and benefits that go along with it. again, after being deemed competent, she opted against the surgery and was managed medically. she was discharged with the understand that she could undergo surgery in the future. b. pump: following cardiac catheterization, the patient creatinine bumped to 1.8. her ace inhibitor was held at that time. an echocardiogram was done to evaluate her lv function which revealed a mildly enlarged left atrium, mild lvh with impaired relaxation. ejection fraction of 30% down from 50% in , moderate to severe hypokinesis of the inferior, posterior and lateral walls and apex. the right ventricle seemed to be dilated with depression function. aortic valve leaflets were mildly thickened, but not stenotic. she had trace ai and 1 to 2+ mr. she had moderate pulmonary artery systolic hypertension without pericardial effusion. she was diuresed on a p.r.n. basis with lasix for pulmonary edema with improvement of her creatinine from 1.8 down to 1.4 prior to discharge. because of her need for afterload reduction, her ace inhibitor was restarted at her previous dose. c. rhythm: the patient was given lopressor titrated up to 75 mg of toprol xl q. day for rate control. she was in sinus rhythm throughout her hospitalization. 2. psych: patient has a history of paranoid schizophrenia for which he had been on an outpatient regimen of haldol 1 mg q. day. after cardiac catheterization, she was very agitated and psychiatry was consulted regarding further management of her schizophrenia. it was recommended at that time to increase the haldol that she received from 1 to 2 mg q. four to q. six hours on a p.r.n. basis. in addition, they recommended withholding any further use of ativan or ambien which could have contributed to her delirium at the time. in addition, psychiatry was consulted to evaluate the patient in terms of competency to make decisions regarding her cardiac surgery which the consultants did feel that she was competent. her mental status cleared and her haldol was decreased to its outpatient dose of 1 mg p.o. q. day. she was alert and oriented times three at the time of discharge understanding the risk and benefits of the coronary artery bypass grafting surgery. she agrees to talk to her primary care physician, . to assist her in making the decision of having this surgery in the future. she was discharged on haldol 1 mg p.o. q.d. as she had been taking on admission. 2. hematology: on the day of discharge without any obvious source of bleeding, the patient was found to have a hematocrit of 26.7. given her significant coronary artery disease, she was transfused with one unit of packed red blood cells prior to discharge. 3. endocrine: the patient was continued on her outpatient dosage of synthroid. discharge medications: 1. toprol xl 75 mg p.o. q. day. 2. trandolapril 2 mg p.o. q. day. 3. haldol 1 mg p.o. q. day. 4. lipitor 20 mg p.o. q. day. 5. synthroid 25 mcg p.o. q. day. 6. aspirin 325 mg p.o. q. day. follow up: the patient will be contact by dr. ' office in an attempt to have an appointment for her this week. she plans to discuss with dr. the possibility of having surgery in the future. in addition she will have follow up arranged with her psychiatrist, dr. and she will have the prior services in place including vna as well as the western suburban elder services which she had prior to admission. condition on discharge: stable. discharge diagnosis: 1. coronary artery disease, left main and three vessel disease requiring coronary artery bypass graft. 2. paranoid schizophrenia. 3. hypothyroidism. 4. dyslipidemia. 5. congestive heart failure with ejection fraction of 30%. 6. hypertension. , m.d. dictated by: medquist36 procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension hyposmolality and/or hyponatremia unspecified acquired hypothyroidism acute myocardial infarction of other inferior wall, initial episode of care paranoid type schizophrenia, unspecified 

Answer: The patient is high likely exposed to