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: this is a 62 year old white male with a history of gastroesophageal reflux disease and cardiac risk factors including strong family history, age, sex and cigar smoking, who presented to an outside hospital with severe ten out of ten substernal chest pain, burning, diaphoresis, nausea and vomiting. he denied any shortness of breath, radiation to the neck, radiation to the jaw or radiation to the arm. he had no recent decrease in exercise tolerance. he denied any edema or weight gain. he denied any abdominal pain. he denied any orthopnea or paroxysmal nocturnal dyspnea. he denied any fever, chills, changes in bowel or bladder function, bright red blood per rectum, melena or weight loss. in the outside hospital, an electrocardiogram showed st elevations in leads ii, iii, and avf. it also showed r wave with st depressions in v1 and v2, and st elevations in v5 and v6. culprit lesion on catheterization was noted to be a total occlusion with thrombus in the midleft circumflex. the lesion was percutaneous transluminal coronary angioplastied, angioject and stented with a hepacoat stent. the patient's flow in that vessel went from timi-0 to timi-3 with resolution of his electrocardiographic changes. he had some reperfusion ectopy which resolved. past medical history: gastroesophageal reflux disease. social history: he lives in with his wife. two children. he smokes cigars but no pipes, tobacco or alcohol. he is works in financing and accounting. family history: mother and father both had myocardial infarctions in their 50s and 60s, respectively. medications on admission: zantac as needed. allergies: none. physical examination: the patient is afebrile, heart rate 66, blood pressure 159/85, respiratory rate 12, oxygen saturation 100% on two liters nasal cannula. in general, the patient is alert and oriented in no apparent distress. no chest pain, no nausea. head, eyes, ears, nose and throat examination is normocephalic and atraumatic. the pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. the oropharynx is clear. chest is clear to auscultation anteriorly with lateral and posterior crackles at the bases. cardiovascular - regular rate and rhythm without murmurs, normal s1 and s2, no s3 or s4. the abdomen is soft, nontender, nondistended, positive bowel sounds, no hepatosplenomegaly, groin - sheaths in the left groin, clean, dry and intact. extremities - no cyanosis, clubbing or edema, palpable pulses distally. psoriatic plaque on bilateral lower extremities. laboratory data: on admission, white blood cell count was 18.0, hematocrit 45.0, platelet count 265,000. sodium 147, potassium 4.2, chloride 107, bicarbonate 27, blood urea nitrogen 25, creatinine 1.4 and glucose 153. liver function tests were within normal limits. first ck was 120 with a troponin of 0.05. chest x-ray was pending. cardiac catheterization revealed left main coronary artery normal. the left anterior descending showed mild luminal irregularities. the left circumflex showed a midsegment total occlusion into om2. ostial 90% lesions in the om1 at the site of occlusion in the left circumflex were also found. the right coronary artery was the dominant vessel with mild luminal irregularities. pressures and other readings on catheterization - cardiac output was 3.45, cardiac index was 1.92, pulmonary capillary wedge pressure was 23, pulmonary artery pressure were 39/18, right ventricular pressure was 39/13, right atrial pressure was 19/14. assessment: this is a 62 year old white male with a history of smoking, strong family history, status post catheterization and stent for an acute st elevation inferior posterior myocardial infarction. hospital course: the following is a summary of the hospital course by problems: 1. ischemia - the patient had no further chest pain while in house. he was kept on integrilin for 18 hours after his cardiac catheterization and then it was discontinued he was continued on a beta blocker and an ace inhibitor. he was loaded with plavix and then given 75 mg p.o. once daily. he was continued on aspirin. he was started on a statin. towards the end of his hospital stay, the patient's beta blocker was changed from metoprolol to one a day atenolol and his ace inhibitor was changed from captopril to one a day lisinopril. the patient's cardiac enzymes were trending and peaked at 4,510 for his ck, 339 for ck mb, and troponin greater than 50. these enzymes down-trended. the patient had cholesterol studies which revealed a normal ldl, normal hdl, and a normal cholesterol. his triglycerides were also normal. 2. pump - the patient was gently diuresed while in house. he received small doses of intravenous lasix with good results. the patient underwent an echocardiogram which revealed that his left atrium was normal in size, left ventricular wall thickness and cavity size were normal, mild regional left ventricular systolic dysfunction existed, resting regional wall motion abnormalities including a basal inferior and inferolateral hypokinesis existed, aortic valve leaflets were mildly thickened, mild aortic regurgitation was seen, mitral valve leaflets were mildly thickened, trivial mitral regurgitation was seen, tricuspid valve leaflets were mildly thickened, mild pulmonary artery systolic hypertension was noted, and there was a trivial pericardial effusion. his ejection fraction was calculated to be 55%. the patient did undergo a chest x-ray which revealed mild upper zone redistribution and for that he was gently diuresed as mentioned above. the patient also had a swan-ganz catheter placed for better monitoring of his right sided pressures. this catheter was discontinued towards the end of his hospital stay. 3. rhythm - the patient was continued on telemetry given the fact that he had two episodes of ventricular tachycardia early during his hospital stay. he did not have any ectopy during the rest of his hospital stay, and was considered to be stable after a 72 hour observation period. 4. tobacco use - the patient was counseled on smoking cessation. 5. fen - the patient had his electrolytes measured daily and if needed these were repleted accordingly without complication. he was also started on a heart healthy diet. based on the patient's stable clinical condition, the decision was made to discharge the patient home with appropriate follow-up. condition on discharge: good. discharge status: to home. discharge diagnoses: 1. coronary artery disease, status post inferoposterior wall myocardial infarction, status post cardiac catheterization and stenting of the left circumflex. 2. mild congestive heart failure secondary to systolic dysfunction with a normal ejection fraction. 3. mild hypertension. 4. gastroesophageal reflux disease. discharge instructions: 1. the patient is to follow-up with cardiology in two to four weeks. 2. his primary care physician is to help him select a cardiologist in his of or he is welcome to select a cardiologist through the system. 3. the patient is to follow-up with his primary care physician to have renal function tests, liver function tests, and blood pressure check within one to two weeks. medications on discharge: 1. lisinopril 5 mg p.o. once daily. 2. atenolol 25 mg p.o. once daily. 3. atorvastatin 10 mg p.o. q.h.s. 4. plavix 75 mg p.o. once daily times thirty days. please note, the patient's cardiologist should determine the length of plavix treatment after the thirty days. 5. aspirin enteric coated 325 mg p.o. once daily. 6. nitroglycerin sublingual p.r.n. , m.d. dictated by: medquist36 procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters injection or infusion of platelet inhibitor diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux tobacco use disorder systolic heart failure, unspecified family history of ischemic heart disease acute myocardial infarction of other lateral wall, initial episode of care 

Answer: The patient is high likely exposed to