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 attending: chief complaint: chest pain, transfer from ste-imi major surgical or invasive procedure: cardiac catherization with three bare metal stents to the right coronary artery history of present illness: mr. is a 63 year old male with htn, hld, and diet controlled pre-diabetes, who was transferred from with an inferior stemi for cardiac catheterization. . mr. was in his usual state of health until he experience chest pain around 8am this morning. his chest pain was substernal and radiated to the arm, lasted for 25-30min, not associated with diaphoresis. he thought it was indigestion, related to breakfast. he tried tums with no relief. he was going to go to his pcp's office, but had a feeling that something was "not right" and decided to go to the ed. of note, he has had on and off arm pain that was non-exertional over the past 3 days. at , his initial vs were t97 bp 170/87 rr 18 and o2 92% ra. an ecg showed 5-6mm st elevations in avf, ii, and iii consistent with an imi. labs were notable for a cr 0.9, hct 46.2, trop i 0.04, and ck 750. he was loaded with clopidogrel 300mg po x2, asa 325mg po x1, nitro sl, and started on a heparin drip. he was med flight transfered to for further management. . here he was started on eptifibatide and went urgently to cath. at cath he was found to have an acute thrombus of his rca. the artery was tortuous and calcified, so the clot could not be aspirated. ultimately it was passed with a wire and 3x bms were placed. a distal rca 50% stenosis was seen at cath that appeared unstable, but given the risks of further intervention this was not stented. r heart cath showed a ra pressure slightly elevated at 12 cmh2o with a wedge pressure in the high 20s cmh2o. he was transfered to the ccu for further management. . currently, he denies any chest pain or shortness of breath. . . 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. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: pre- diabetes, +dyslipidemia, +hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: - htn - hld - pre-diabetes, was on metformin x6months, but medication was stopped. currently diet controlled - h/o cp, had negative ett and nuclear study 5 years ago - lower gi bleed after having a screening colonoscopy that showed internal hemorrhoids social history: patient is an engineer. he lives with his wife and has two sons. - history: 30+ years, 2ppd -etoh: none -illicit drugs: none family history: mother with cervical cancer. father with mi in his 60s. physical exam: general: wdwn in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 10 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. r cath site, c/d/i. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: admission labs: 12:11pm blood wbc-9.8 rbc-4.68 hgb-14.7 hct-42.8 mcv-92 mch-31.5 mchc-34.3 rdw-13.8 plt ct-235 12:11pm blood neuts-90.6* lymphs-7.3* monos-1.3* eos-0.6 baso-0.2 12:11pm blood pt-13.9* ptt-32.7 inr(pt)-1.2* 12:11pm blood glucose-161* urean-14 creat-0.9 na-139 k-4.2 cl-103 hco3-29 angap-11 12:11pm blood alt-80* ast-264* ld(ldh)-683* ck(cpk)-3355* alkphos-70 totbili-0.6 12:11pm blood ck-mb-293* mb indx-8.7* 12:11pm blood albumin-4.2 calcium-8.8 phos-2.6* mg-1.8 cholest-130 12:11pm blood %hba1c-6.3* eag-134* . cath: comments: 1. coronary angiography of this right dominant system demonstrated two vessel coronary artery disease. the lmca was calcified but without obstructive disease. the lad had a proximal 40-50% stenosis and diffuse luminal irregularities. the lcx had no obstructive lesions. the rca was occluded distally. there was a proximal focal 60% lesion, an eccentric 50% lesion in the mid-vessel, and an ulcerated 70% stenosis at the acute marginal branch distally. 2. resting hemodynamics revealed mildly elevated right sided and moderately elevated left sided filling pressures (rvedp 14 mm hg, pcwp mean 25 mm hg, respectively). the systemic arterial blood pressure was normal (sbp 114 mm hg). there was mild pulmonary arterial hypertension (pasp 40 mm hg). the cardiac index was mildly depressed (2.2 l/min/m2). the systemic and pulmonary vascular resistances were normal (svr 1444 dynes-sec/cm5, pvr 87 dynes-sec/cm5). 3. successful ptca and placement of a 3.5x12mm vision bare metal stent in the proximal rca, a 3.0x15mm vision bare metal stent in the mid rca, and a 3.0x18mm vision bare metal stent in the proximal rca were performed. final angiography showed normal flow, no apparent dissection, a 20% residual stenosis in the proximal rca stent, no residual stenoses in the mid and distal rca stents, and a residual 50% stenosis in the native mid rca that we elected not to place a stent. (see ptca comments.) 4. the right common femoral arteriotomy was successfully closed using a 6 fr angioseal vip device. final diagnosis: 1. two vessel coronary artery disease with thrombotic occlusion of rca. 2. mild to moderate biventricular diastolic dysfunction. 3. mildly decreased cardiac index. 4. placement of bare metal stents in the rca. . echo: the left atrium and right atrium are normal in cavity size. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with hypokinesis of the basal half of the inferior and inferolateral walls. the remaining segments contract normally (lvef = 45 %). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is normal estimated pulmonary artery systolic pressure. there is no pericardial effusion. impression: suboptimal image quality. normal left ventricular chamber size with regional systolic dysfunction c/w cad (pda distribution). mild mitral regurgitation. . ekg: baseline artifact. sinus rhythm at lower limits of normal rate. q waves in leads iii and avf with st segment elevation in leads ii, iii and avf. st segment depressions in leads i, avl and v1-v2 and st segment elevations in the lateral precordial leads suggesting inferolateral acute myocardial infarction. no previous tracing available for comparison. clinical correlation is suggested. . ekg: sinus rhythm at lower limits of normal rate. since the previous tracing st segment depressions in leads i, avl and v2 are more prominent. otherwise, no significant change and there are no ectopic beats. brief hospital course: 63 year old male with htn, hld, and diet controlled pre-diabetes, who was transferred from with an inferior stemi and is s/p cardiac catheterization with 3 bms placed to the rca. . # coronaries: patient has several cardiac risk factors: smoking, htn/hld, and family history. he is status post catheterization with 3 bms placed to his rca. patient was started on atorvostatin, aspirin, metoprolol and lisinopril. he will follow up with a cardiologist, dr. on . . # pump: echo showed ef of 45-50% and regional systolic dysfunction c/w cad (pda distribution). patient was euvolemic on hospital discharge. . # rhythm: currently, in sinus rhythm. . # htn: home hctz discontinued and patient started on metoprolol and lisinopril. . # hld: changed from lipitor to high dose atorvostatin. . # elevated blood sugar: patient has pre-diabetes. hgba1c is 6.3, however he has had elevated blood sugars this admission. outpatient follow up recommended, please consider starting on metformin. . atrial fibrillation: patient went into atrial fibrillation in the ccu. he broke out of this into sinus rhythm. episode was self-resolving and given that he will need to be on full dose asa and plavix for his bms in addition to history of bleeding coumadin was not started. patient should be evaluated by cardiology as outpatient; recommend starting coumadin when plavix course completed. medications on admission: hctz 25mg daily - lipitor 20mg daily discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. atorvastatin 80 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 4. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*2* 6. zantac 150 mg tablet sig: one (1) tablet po once a day. 7. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet sublingual every 5 minutes for a total of 3 as needed for chest pain. disp:*25 tablets* refills:*0* discharge disposition: home discharge diagnosis: acute inferior myocardial infarction hypertension hyperlipidemia hyperglycemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had chest pain and a heart attack or myocardial infarction. you were flown to for a cardiac catheterization and 3 bare metal stents were placed in your right coronary artery. your heart function is not as strong as before the heart attack but we hope this will improve over the next few months. it is very important that you take all of your medicines to help your heart recover from the heart attack. 1. aspirin and plavix: to keep the stents from clotting off and causing another heart attack. do not stop taking plavix and aspirin or miss unless dr. tells you to for at least one month. 2. stop taking hydrochlorothiazide 3. increase lipitor to 80 mg daily 4. start lisinopril to lower your blood pressure and help your hear pump better 5. start metoprolol to lower your heart rate and help your heart pump better 6. start zantac if needed to prevent stomach upset from the plavix. 7. start nitroglycerin if you have chest pain again. sit down, take one tablet at a time under your tongue 5 minutes apart. do not take any more than 3 tablets. call dr. if you have any chest pain. followup instructions: cardiology: dr. phone: to nine acre corner , date/time: friday at 9:15am. . primary care: np with dr. phone: wednesday 10:15am. procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters injection or infusion of platelet inhibitor angiocardiography of right heart structures right heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation other and unspecified hyperlipidemia acute myocardial infarction of other inferior wall, initial episode of care 

Answer: The patient is high likely exposed to