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: tetracycline analogues attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization with drug eluting stent to the left anterior descending artery history of present illness: 57f w/ htn, dm, hl, obesity, pafib who presented w/ chief complaint of chest pain. the patient awoke at 4 pm with sscp, band-like feeling across chest and nausea. she tried mylanta and motrin, but the pain came back. she called 911 by 5pm. she was brought in by ambulance and threw up all the meds she was given en-route and went immediately up to lab, without getting off ambualnce stretcher or stop in ed. she got asa 325, heparin 5000, and was started on integrillin in lab. she was pain free before getting on the table. after access through the right radial, she got ballooned and stented to her lad. she also had a distal cut off in the lad which was not repaired. om1 was 60% diseased and not internvened upon. she was transferred to the ccu afterwards. she remained hemodynamically stable throughout. on review of systems, s/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, paroxysmal nocturnal dyspnea, orthopnea, palpitations. past medical history: 1. cardiac risk factors: + diabetes, + dyslipidemia, + hypertension 2. cardiac history: - paroxysmal afib diagnosed in , s/p dccv, now on rhythm control 3. other past medical history: - hx of asthmatic bronchitis - autonomic neuropathy - gerd - vocal cord surgery - cholelithiasis - hiatal hernia social history: nurse 4 but unable to work since - tobacco history: 10 pack years, quit in 98 - etoh: - - illicit drugs: - family history: both parents, alive in 80s, have afib and htn physical exam: admission: general: 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 not seen. 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. skin: no stasis dermatitis, ulcers, scars, or xanthomas. 1+ pedal edema neuro: aaox3, cnii-xii intact, 5/5 strength biceps, triceps, wrist, knee/hip flexors/extensors, 2+ reflexes biceps, brachioradialis, patellar, ankle. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ dishcarge: vs: 97.7 bp 105-113/47-54 hr 60-68 rr 18-20 97-99% ra fs:169>199>113>108; am? i/o:+ general: nad. oriented x3. mood, affect appropriate. obese heent: ncat. sclera anicteric. perrl, eomi neck: supple with jvp not seen. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, distant 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. obese extremities: no c/c trace edema, obese pertinent results: labs on admit: 06:15pm blood wbc-10.8 rbc-4.75 hgb-13.7 hct-38.8 mcv-82# mch-28.8 mchc-35.3* rdw-13.3 plt ct-249 07:15pm blood pt-14.6* ptt-150* inr(pt)-1.4* 06:15pm blood glucose-327* urean-27* creat-1.3* na-134 k-3.4 cl-95* hco3-23 angap-19 06:15pm blood alt-60* ast-33 ck(cpk)-73 alkphos-72 amylase-33 totbili-0.4 11:51pm blood ck-mb-27* 05:25am blood ck-mb-47* ctropnt-1.29* 12:08pm blood ck-mb-22* mb indx-5.6 ctropnt-0.52* 06:15pm blood vitb12-749 06:15pm blood %hba1c-11.3* eag-278* labs on dc: 07:15am blood wbc-6.7 rbc-4.35 hgb-12.5 hct-38.5 mcv-89 mch-28.6 mchc-32.3 rdw-13.3 plt ct-250 07:15am blood pt-18.5* ptt-43.6* inr(pt)-1.7* 07:15am blood glucose-131* urean-28* creat-1.0 na-137 k-4.6 cl-103 hco3-27 angap-12 07:15am blood calcium-8.5 phos-4.2 mg-2.1 cath : comments: 1. selective coronary angiography of this right dominant system demonstrated two vessel coronary disease. the lmca was patent. the lad had a 95% proximal occlusion with visible thrombus. the lcx had an 80% lesion in the om1. the rca had mild disease diffusely. 2. limited resting hemodynamics revealed systemic arterial hypertension. final diagnosis: 1. two vessel coronary artery disease. 2. stemi 3. got des to lad echo : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with mild apical aneurysm/dyskinesis and akinesis of the distal inferior wall (clip ). the distal septum is also mildly hypokinetic. the remaining segments contract normally (lvef = 55 %). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets are mildly thickened (?#). there is mild aortic valve stenosis (valve area 1.2-1.9cm2). no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: suboptimal image quality. normal left ventricular cavity size with regional systolic dysfunction c/w cad (distal lad distribution). mild aortic valve stenosis. compared with the prior study (images reviewed) of , the findings are new. brief hospital course: hospital course: 57 year old female w/ htn, hl, dm 2, pafib who presented w/ stemi - got stented to her lad and admitted to ccu for post-cath monitoring. discharged in stable condition. active issues: # stemi: pt presented with ste in v1-6 and was found to have an lad lesion. she got ballooned and des to lad and the procedure was uneventful. she has an unrepaired distal lad lesion and a 60% om1. pt found to have apical dyskinesises in tte. ces were downtrending. we started asa 325, plavix 75, d/ced pradaxa and started lovenox bridge until inr therapeutic on warfarin. # afib: pt has paroxysmal afib that was diagnosed last year after w/u for cholelithiasis. underwent dccv and was started on pradaxa, flecainide, metoprolol. was last seen in clinic by dr in at which time she was seen to be doing well. was initially started on sotalol 80 which increased her qtc to abt 480-500. dose reduced to 40 on which qtc was 470 2 hr post dose. we continued warfarin and lovenox bridge # htn: bps in 160s on transfer but stable since call out. we increased lisinopril to 30 and then d/c on home 40. # hl: last lipid panel chol 286* tg 187*1 hdl 55 ldl calc 194* in . we started her on atorva 80 and co enzyme q to prevent msucle cramps # dm 2: pt insulin dependant and on metformin. obesity increasing. followed in . hba1cs >10. also has autonomic neuropathy. we held metformin but kept increasing her insulin doses. she was on hiss (30, 25, 40 standing) and lantus (45, 50) dosing. # asthma: stable. we continued home inhalers, fexofenadine # depression: stable. we continued home citalopram # hypothyroid: stable. we continued synthroid # gerd: stable. we continued omeprazole code: fc (confirmed) comm: patient, husband transitional issues: we stopped wellchol, dabigitran, metoprolol, odansetron, hydrochlorothiazide, and flecainide and started asa, plavix, warfarin (w/ lovenox), sotalol, mg oxide, co-enzyme q and atorva. inr will be checked on wednesday at dr. office during appt. medications on admission: albuterol inhaler 2 puffs p.r.n. astelin in each nostril 2 inhalations p.r.n. citalopram 10 mg daily welchol 3.75-g powder daily dabigatran 150 mg b.i.d flecainide 150 mg b.i.d. hiss as directed per sliding scale; 25 units qam, 35 units at noon and 35 units qpm lantus; 50 units hs and 45 units qam levothyroxine 25 mg daily lisinopril 40 mg daily loratadine 10 mg daily meclizine 25 mg b.i.d. p.r.n. metformin er 1000 mg b.i.d. metoprolol er 25 mg daily omeprazole 20 mg daily ondansetron 4 mg b.i.d. p.r.n vitamin d calcium replacement therapy. htz 25 qam discharge medications: 1. outpatient lab work please check inr and chem-7 on with results to dr. , i. location: address: 545a centre st, , phone: icd-9 427.31 fax: 2. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet sublingual as directed as needed for chest pain. disp:*25 tablets* refills:*0* 3. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 5. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: one (1) puff inhalation q6h (every 6 hours) as needed for wheezing. 6. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 7. astelin nasal 8. insulin lispro 100 unit/ml solution sig: as per sliding scale units subcutaneous three times a day. 9. lantus 100 unit/ml solution sig: forty five (45) units subcutaneous once a day: 50 units at night. 10. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 11. lisinopril 40 mg tablet sig: one (1) tablet po once a day. 12. loratadine 10 mg tablet sig: one (1) tablet po once a day. 13. meclizine 25 mg tablet sig: one (1) tablet po twice a day as needed for vertigo. 14. metformin 1,000 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po twice a day. 15. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 16. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 17. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 18. coenzyme q10 200 mg capsule sig: one (1) capsule po daily (). disp:*30 capsule(s)* refills:*2* 19. warfarin 2 mg tablet sig: 2.5 tablets po once a day. disp:*75 tablet(s)* refills:*2* 20. enoxaparin 150 mg/ml syringe sig: one (1) syringe subcutaneous q12h (every 12 hours). disp:*8 syringe* refills:*2* 21. sotalol 80 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 22. magnesium oxide 400 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: st elevation myocardial infarction secondary: atrial fibrillation diabetes mellitus hypertension dyslipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you at . you were admitted for a heart attack. you were treated with a drug eluting stent to your left anterior descending artery. you will need to take aspirin and plavix every day without fail to ensure that your stent remains open and does not clot off and cause another heart attack. do not stop taking aspirin and plavix unless dr. tells you it is ok. your heart function still remains good but there is an area that is not moving well after the heart attack. therefore, you have been changed from dabigitran to warfarin until your heart wall motion improves. it is very important that you take all of your medicines and optimize your blood sugar control. . we made the following changes to your medicines: 1. stop taking wellchol, dabigitran, metoprolol, odansetron, hydrochlorothiazide, and flecainide 2. start taking aspirin 325 mg daily and plavix 75 mg daily to prevent the stents from clotting off. 3. start taking atorvastatin to lower your cholesterol 4. start taking warfarin instead of dabigitran to prevent blood clots and a stroke 5. start taking nitroglycerin if you have chest pain at home. take one tablet under your tongue and wait 5 minutes, you can take another tablet if you still have chest pain but please call 911 if the chest pain persists. 6. start co enzyme q12 to prevent muscle aches from the atorvastatin 7. start enoxaparin sc to take twice daily until the inr is > 2.0 8. start mag oxide twice daily to increase your magnesium levels. you can get your inr checked on wednesday at dr. office during your appt. followup instructions: the following appointments were made for you: department: bidhc when: wedenesday at 9:15 am. with: , md building: 545a centre st. (, ma) none campus: off campus best parking: department: cardiac services when: thursday at 10:20 am with: , md building: sc clinical ctr campus: east best parking: garage department: neurology when: thursday at 1 pm with: , md building: campus: east best parking: garage procedure: coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) 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 esophageal reflux unspecified essential hypertension unspecified acquired hypothyroidism acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation asthma, unspecified type, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled depressive disorder, not elsewhere classified other and unspecified hyperlipidemia long-term (current) use of insulin morbid obesity dizziness and giddiness peripheral autonomic neuropathy in disorders classified elsewhere 

Answer: The patient is high likely exposed to