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 catherization with drug eluting stent to left anterior descending artery. history of present illness: mr. is a 60 yo male with cad, htn, borderline dm who recently underwent a cardiac cath with a stent lad that did not fully deploy who presents with cp that began at noon today. the patient was shoveling snow at a moderate pace when he developed the chest pain. cp became very severe and was similar to cp (sscp with radiation to right shoulder) with his previous mi so he presented to the ed. he reports diaphoresis, but he denies associated nausea, vomiting, sob, palpitations or dizziness. he has been experiencing doe regularly for the past year or so. patient presented in with complaints of excertional chest pain similar to his chest pain prior to his mi in . he was seen by dr. in clinic and underwent cardiac cath on that showed a totally occluded lad and 80%. the lad was a very small vessel, and was crossed and stented. in the proximal portion of the stent, there was substantial rigidity of the lad and it would not fully dilate. this resulted in a 40-50% residual stenosis but normal flow into the distal vessel. he continued to have excertional sob and discussed with dr. cabg vs pci and returned on with stent placement to the om1 lesion. today, he was found to have acute stent thrombosis in lad stent with hyper-acute t waves in the anterior leads. in the ed, he was started on heparin and given 4mg iv morphine. potassium was 6.8, but hemolyzed. he was taken to the cath lab where the clot was extracted with an aspiration catheter. a balloon was used first, but arotational atherectomy was required followed by recurrent ballooning. at the end of the case timi 3 flow was restored an the patient did not have any residual stenosis. on arrival to floor, he reports some mild nausea and sob. he is not in any distress. he denies chest pain or pressure. 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. 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: (+) htn (+) chol (+) borderline dm 2. cardiac history: mi in -percutaneous coronary interventions: s/p stent to lad on s/p stent to om1 on 3. other past medical history: - colon cancer: s/p resection, radiation and chemotherapy - copd - lower back arthritis - tonsillectomy - hernia - h/o train accident right arm disability. social history: he is not currently working but would like to return to employment. he does not currently smoke cigarettes but did smoke 1.5 packs for 30 years. he quit in . he does not drink alcohol and is very active physically. -illicit drugs: denied family history: + for dm & cad. father died at the age of 48 of mi. one sister dies at 10 months from congential heart disease. another sister died at age is 35 years from mi. 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: unable to assess jvp. 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. cta anteriorly, no crackles, wheezes or rhonchi. abdomen: + scars. soft, obeses ntnd. bilat lower quad tenderness. no rebound/guarding. no abdominial bruits. extremities: no c/c/e. no femoral bruits. no hematoma dressing c-d-i. skin: scar on right shoulder. chronic macular erythematous rash on chest. pulses: right: femoral 2+ dp 2+ pt 2+ left: femoral 2+ dp 2+ pt 2+ pertinent results: 07:25pm glucose-151* urea n-17 creat-0.8 sodium-139 potassium-4.2 chloride-102 total co2-23 anion gap-18 01:15pm wbc-9.9# rbc-5.90 hgb-17.9 hct-50.8 mcv-86 mch-30.4 mchc-35.3* rdw-13.1 01:15pm neuts-79.9* lymphs-12.0* monos-4.0 eos-3.7 basos-0.4 01:15pm pt-11.6 ptt-25.2 inr(pt)-1.0 01:15pm ck(cpk)-208* 01:15pm ctropnt-0.01 01:15pm ck-mb-4 07:25pm ck(cpk)-5122* 06:17am blood ck(cpk)-3040* 06:17am blood ck-mb-379* mb indx-12.5* ctropnt-8.59*ekg: ekg: 13:15 - sr 81 hyper-acute t waves in v1-v4 no st changes 16:06 - sr 87 less that 1 mm ste in v1 -v4 telemetry: st 100 2d-echocardiogram: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. 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. cardiac cath: : lmca: normal lad: acute stent thrombosis in mid lad lcx: widely patent stend in omb. minor lumen irregularities in lcx rca: not injected. cxr: : mild interstitial pulmonary edema. linear opacity projecting over the region of the proximal svc and left brachiocephalic vein which may be artifactual versus retained catheter, not seen in the prior ct study (ct ). clinical correlation advised and repeat imaging as warranted. 2d-echo: the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. there is moderate regional left ventricular systolic dysfunction with near akinesis of the distal segments and apex and hypokinesis of the mid septum and mid anterior wall. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: moderate focal lv systolic dysfunction, consistent with cad (lad territory). no significant valvular abnormality seen. brief hospital course: mr. is a 60 yo gentleman with pre-diabetes, htn, and cad who presents with chest pain and was found to have an acute stent thrombosis. 1. coronaries: patient presented with stent thrombosis in lad stent that was not full expanded. treated with arotational atherectomy followed by recurrent ballooning with restoration of timi 3 flow. ck and ckmb peaked at 5122 and > 500 respectively. patient was given 1l ns for renal protection post catheterization and had no evidence of acute kidney injury through duration hospital stay. tolerated procedure well, with no complications. he was continued on his acs medications: asa 325, metoprolol, lisinopril, atorvastatin. plavix was discontinued and he was bolused 60mg of prasugrel and started on a regimen of 10mg daily given history of instent restenosis. also started on omeprazole for gastritis prevention given anticoagulation with numerous medications. post cath echo showed ef of 30-35% with moderate focal lv systolic dysfunction. patient was started on coumadin withheparin bridge for lv thrombus prophylaxis. he was discharged on lovenox to complete bridge to therapeutic inr goal of . 2. copd/sob: stable, continued on home medications of flovent and albuterol inhalers. maintained adequate o2 saturations on room air. 3. impaired glucose tolerance: finger sticks monitored qachs throughout hospital stay; patient placed on sliding scale insulin as needed to maintain euglycemia. a ha1c was pending at the time of discharge 4. htn - remained normotensive on metoprolol and lisinopril as above. of note, metoprolol tartrate was switched to long acting form during hospital stay and uptitrated as tolerated by blood pressure to maintain optimal heart rate. 5. hyperlipidemia: stable, continued on home dose of atorvostatin 80mg. lipid panel at goal with ldl < 70 and hdl of 41. medications on admission: albuterol sulfate (proair) 90mcg mdi q 6 hours prn non compliance atorvastatin 80mg one tablet at night fluticasone 50mcg spray two puffs nasal daily -non compliance fluticasone (flovent) 44 mcg mdi two puffs inh twice a day non compliance folic acid 1mg tablet daily lisinopril 10mg one tablet daily metoprolol succinate (toprol xl) 50mg one tablet daily aspirin 325mg daily omega-3 fatty acids 1200mg one capsule daily plavix 75mg once daily discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. prasugrel 10 mg tablet sig: one (1) tablet po daily (daily): take every day for at least one year, do not stop taking unless dr. tells you to. . disp:*30 tablet(s)* refills:*11* 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 6. fluticasone 110 mcg/actuation aerosol sig: one (1) puff inhalation (2 times a day). disp:*1 bottle* refills:*2* 7. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal (2 times a day). disp:*1 bottle* refills:*2* 8. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take up to three tablets 5 minutes apart. call dr. if you have chest pain. . disp:*25 tablet, sublingual(s)* refills:*0* 9. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 10. flovent hfa 44 mcg/actuation aerosol sig: two (2) puffs inhalation twice a day. 11. xopenex hfa 45 mcg/actuation hfa aerosol inhaler sig: two (2) puffs inhalation four times a day as needed for shortness of breath or wheezing. 12. folic acid 1 mg tablet sig: one (1) tablet po once a day. 13. outpatient lab work please check your inr on via your vna and call results to dr. office at 14. coumadin 2.5 mg tablet sig: two (2) tablet po once a day: continue 5mg daily until your are advised to change your dose. you will have your inr checked w/ goal 1.8-2.5. disp:*60 tablet(s)* refills:*2* 15. enoxaparin 150 mg/ml syringe sig: one (1) subcutaneous daily (daily) for 7 days. disp:*7 syringe* refills:*0* 16. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 17. toprol xl 25 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po once a day. disp:*90 tablet sustained release 24 hr(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: st elevation myocardial emphysema hypertension hyperlipidemia discharge condition: stable, aa0x3, sats >95% ra, ambulating activity status:ambulatory - independent level of consciousness:alert and interactive mental status:clear and coherent discharge instructions: you had a major heart attack because the stent clotted off and your heart function is weakened. we have changed the medicine from plavix to prasugrel to try to keep the stent open. you will continue on your other medicines. weigh yourself every morning, md if weight goes up more than 3 lbs in 1 day or 6 pounds in 3 days. . medication changes: 1. stop taking fish oil, this can interact with all of the other blood thinners 2. start taking prasugrel, this is to keep the stent open. you will need to take this every day for one year and possibly longer. do not stop taking this medicine unless dr. tells you to. missing doses on this medicine can cause the stent to clot off again and lead to another heart attack. 3. continue to take a aspirin 325 mg. 4. start taking coumadin to prevent blood clots in your heart. you will need to have your coumadin level checked frequently and keep the level between 1.8 and 2.5. please continue on 5mg daily until your level is checked. 5. stop taking plavix. 6. decrease the lasix dose to 20mg daily. please check your inr via your vna and have them call results to dr. office at 7. start taking omeprazole to prevent stomach upset from the blood thinners. 8. you will take lovenox 150mg daily that will be given by your vna until your inr reaches 1.8. 9. your toprol xl was increased to 75mg daily followup instructions: primary care: provider: . , md phone: date/time: thursday at 4:00pm. provider: . , md phone: date/time: 2:00 cardiology: provider: , md phone: date/time: at 11:20am. provider: , md phone: date/time: 11:20 procedure: coronary arteriography using two catheters left heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia other emphysema cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft personal history of malignant neoplasm of large intestine acute myocardial infarction of other specified sites, initial episode of care personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health chronic total occlusion of coronary artery 

Answer: The patient is high likely exposed to