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: no known allergies / adverse drug reactions attending: chief complaint: cp major surgical or invasive procedure: pci with angioplasty and des to mid-rca history of present illness: 68-year-old woman haitian crecole speaking only with history of type 2 dm, hypertension and hyperlidpedemia who presented to ed with 3 days of chest pain. patient reports that about three days ago while she was putting her clothes in the laundry she had suddedn onset of substernal chest pain with radiation to her neck, right arm and her abdomen. she attributed this pain to indigestion. the pain was and remained constant. today at 6:30am patient patient acutely worsened associated with nasuea, diaphoresis and shonrtess of breaht. . in the ed, initial vitals were 45 96/45 16 100% ra. ecg showed st elevation myocardial infarction in inferior leads. she was given aspirin 325 mg, plavix 600 mg, eptifibatide 180 mcg/kg x 1 and heparin 4000 units iv bolus. she was noted to be bradycardic and hypotensive and thus given atropine 1mgx2 and started on dopamine gtt which improved her blood pressure. she was transfer to cath lab. . in the cath lab, she was noted to acute mid rca occlusion which was treated with angioplasty x 3 (10 mm/12 mm/14 mm) with residual thrombus which was exported and promus des was placed in mid rca. his cath lab course was complicated by intermittent complete heart block requiring temporary pacemaker pre-stenting though she was conducting 1:1 in nsr after stenting. she was also noted to have aivr. dopamine at 5 mcg/kg/min was turned off at the end of her cath lab course. a small 1.5cm hematoma was visible at the rfv access site after the case, and manual pressure was applied for 10 minutes. . in the ccu, she did not report chest pain, discomfort, palpatations or shortness of breath. she desnies any history of chest pain. past medical history: dm2 htn tuberculosis peripheral neuropathy aseptic thrombophlebitis of the left internal jugular in . social history: lives with husband, ha two children who live in . creole speaking from 14 years ago. three children. no history of tobacco, etoh or illicit. family history: non-contributory physical exam: admission physical: general: appears well nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl. mmm neck: supple with no jvd 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: 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: wamr and well perfused no femoral bruits. 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: 11:35am blood wbc-10.8# rbc-3.35* hgb-10.3* hct-30.8* mcv-92 mch-30.7 mchc-33.4 rdw-12.8 plt ct-178 11:35am blood pt-12.5 ptt-30.7 inr(pt)-1.2* 11:35am blood glucose-394* urean-22* creat-1.2* na-135 k-4.0 cl-99 hco3-25 angap-15 11:35am blood ck-mb-11* mb indx-1.2 05:15pm blood ck-mb-16* mb indx-1.9 05:28am blood ck-mb-10 mb indx-1.8 ctropnt-3.44* 11:35am blood ck(cpk)-891* 05:15pm blood ck(cpk)-821* 05:28am blood ck(cpk)-555* cardiac cath 1) selective coronary angiography of this co-dominant system demonstrated three-vessel coronary artery disease. the lmca had mild luminal irregularities. the proximal-mid lad had an 80% trifurcation lesion that was tightest at the large diagonal branch takeoff; there was a high diagonal branch (functionally a ramus) that had diffuse proximal 70% stenosis. the lcx was a diffusely-diseased vessel with a likely stump-occluded om2 and severely diseased distal vessel; it provided a smaller left pda. the mid-rca was 100% occluded without anterograde flow into the distal vessel; there was also haziness noted at the am origin. the ostial rca had a 30-40% stenosis. 2) 3) during the procedure, and given the degeneration of the conduction disease to high-grade heart block associated with hypotension, a temporary pacing wire was inserted through the 5 french venous sheath with successful capture at 80 bpm and ma. after the pci, pacing was discontinued, and the patient remained in sinus rhythm with 1:1 conduction at a rate of 80 bpm with normotensive blood pressures. the temporary pacing wire was therefore removed and the dopamine was discontinued. 4) after the procedure, the 6 french right femoral arteriotomy site was angiosealed with adequate hemostasis. the 5 french right femoral venous sheath was left in place in case of worsening conduction disease overnight. a small 1.5cm hematoma was noted after the procedure. final diagnosis: 1. inferior wall stemi with high-grade av block. 2. successful emergent primary pci of occluded mid rca with ptca, export thrombectomy, and promus drug eluting stent. 3. emergent temporary pacing wire placement with active pacing during the procedure. . tte: : 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 severe hypokinesis of the inferolateral wall. the remaining segments contract normally (lvef = 40 %). 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 (3) are mildly thickened but aortic stenosis is not present. there is no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . impression: mild symmetric left ventricular hypertrophy with regional systolic dysfunction c/w cad (pda distribution). mild-moderate mitral regurgitation most likely due to papillary muscle dysfunction. pulmonary artery hypertension. . clinical implications: based on aha endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is not recommended. clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. . discharge labs: brief hospital course: 68-year-old woman, haitian-creole speaking, with history of type 2 dm, hypertension, and hyperlidpedemia, presented with inferior stemi now s/p des to mid rca. . # stemi: patient with multiple cardiovascular risk factors (uncontrolled diabetes, uncontrolled hypertension and hyperlidemia) presented with worsening chest pain. ecg was consistent with st elevation myocardial infarction in inferior leads. she was given aspirin 325 mg, plavix 600 mg, eptifibatide 180 mcg/kg x 1 and heparin 4000 units iv bolus. she was noted to be bradycardic and hypotensive and thus given atropine 1mgx2 and started on dopamine gtt which improved her blood pressure. she was transfer to the cath lab. in the cath lab, she was noted to have acute mid rca occlusion which was treated with angioplasty x 3 (10 mm/12 mm/14 mm) with residual thrombus, which was removed, and promus des was placed in the mid rca. her cath lab course was complicated by intermittent complete heart block requiring temporary pacemaker pre-stenting though she was conducting 1:1 in nsr after stenting. she was also noted to have aivr. dopamine at 5 mcg/kg/min was turned off at the end of her cath lab course. she had an echo report that showed mild regional left ventricular systolic dysfunction with severe hypokinesis of the inferolateral wall with ef 40%. mild symmetric left ventricular hypertrophy with regional systolic dysfunction c/w cad (pda distribution). mild-moderate mitral regurgitation most likely due to papillary muscle dysfunction. pulmonary artery hypertension. during her ccu course, patient had one episode of shortness of breath and increased respiratory rate with bilateral crackles on exam. she was treated with lasix which improved her sxs and she had no further episodes of chest pain or shortness of breath during her hospital stay. patient was evaluated by physical therapy on the day of discharge and determined safe to go home. patient will follow up with dr. in cardiology and with her pcp . . she was discharged on the following medications: lasix, metoprolol, lisinopril, atorvastatin, and plavix. . # arrythmia: patient had bradycardia with dropped beats and atrial ectopy likely in the setting of reperfusion post . she did not have any symptomatic episodes of bradycardia during her ccu course. she was also started on low dose metoprolol which she tolerated very well. . # diabetes type 2: poorly controlled and complicated by diabetic nephropathy, retinopathy, and neuropathy. last a1c was 8.7 in 3/. she was continued on 11units of nph and insulin sliding scale. on discharge, she was put on ----. . # anemia: hematocrit during this admission was around 30. prior hct on omr from shows hct of 37.9. unclear etiology. no source of obvious bleeding and normal coags. patient will follow up with pcp for further management. . # hypertension: patient blood pressure was well controlled on low dose metoprolol. her home chorthalidone, amlodopine, and lisinopril were initally held due to low bps. she was discharged on metoprolol, lisinopril and lasix. . # hyperlidemia: started atorvastain 80mg daily. . transitional issues: - needs close follow-up with cardiology, pcp recommend consultation for dm medications on admission: preadmission medications listed are correct and complete. information was obtained from webomr. 1. aspirin 81 mg po daily 2. amlodipine 10 mg po daily 3. chlorthalidone 25 mg po daily 4. lisinopril 40 mg po daily 5. metformin (glucophage) 1000 mg po bid 6. ranitidine 150 mg po bid 7. nph 32 units breakfast nph 22 units dinner discharge medications: 1. aspirin ec 325 mg po daily rx *aspirin 325 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 2. ranitidine 150 mg po bid 3. atorvastatin 80 mg po daily rx *atorvastatin 80 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 4. clopidogrel 75 mg po daily for the recommended duration rx *clopidogrel 75 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 5. metoprolol succinate xl 50 mg po daily rx *metoprolol succinate 50 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 6. metformin (glucophage) 1000 mg po bid 7. nph 32 units breakfast nph 22 units dinner 8. lisinopril 20 mg po daily rx *lisinopril 40 mg 0.5 (one half) tablet(s) by mouth daily disp #*15 tablet refills:*2 9. furosemide 20 mg po daily rx *furosemide 20 mg one tablets by mouth daily disp #*30 tablet refills:*2 10. outpatient lab work please check chem-7 at on with results to dr. at phone: fax: icd-9 428 discharge disposition: home with service facility: vna discharge diagnosis: inferolateral st elevation myocardial infarction acute systolic congestive heart failure hypertension diabetes discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mrs. , it was a pleasure taking care of your during your admission at . you were admitted because you were having chest pain and you were found to have a heart attack for which you had a stent placed in your heart. you have also been started on new medications (aspirin and clopidogrel) to prevent the stenting of the clot which you should continue to take unless told otherwise by your cardiologist. weigh yourself every day before breakfast. call dr. if weight increases more than 3 pounds in 1 day or 5 pounds in 3 days. the visiting nurse will help you with a low salt diet. . please continue to take your medications as directed in your discharge medication sheet. please do not stop any medication especially clopidogrel unless told by your cardiologist. you risk having a heart attack if you do not take this medicine every day. followup instructions: department: cardiac services when: thursday at 1 pm with: , md building: sc clinical ctr campus: east best parking: garage department: health center when: tuesday at 11:50 am with: , md building: sc clinical ctr 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: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere coronary atherosclerosis of native coronary artery congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes chronic kidney disease, unspecified other and unspecified hyperlipidemia atrioventricular block, complete cardiogenic shock acute myocardial infarction of inferolateral wall, initial episode of care acute systolic heart failure diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy 

Answer: The patient is high likely exposed to