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: vicodin attending: chief complaint: chest pain major surgical or invasive procedure: cardiac cath 1. coronary angiography in this left dominant system demonstrated two-vessel disease. the lmca had no significant stenosis. the lad had a diffuse 70% stenosis in the mid portion. the lcx had a 99% thrombus in the proximal portion. there was a small om2 with diffuse disease and high om1 free of significant disease. the rca was small and non-dominant with an anterior take-off. 2. inferolateral stemi 3. successful aspiration thrombectomy and pci of the proximal lcx with 3.0x18mm drug-eluting stent post-dilated to 3.5mm (see ptca comments). 4. successful right femoral arteriotomy closure with 6f exoseal device. history of present illness: 70 year old female with a history of hypertension, hyperlidipemia, diabetes, smoking history and no known cad who presented to the ed complaining of chest pressure. patient reports that about six months ago started experinced substernal chest pressure with radiation to the neck, jaw and back on excertion after walking for 2 blocks which would resolve after resting for few seconds. in the interim she was seen by her pcp who recommended stress test which patient refused. yesterday patient reports as she was walking outside she starting getting similar chest pain that were happening more frequently with less amount of exertion and she had to rest frequently to relieve her symptoms. then this morning at 7:30 am she was in her bed when she developed dull ache in the chest associated with worsening sob, nausea and diaphoresis. she took aspirina and tylenol which did not relive her symptoms. she continued to have constant pain and sob until 12:30pm when her daugther insisteted that she co to the ed and called ems. ems arrived today and administered aspirin and one nitroglycerin and her symptoms almost completely resolved. she has not had any recent surgeries travel immobilization, no history of thromboembolic disease in self or family. . initial vitals in ed triage were t 97.2, hr 114, bp 127/70, rr 22, and spo2 90% on ra. initial troponin was 0.03 with ck 101 and ckmb 5. labs were notable for wbc 13.0 (n 87.8%), hct 36.4 (unclear baseline), plt 269, cr 1.1 (at baseline), unremarkable electrolytes, and normal coags. ekg showed sinus tachycardia with inferolateral . code stemi was called. she was given nitroglycerin sl, morphine 5 mg iv, metoprolol 5 mg iv, and started on a heparin drip. she was taken directly to the cath lab. vitals prior to cath lab transfer were hr 125, bp 156/84, rr 24, and spo2 96% on ra. she was found to have a proximal lcx 99% lesion with thrombus which was treated with export aspiration thrombectomy followed by ptca and stenting with a promus des. her rfa access site was closed with a 6f exoseal device. she was admitted to the ccu for post-cath monitoring. . on reaching the ccu, she reports feeling well without any chest pain or shortness of breath. she dnies any hsitory of orthiopnea, pnd or peripheral edema, syncope, lightheadedness. past medical history: # cardiac risk factors: (+)diabetes, (+)dyslipidemia, (+)hypertension # diabetes mellitus type 2 -- last hgba1c 8.3% on # diabetic neuropathy # ckd stage 3 -- egfr 30-59 ml/min # hypothyroidism # mrsa cellulitis history # obesity # anxiety social history: # work: homeless shelter director. lives with daughter, # alcohol: none # tobacco: 40 pack year hitory of smoking. quit smoking in # drugs: none family history: # father -- cancer, alcoholism, died at age 75 # mother -- glaucoma # brother -- died from prostate cancer # sister -- stoke at age 42 still living # daughters -- diabetes mellitus type 2--> now resolved after bypasss usrgery. physical exam: gen: elderly obese female in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva without pallor or injection. mmm, op clear. neck: supple, full rom. jvp ~. no cervical lymphadenopathy. cv: pmi not displaced. rrr with normal s1, s2. no m/r/g. no thrills or lifts. no s3 or s4. chest: respiration unlabored, no accessory muscle use. ctab with no crackles, wheezes or rhonchi. abd: soft, nt, nd. no organomegaly. abdominal aorta not enlarged by palpation. no abdominal bruits. ext: wwp. no femoral bruits. distal pulses intact 2+ radial, dp, and pt. skin: no stasis dermatitis, ulcers, rashes, or other lesions. neuro: alert and oriented x3. pertinent results: 01:45pm blood ctropnt-0.03* 05:51am blood ck-mb-14* ctropnt-0.66* 11:38pm blood ck-mb-5 06:05am blood ck-mb-4 01:45pm blood wbc-13.0*# rbc-4.33 hgb-12.0 hct-36.4 mcv-84 mch-27.8 mchc-33.1 rdw-15.4 plt ct-269 06:05am blood wbc-8.9 rbc-3.52* hgb-9.7* hct-29.5* mcv-84 mch-27.6 mchc-33.0 rdw-15.7* plt ct-183 06:05am blood glucose-200* urean-15 creat-1.0 na-137 k-4.9 cl-102 hco3-24 angap-16 cardiac echo: the left atrium is elongated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. there is an inferobasal left ventricular aneurysm. overall left ventricular systolic function is severely depressed (lvef = 25 %) secondary to severe hypokinesis/akinesis of the inferior septum, inferior free wall, posterior wall, and lateral wall. right ventricular chamber size and free wall motion are normal. the aortic valve is not well seen. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: inferoposterolateral myocardial infarct; severe left ventricular systolic dysfunction; inferobasal aneurysm cardiac cath: 1. coronary angiography in this left dominant system demonstrated two-vessel disease. the lmca had no significant stenosis. the lad had a diffuse 70% stenosis in the mid portion. the lcx had a 99% thrombus in the proximal portion. there was a small om2 with diffuse disease and high om1 free of significant disease. the rca was small and non-dominant with an anterior take-off. 2. inferolateral stemi 3. successful aspiration thrombectomy and pci of the proximal lcx with 3.0x18mm drug-eluting stent post-dilated to 3.5mm (see ptca comments). 4. successful right femoral arteriotomy closure with 6f exoseal device. brief hospital course: 70 year old female with a history of hypertension, hyperlidpiemia, diabetes, smoking history and no prior known cad who presented found to be having a inferolateral stemi with thrombotic lesion in the proximal lcx treated successfully with aspiration thrombectomy and des. active issues addressed on this hospitalization: # inferolateral stemi: patient with multiple cardiovascualr risk factors (obeseity, htn, hld, smoking history)and 6 months of exertional chest pain presented lcx stemi. she had successful pci to the lcx with placement of a des. she did well post-procedure. she was started on asa 81mg, plavix, metoporol, and atrovastatin and her home lisinopril was continued. she had a follow up echo (report included in this d/c summary) that showed significant wall motion abnormalitis with a moderatly depressed ejection fraction. she will follow up with dr. as an outpatient for follow up cardiac echo and for nuclear stress test for her cad as discussed below. # cad: the patient had a stent to the lcx but was also found to have that her lad had a diffuse 70% stenosis in the mid portion. there was a small om2 with diffuse disease and high om1 free of significant disease. the rca was small and non-dominant with an anterior take-off. she has proper medical managment for this level of disease at this time. it was also stressed to her that she needed to keep her diabetes under better contol and she should exercise more often. she will need outpatient mibi for evaluation of this lesion. chronic issues: # htn: her blood pressures following the pci were well controlled on metoprolol and lisinopril. her hctz was held given her sbp in the 110s-120s. #dm: she was placed on a insulin sliding scale while hospitalized as she recieved contrast for her pci. she was instructed to restart her home medications at time of discharge. transitional issues: # lad had a diffuse 70% stenosis in the mid portion. she will need outpatient mibi for evaluation of this lesion. this will be scheduled with dr. . # htn: her hctz was stopped on this admission in favor of starting a beta-blocker in the peri-mi time. her blood pressure was well controlled with sbp in the 110s-120s and so she was instructed to not restart the hctz until instructed to do so by her pcp. # dm: at time of discharge the patient had a a1c pending. the patietn last had her a1c checked in and was elevated at that time. medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. gabapentin 900 mg po qid 2. levothyroxine sodium 100 mcg po daily 3. lisinopril 40 mg po daily 4. metformin (glucophage) 850 mg po bid 5. hydrochlorothiazide 12.5 mg po daily 6. duloxetine 30 mg po bid 7. glipizide 5 mg po bid discharge medications: 1. duloxetine 30 mg po bid 2. gabapentin 900 mg po qid 3. levothyroxine sodium 100 mcg po daily 4. lisinopril 40 mg po daily 5. aspirin 81 mg po daily rx *aspirin 81 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 6. atorvastatin 80 mg po daily rx *atorvastatin 80 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 7. glipizide 5 mg po bid 8. metformin (glucophage) 850 mg po bid 9. metoprolol succinate xl 200 mg po daily rx *metoprolol succinate 200 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 10. clopidogrel 75 mg po daily rx *clopidogrel 75 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 11. nitroglycerin sl 0.4 mg sl prn chest pain please take every 5 mintues as needed for chest pain. please take only 3 and call your doctor or 911 if the pain does not resolve. discharge disposition: home discharge diagnosis: st-elevated myocardial infarction discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mrs. , you were hospitalized for a heart attack (myocardial infarction). you had a blockage of an artery in your heart (the left circumflex artery) that was opened up and a stent was placed. you were monitored overnight in the cardiac icu and you did well. you were started on a number of new medications because of the heart attack. they are listed below. please take the medications as directed and do not stop the plavix without your cardiologist telling you that it is ok to do so. it is also important that you take your medications for your diabetes as your doctor perscribes them to you because if your diabetes is not controlled it will make having an additional heart attack more likely. we are also giving you a perscription for nitroglycerin. please take every 5 mintues as needed for chest pain. please take only 3 and call your doctor or 911 if the pain does not resolve. please start: plavix (clopidogrel) 75mg daily metoprolol succinate 200mg daily aspirin 81mg daily nitro 04.mg under your tounge every 5 mintues as needed for chest pain. please take only 3 and call your doctor or 911 if the pain does not resolve. please stop until you see your primary care doctor: hydrochlorothiazide - please stop this becase we started other medication for your heart and your blood pressure has been in the 110s-120s without this medication. your primary care doctor will let you know if you should restart this medication. followup instructions: please follow up with dr. in 1 week to discuss your heart attack and to have a blood pressure check to see if your hydrochlorothiazide should be restarted. please follow up with dr. (cardiologist) in 2 weeks. his office will call you in the next several days. if you do not hear from the office at the end of the week please call (. procedure: coronary arteriography using two catheters 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 other operations on nervous system intravascular pressure measurement of coronary arteries diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified aortic valve disorders diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes personal history of tobacco use other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) anxiety state, unspecified other specified cardiac dysrhythmias acute myocardial infarction of inferolateral wall, initial episode of care hypoxemia obesity, unspecified acute systolic heart failure do not resuscitate status 

Answer: The patient is high likely exposed to