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: chest pain major surgical or invasive procedure: left heart catheterization with percutaneous coronary intervention history of present illness: the patient is a 61 year old female with a past medical history of diabetes, hypertension, hyperlipidemia who presents with substernal chest pain for three days. she was in her normal state of health until saturday when she developed sudden onset substernal chest pressure - "like someone was sitting on my chest." she initially attributed this to her upper respiratory tract illness. the pain did not radiate, was not pleurtic, and was associated with diaphoresis and some shortness of breath. she went to bed for the rest of the day and all of sunday. she woke up monday morning and the pain was still present. she went to an oncology appointment (s/p resection of lung nodule several months ago) where she relayed the above history, so she was sent to urgent care for evaluation. ekg there reportedly showed 1.5mm ste iii, 1mm ste avf. she was given one aspirin and was transferred to . . of note, pt notes intermittent chest pain with activity for past six months. she an had abnormal stress test in with small to moderate intensity perfusion defect in the basal and mid inferolateral and lateral wall with complete reversibility. this was managed medically. . in the ed, her initial vitals were 104/54 hr:77, rr: 15, 100%o2 on 2lnc . labs notable for a wbc count of 17, creatinine of 1.0, and troponin of 0.9. ekg notable for 1mm st elevation in lead iii. she was started on heparin and was taken to the cardiac catheterization lab. access was right radial, she was found to have mid rca 100% occlusion that underwent poba as well as lcx with focal 70% om1 stenosis. . 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 absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. . past medical history: 1. cardiac risk factors: +diabetes, +dyslipidemia, +hypertension 2. other past medical history: -lung carcinoid s/p right upper lobe wedge resection in at , complicated by wound dehiscence -left adrenal adenoma -adjustment disorder with depression -thyroidectomy in not on thyroid replacement -obstructive sleep apnea not on cpap -cataract surgery in -obesity hypoventilation with pfts showing some restrictive physiology -suburethral sling in social history: - works for school department in special ed - married, three children - tobacco history: former 80 pack year smoker, quit 14wks ago - etoh: denies - illicit drugs: denies family history: - mother: mi - father: mi physical exam: admission exam vs: afebrile, 125/61 66 98%2l nc 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: jvp difficult to assess due to body habitus 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: right wrist in band, no edema 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+ . discharge exam: vitals - tm/tc:9.9/98.6 hr: 82-86 bp:103-113/61-65 rr: 16-18 02 sat: 95% ra in/out: last 24h: last 8h: . tele: sr, no vea general: 61 yo f in no acute distress heent: perrla, no pharyngeal erythemia, mucous membs moist, no lymphadenopathy, jvp non elevated chest: ctabl no wheezes, no rales, no rhonchi cv: s1 s2 normal in quality and intensity rrr no murmurs rubs or gallops abd: soft, non-tender, non-distended, bs normoactive. ext: wwp, no edema. dps, pts 2+. right wrist with no ecchymosis or hematoma. neuro: cns ii-xii intact. 5/5 strength in u/l extremities. gait wnl. skin: no rash psych: a/o, somewhat sad this am. pertinent results: admission labs 12:15pm blood wbc-17.0* rbc-4.10* hgb-12.4 hct-37.6 mcv-92 mch-30.3 mchc-33.0 rdw-13.2 plt ct-228 12:15pm blood neuts-82.0* lymphs-14.9* monos-2.6 eos-0.3 baso-0.2 12:15pm blood pt-11.3 ptt-32.8 inr(pt)-1.0 12:15pm blood glucose-140* urean-23* creat-1.0 na-137 k-4.2 cl-98 hco3-26 angap-17 05:03am blood alt-24 ast-83* ld(ldh)-500* ck(cpk)-626* alkphos-65 totbili-1.2 05:03am blood calcium-9.1 phos-3.0 mg-1.9 pertinent labs and studies 12:15pm blood %hba1c-6.3* eag-134* 12:15pm blood ck-mb-75* mb indx-9.8* 12:15pm blood ctropnt-0.90* 09:53pm blood ck-mb-58* mb indx-6.8* 05:03am blood ck-mb-34* mb indx-5.4 ctropnt-2.00* 07:23pm blood ck-mb-10 mb indx-3.5 ctropnt-2.06* 01:36am blood ck-mb-7 ctropnt-2.59* 12:15pm blood ck(cpk)-762* 09:53pm blood ck(cpk)-857* 07:23pm blood ck(cpk)-283* 01:36am blood ck(cpk)-229* 06:50am blood triglyc-212* hdl-37 chol/hd-3.9 ldlcalc-64 left heart cath (prelim) 1. selective coronary angiography of this right dominant system demonstrated two vessel disease. the lmca was patent. the lad had less than 30% lumen irregularities. the lcx had a focal 70% om1 stenosis, and a difuse 80% stenosis om2. the rca had 100% occlusion of mid rca with contrast staining. 2. limited resting hemodynamics revealed normal systemic arterial pressures at the central aortic level 102/52 mmhg. 3. successful aspiration thrombectomy and balloon angioplasty of the rca (see ptca comments). final diagnosis: 1. two vessel coronary artery disease. 2. successful pci of the rca. cxr heart size is enlarged. mediastinum is unremarkable. bilateral perihilar interstitial opacities are most likely consistent with pulmonary edema. underlying infectious process might be obscured, in particular in the right lower lung. evaluation of the patient after diuresis is recommended. no evidence of pneumothorax is seen. small amount of pleural effusion cannot be excluded. echocardiogram the left atrium is mildly dilated. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with mild basal inferior hypokinesis. the remaining segments contract normally (lvef = 50-55%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: mild regional left ventricular systolic dysfunction, c/w cad. no echocardiographic evidence of right ventricular involvement with the recent infarction. mild mitral regurgitation. discharge labs 06:50am blood wbc-11.7* rbc-3.71* hgb-11.4* hct-33.5* mcv-90 mch-30.8 mchc-34.1 rdw-13.1 plt ct-205 06:50am blood glucose-152* urean-17 creat-0.9 na-140 k-3.8 cl-103 hco3-29 angap-12 brief hospital course: the patient is a 61 year old female with risk factors of diabetes, hypertension, hyperlipidemia, tobacco use presenting with several day of chest pain found to have late presentation st elevation inferior myocardial infarction with 100% mid rca occlusion now s/p balloon angioplasty . #inferior stemi: late presentation of inferolateral stemi (elevations in iii>ii), found to have two vessel cad on catheterization with culprit thought to be mid rca lesion, with successful recanalization using balloon ptca. she has remained chest pain free since the cath. she was started on medical management with aspirin, prasugrel, heparin x24hours, atorvastatin, metoprolol, lisinopril. . #diabetes: a1c is 6.3%, suggesting good control prior to admission. on 50-56 units of lantus qam at home as well as metformin. am fs was 142 today, treated with iss during hospitalization. . #hypertension: systolic bp remains in the 90-100s since admission, is currently on metoprolol and lisinopril. also on amlodipine and hctz as an outpatient, but this was held at time of d/c as the patient's bp was consistently 90-100 systolic. . #hyperlipidemia: ldl 91, hdl 46, tg 377 in in atrius records. on simvastatin 80mg daily at home, this was changed to atorvastatin 80mg. she may benefit from better dietary control or fibrate for tg control as an outpatient. . # full code # contact: , husband # issues to address at follow up: -consider fibrate for improved tg control -lcx with untreated disease: focal 70% om1 stenosis, and a diffuse 80% stenosis om2. # pending studies at time of discharge: final cardiac cath report. medications on admission: -metoprolol tartrate 25 mg -hydrochlorothiazide 12.5 mg daily -nystatin (nystop) topical powder apply under breast -simvastatin 80mg qhs -lisinopril 40 mg daily -amlodipine 5 mg daily -oxybutynin chloride 10 mg daily -metformin 1,000 mg oral -insulin glargine (lantus solostar) 58-65 units daily -betamethasone dipropionate non-augmented 0.05 % ointment discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. prasugrel 10 mg tablet sig: one (1) tablet po daily (daily). 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. insulin glargine 100 unit/ml solution sig: 52-65 units subcutaneous once a day: resume home dosing. 6. oxybutynin chloride 10 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po at bedtime. 7. atorvastatin 80 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 8. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. discharge disposition: home discharge diagnosis: st elevation myocardial infarction . secondary diagnosis: hypertension hyperlipidemia diabetes mellitus type 2 lung carcinoid discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had chest pain and was found to be having a heart attack. you were transferred to and a cardiac catheterization was performed that showed blockages in 2 arteries. the right coronary artery was opened with a balloon procedure because it was felt that this blockage was causing the heart attack. the second blockage was not treated at this time. you will be started on medicines to help keep the blockages open and help your heart recover from the heart attack. it is very important that you take these medicines every day and see your new cardiologist, dr. . an echocardiogram was done that showed your heart function is nearly normal and your heart vavles are working well. . we made the following changes to your medicines: 1. start taking prasugrel to keep the blockage that was treated open and prevent more clots in your heart arteries. do not stop taking this medicine until dr. tells you it is ok. 2. increase your aspirin to 325 mg daily for now to work with the prasugrel 3. stop taking simvastatin, take atrovastatin (lipitor) instead to lower your cholesterol. 4. decrease your lisinopril to 10 mg daily for now as your blood pressures have been a bit lower during your hospital stay. 5. stop hydrochlorothiazide and amlodipine for now as your blood pressure have been somewhat low followup instructions: cardiology: dr. , , 8:40 am phone: . name: , location: address: 291 independence dr, , phone: appointment: wednesday 3:45pm procedure: coronary arteriography using two catheters left heart cardiac catheterization excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel transluminal coronary atherectomy diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of tobacco use acute myocardial infarction of inferolateral wall, initial episode of care adjustment disorder with depressed mood obesity hypoventilation syndrome personal history of malignant neuroendocrine tumor 

Answer: The patient is high likely exposed to