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 and shortness of breath major surgical or invasive procedure: cardiac catheterization with 1 stent placed history of present illness: 81 yo with a history of cad who presented to an osh today with chest pain. the patient reports that he started to experience chest pain about three days ago associated with shortness of breath. the pain came on after he worked on an iron stove for a couple of hours. the chest pain was associated with ambulation. however this morning at about 3am he started to have chest pain at rest associated with more severe shortness of breath. he went to where he was found to be in pulmonary edema with a sbp of 80-90 and o2 sats in the low 80s. he was given lasx iv 10mg and was transiently on bipap. an ekg revealed lbbb with no prior ekg for comparison. he was started on heparin. initial enzymes revealed a ck of 132, ck-mb 36 and an index of 27, trop i of 1.41. he was transferred to for further management. . on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. he endorses a cough productive of thick sputum for several weeks. he denies any abdominal pain or dysuria. 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 prior to the current event. he never had any pulmonary edema or . . in the ed the patient was found to have a hr at 104, bp 126/86, o2sat of 100% on nrb. he was complaining of cp and nitro gtt was continued from the osh. however his bp was low on nitro gtt and he was then given morphine and nitro gtt was titrated off as he was chest pain free. a plavix load of 600mg was given and zofran was given for nausea. . he currently is chest pain free and breathing comfortably. he only complains of mild chest pain with inspiration which he has not noticed before. he denies any other complaints. past medical history: cad with mi in , pt underwent angiogram at (no stent placed) s/p icd placement in at prostate cancer, no intervention, "slow growing" per patient htn h/o nephrolithiasis gout h/o pancreatic duct obstruction borderline diabetes, diet controlled social history: social history is significant for the absence of current tobacco use. past tobacco use over 50years ago. there is no history of alcohol abuse. pt worked as a firefighter and is currently still very active working with lumber. he ambulates 2 flights of stairs easily. family history: there is no family history of premature coronary artery disease or sudden death. father lived to years. physical exam: vs: t 98.7, bp 97/71, hr 72, rr 18, 95 o2% on 5l gen: nad, resp or otherwise. oriented x3. mood, affect appropriate. pleasant. heent: sclera anicteric. perrl. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. dry mucous membranes neck: supple with jvp of 10 cm. cv: pmi laterally displaced. rr, distant heart sounds. no s4, no s3. systolic murmur over rusb radiating into his carotids. different more holosystolic murmur over apex. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. no wheeze, rhonchi. crackels about 1/3 up bilaterally. abd: soft, ntnd, no hsm or tenderness. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ with bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ with bruit; femoral 2+ without bruit; 2+ dp pertinent results: admission labs cbc: wbc-17.1* rbc-5.07 hgb-16.2 hct-46.3 mcv-91 mch-31.9 mchc-34.9 rdw-15.0 plt ct-188 . coags: pt-13.2* ptt-126.1* inr(pt)-1.2* . chemistry: glucose-146* urean-17 creat-1.3* na-144 k-5.1 cl-107 hco3-22 angap-20 calcium-8.6 phos-3.0 mg-2.2 . ces: 06:55am blood ck(cpk)-301* ck-mb-56* mb indx-18.6* ctropnt-0.42* 04:00pm blood ck-mb-108* mb indx-18.3* ctropnt-1.32* 12:30pm blood ck-mb-37* mb indx-15.9* ctropnt-1.69* 04:45am blood ck-mb-20* mb indx-11.0* ctropnt-2.10* . cholesterol panel: cholest-169 triglyc-111 hdl-45 chol/hd-3.8 ldlcalc-102 . diabetes monitoring: %hba1c-5.9 . studies: tte the left atrium is moderately dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. no masses or thrombi are seen in the left ventricle. overall left ventricular systolic function is severely depressed (lvef= 15-20 %) with global hypokinesis. the inferior and infero-lateral walls are thinned and akinetic. there is no ventricular septal defect. right ventricular chamber size is normal. there is mild global right ventricular free wall hypokinesis. the aortic valve leaflets are moderately thickened. significant aortic stenosis is present (not quantified). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: ischemic cardiomyopathy with severely depressed lvef. aortic stenosis is present but the severity cannot be determined from this study. if clinically indicated, a complete tte is recommended to clarify the severity of as. . cardiac cath: comments: 1. selective coronary angiography of this right dominant system shows 1 vessel severe coronary artery disase. the lmca shows mild calcifications without critical lesions. the plad has 90% lesion. the rest of the vessel and its branches are without obstructive disease. the lcx is a non-dominant vessel with 40% lesion in its mid-section. the rca is a dominant vessel with 40% lesion in its mid-section. 2. resting hemodynamic measurement shows aortic stenosis with a peak to peak gradient of 30mmhg and calculated valve area of 0.8cm2. the central aortic pressure is normal at 108/65mmhg. the left sided filling pressure is elevated with a pcwp and lvedp of 25mmhg. there is moderate to severe pulmonary hypertension with a pulmonary artery systolic pressure of 61mmhg. the cardiac index is mildly depressed at 2.3 l/min/m2. 3. successful stenting of the proximal lad with a 3.0 x 18 mm minivision baremetal stent postdilated to 3.25 with no residual stenosis (see ptca comments for detail). final diagnosis: 1. one vessel coronary artery disease. 2. moderate aortic stenosis with moderately elevated lvedp. 3. pulmonary hypertension. 4. mildly depressed cardiac output. 5. successful stenting of the proximal lad with a bare metal stent. brief hospital course: 81 yo with cad who presents with nstemi and chf. had cath with 1vd and stenting with bms. hospital course discussed by problem: . # nstemi: pt likely with ua initially and plaque rupture leading to nstemi. ekg changes improved with heparin, nitro, morphine, asa and plavix load. patient was then chest pain free, and intervention occurred the following morning. at cath a bms was placed to the proximal lad. integrilin gtt was begun peri-procedurally and continued for 18 hours post-cath. medical management was continued with asa, plavix, atorvastatin, added ezetimibe (lipid panel revealed ldl not at goal) and metoprolol 12.5mg as tolerated. attempt at ace held due to cri. serial ekgs revelaed lbbb. . # valve disease: echo with possible significant as, however poor study. might need preload for adequate co. . # chf, acute: no history of chronic chf, but ef is severely depressed at 15-20% with evidence of ischemic cardiomyopathy. was mildly hypervolemic following cath and diuresed well to 20mg iv lasix. care taken not to overdiurese in setting of as. . # rhythm: sinus, one run of vt, about 20 beats. started metoprolol as above for anti-arrhythmia effects. prior icd in place. . # borderline diabetes: hba1c wnl at 5.9%. riss prescribed prn. . # htn: well controlled (actually borderline hypotensive) throughout this stay with addition of beta blockade and diuretic . # leukocytosis: likely a stress response in the setting of acute mi, as it resolved spontaneously. however to rule out infection a u/a was sent (negative), and urine culture was negative. cxr was without convincing evidence of infiltrate (volume overload). . # chronic renal failure: stable at baseline 1.3, gfr of 40-50. . # gout: cont allopurinol at renal dose . # gerd: cont omeprazole . # fen: cardiac, low salt diet, diabetic . # prophylaxis: was on heparin gtt followed by sq heparin tid, bowel regimen, ppi . # code: full medications on admission: atorvastatin 80mg qdaily lisinopril 10mg qdaily toprol xl 25mg qdaily allopurinol 300mg qdaily omeprazole 20mg qdaily aspirin 81mg qdaily vit b12 250mcg qdaily vit e 400 iu qdaily discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. toprol xl 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. cyanocobalamin 250 mcg tablet sig: one (1) tablet po daily (daily). 8. allopurinol 300 mg tablet sig: one (1) tablet po once a day. 9. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: nstemi . secondary: aortic stenosis borderline dm htn chronic renal failure gout gerd discharge condition: stable, improved, chest pain free discharge instructions: you were admitted to the hospital with chest pain and shortness of breath. you were found to have had a heart attack, and were taken to the catheterization lab, where a stent was placed into an artery that was closed off. after the blockage was opened your symptoms dramatically improved. . please take all your medicines as prescribed. you have a new medication called zetia, which is for high triglycerides, you should take this in addition to the atorvastatin. please keep all of your outpatient appointments. we have also decreased your lisinopril to 2.5 mg daily. . if you experience any symptoms that are disturbing to you, such as chest pain or shortness of breath, please call your doctor or go to the nearest er. followup instructions: please follow-up with your pcp: , . (). you have an appointment for . 3pm. you can call for changes. md, procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified aortic valve disorders chronic kidney disease, unspecified automatic implantable cardiac defibrillator in situ acute on chronic systolic heart failure 

Answer: The patient is high likely exposed to