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: history of present illness: the patient is a 78 year old woman with a history of coronary artery disease status post an anterior myocardial infarction on , who received a balloon angioplasty to the distal left anterior descending, who was admitted to for recatheterization for an elevated troponin level. the patient presented to her primary care physician's office a week prior to admission and was found to have a hematocrit of 26. she was admitted to where she received two units of packed red blood cells and her hematocrit bumped appropriately. on routine labs at that time, she was found to have an increase in troponin level to 3.8, felt to be another ischemic event. the patient was asymptomatic at that time. she was accepted to for re-catheterization and transferred on nitroglycerin, aspirin, lopressor, protonix and lipitor. past medical history: 1. coronary artery disease status post myocardial infarction on . 2. history of iron deficiency anemia. 3. peptic ulcer disease status post esophagogastroduodenoscopy and colonoscopy on 01/. 4. hiatal hernia. 5. erosive gastritis. 6. history of breast carcinoma status post left breast lumpectomy and xrt. 7. rheumatoid arthritis. 8. cck. 9. hypercholesterolemia. 10. hypertension. allergies: penicillin with a rash. medications on admission: 1. lisinopril. 2. lipitor. 3. iron. 4. protonix. 5. lopressor. 6. aspirin. 7. nitroglycerin. 8. coumadin. family history: mother died of renal cancer and esophageal cancer at age 75. father died at age of unknown cause. two sisters with "brain cancer". social history: the patient denied tobacco or alcohol use. she has been a widow for years. she lives with her son. she works as a mother for medically involved infants. physical examination: blood pressure 98/47 to 118/52; heart rate 81 to 94; the patient was afebrile and saturation of 97% on room air. cardiac examination is a regular rhythm with no murmurs. lungs clear with few left sided crackles. extremities with no edema, warm, bounding dorsalis pedis and posterior tibial pulses bilaterally. no hematoma at the femoral site. laboratory: significant labs include hematocrit between 30 and 32. hospital course: in catheterization the patient was found to have a 90% new proximal left anterior descending stenosis not seen on the catheterization two weeks earlier. a stent was placed in the proximal left anterior descending. in addition, a small pleural effusion consistent with blood was seen, that was felt to be smaller than the pleural effusion seen on the catheterization report two weeks earlier. pulsus was observed on hemodynamic measurements. also of note, in the distal left anterior descending, a small area of localized perforation consistent with a walled off perforation from prior catheterization or a small aneurysm were observed. other catheterization findings include: 1. lmca mild disease. 2. left anterior descending 90% proximal, diffuse disease distal, localized perforation in distal left anterior descending. 3. left circumflex: moderate disease. 4. right coronary artery: mild disease. 5. left anterior descending stenting proximally with minimal anti-coagulation (2.5 hepacoat taken to 3.0), since proximal left anterior descending lesion new and unstable plaque. an echocardiogram was performed due to the pulsus paradoxus readings. left ventricular ejection fraction was calculated to be 40%. the apex was found to be akinetic. a small to moderate sized pericardial effusion septating mainly the sub-diaphragmatic surface of the right ventricular free wall was seen. the effusion was echo-dense consistent with blood, inflammation or other cellular elements. no evidence of tamponade. the pericardial effusion was felt to be smaller compared to the previous study of . the patient was given 1500 units of intravenous heparin during the procedure and reversed with protamine. she was transferred to the cardiac care unit for monitoring. she received anti-platelet therapy of aspirin and plavix but no heparin, coumadin or integrilin treatment in light of her gi bleed. when the patient arrived to the unit, she demonstrated two episodes of atrial fibrillation with left bundle branch block. she was rate controlled with metoprolol 5 mg intravenous and metoprolol 25 mg p.o. twice a day, and remained in normal sinus rhythm for the duration of her stay. with respect to her gi bleed, serial hematocrits were followed and remained stable throughout her hospital course. the patient required no transfusions. the gastroenterology service was consulted. they felt it most appropriate to follow-up with endoscopic studies once the patient was stable. the patient had guaiac positive stool, but no frank bleed was evident. she was maintained on intravenous protonix and iron supplements. she was not anti-coagulated with heparin or coumadin despite her apical akinesis. this decision is deferred to her cardiologist, dr. , with whom she has an appointment on monday, , at 02:30 p.m. in addition, she has agreed to follow-up with an esophagogastroduodenoscopy and colonoscopy at which is much more convenient and closer to home. this decision was felt to be appropriate by the gastroenterologist, who felt the patient to be stable. troponin peaked at 15.8; maximum ck was 53. disposition: the patient will be discharged home in stable condition. discharge medications: 1. aspirin 325 mg p.o. q. day. 2. plavix 75 mg p.o. q. day. 3. protonix 40 mg intravenously p.o. twice a day. 4. metoprolol 25 mg p.o. twice a day. ace inhibitor was not started because it was felt that the patient could not tolerate it due to low blood pressure. she was instructed to discuss the option of starting it with her primary care physician. , m.d. dictated by: medquist36 d: 17:04 t: 17:41 job#: 1 1 1 dr procedure: insertion of non-drug-eluting coronary artery stent(s) other and unspecified coronary arteriography diagnoses: coronary atherosclerosis of native coronary artery atrial fibrillation percutaneous transluminal coronary angioplasty status accidental puncture or laceration during a procedure, not elsewhere classified unspecified disease of pericardium iron deficiency anemia, unspecified rheumatoid arthritis hemorrhage of gastrointestinal tract, unspecified acute myocardial infarction of other inferior wall, subsequent episode of care 

Answer: The patient is high likely exposed to