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: dissected lad during cardiac catheterization major surgical or invasive procedure: cardiac catheterization with stent placement x 3 diagnostic catheterization history of present illness: 81 y.o. man pmhx with atrial fibrillation, htn, hld and presented to osh on secondary to acute onset chest pain at rest and overwhelming fatigue. while the patient was at the office he started to feel a heaviness above his sternum that did not radiate. the chest pain was associated with diaphoresis, but not shortness of breath. he went to emergency department. at osh the patient was found to have a troponin leak of 0.23. the patient had anticoagulation reversed and was transferred to for cardiac catherization. during the cardiac catherization the lad was found to have a 40% proximal stenosis, 50-60% diffuse stenosis in the mid-lad, and a focal 95% stenosis in the distal lad. while attempting to deliver a stent across the lad lesions the wire was lost and the mid and distal lad were dissected. a balloon was used to tack up the dissection. three endeavor stents were deployed overlapping and post-dilated to 3 mm. the post angiography revealed normal flow and no residual stenosis. the distal dissection was observed to be stable and was not flow limiting. he was started on integrillin and admitted to the ccu overnight for close monitoring. he was hemodynamically stable throughout the procedure. . on review of systems, he denies any prior history of stroke, tia, deep venous thrombosis, bleeding at the time of surgery, cough. he denies recent fevers, chills or rigors. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: + diabetes, + dyslipidemia, +hypertension 2. cardiac history: atrial fibrillation -percutaneous coronary interventions: as above 3. other past medical history: obstructive sleep apnea gerd non-insulin dependent diabetes mellitus social history: -tobacco history: none -etoh: occasional -illicit drugs: none family history: mother - heart disease of unknown type and diabetes brother: deceased - mi in 60s brother: 2 hip replacments, 2 knee replacments, cancer unknown type no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: on admission: vs: t=97.3, bp=151/75, hr=63, rr=17, o2 sat= 96% on ra general: wdwn male in nad. oriented x3. mood, affect appropriate. heent: normocephalic, atraumatic. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with no jvp appreciated, no carotid bruits appreciated. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no s3 or s4 appreciated. pulsus noted to be at 7-8 lungs: no chest wall deformities, scoliosis or kyphosis. respirations were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abdominal aorta not enlarged by palpation. extremities: no c/c/e. no femoral bruits. right femoral entrance site bandaged c/d/i. 1x1 cm nodule at superior border of entrance site for catheter. capillary refill 1-2 seconds skin: no stasis dermatitis or ulcers. an 8 cm well healed scar on right lower neck. pulses: right: radial 2+ carotid 2+ femoral 2+ dp 2+ pt by doppler left: radial 2+ carotid 2+ femoral 2+ dp 2+ pt by doppler pertinent results: labs on admission: 11:43pm sodium-135 potassium-3.8 chloride-100 11:43pm ck(cpk)-98 11:43pm ck-mb-6 11:43pm plt count-212 cath report : comments: limited coronary angiography was done of left coronary system. seperate ostia for lad and lcx. only lad engaged selectively lad-widely patent stents. no visible dissection. mid vessel 40% stenosis. diagonal 70% proximal stenosis lcx: mild disease (unchanged) final diagnosis: 1. widely patent stents in lad. 2. continue current medical management labs on discharge: pending 06:40am blood wbc-9.4 rbc-4.09* hgb-13.4* hct-39.0* mcv-95 mch-32.9* mchc-34.5 rdw-13.9 plt ct-252 06:40am blood pt-13.6* ptt-22.9 inr(pt)-1.2* 06:40am blood glucose-129* urean-22* creat-1.1 na-139 k-4.1 cl-100 hco3-29 angap-14 06:40am blood calcium-9.2 phos-3.5 mg-2.4 brief hospital course: 81 y.o. man with chronic atrial fibrillation, htn, hld, dm, and new onset chest pain admited to ccu after cardiac catheterization was complicated by left anterior descending artery dissection, s/p 3 stents. # lad dissection s/p stent placements: ccu course was uncomplicated. the patient remained hemodynamically stable and without evidence of tamponade. integrillin was continued for 18h post cath per protocol, and asa 325 mg daily was started; clopidogrel 75 mg daily was also started for a planned course of 6 months. repeat catheterization on showed no visible dissection with widely patent stents. # cad/angina: the patient remained hemodynamically stable throughout the hospitalization. he had 2 bouts of chest pain in the setting of no ischemic changes on ekg. discharged on asa, plavix, statin. # chronic atrial fibrillation: remained well rate controlled on digoxin 0.25mg daily (same as home dose) and diltiazem 60mg tid (home dose, cartia xt 180mg daily). as recommended by his primary cardiologist, dr. , he was discharged on his home regimen without changes. prior to discharge, the patient was started on asa 81mg daily and 5 mg coumadin for anticoagulation. # htn: he remained normotensive throughout the hospitalization. the patient's daily 40mg lasix dose was held during the hospitaliation and restarted prior to discharge. # diabetes: blood sugars remained well controlled on an iss. his home metformin dose was restarted prior to discharge. # gerd: omeprazole was stopped and ranitidine was started given initiation of plavix. the patient was full code for this admission. medications on admission: digoxin 0.25 mg p.o. once daily metformin 500 mg p.o. twice daily cartia xt 180 mg p.o. once daily simvastatin 20 mg p.o. q.h.s. omeprazole 20 mg p.o. once daily sertraline 50 mg p.o. once daily coumadin 2.5 to 5 mg p.o. once daily potassium chloride 20 meq p.o. 2 tabs once daily lasix 40 mg 1.5 tabs p.o. once daily discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily) as needed for cad: s/p lad des : do not stop taking unless dr. tells you to. disp:*30 tablet(s)* refills:*11* 2. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 4. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 5. cartia xt 180 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po once a day: no substitutions please. disp:*30 capsule, sust. release 24 hr(s)* refills:*2* 6. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take one tablet under tongue 5 minutes apart for maximum of 2 . call dr. for any chest pain. disp:*25 tablet, sublingual(s)* refills:*0* 7. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). 8. furosemide 40 mg tablet sig: 1.5 tablets po once a day. 9. potassium chloride 20 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po once a day. 10. metformin 500 mg tablet sig: one (1) tablet po twice a day: do not start until sunday . 11. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily) as needed for cad: s/p lad des. 12. warfarin 5 mg tablet sig: one (1) tablet po once a day: every third day, take tablet. 13. outpatient lab work please check your inr and chem-7 panel on monday with results to dr. at discharge disposition: home discharge diagnosis: coronary artery disease atrial fibrillation with rapid ventricular response diabetes mellitus type 2 discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had some chest pain and fatigue and was transferred to for a cardiac catheterization. during the cathteterization, there were multiple blockages found in your left anterior coronary artery and three endeavor drug coated stents were placed. the coronary artery was somewhat damaged during the procedure and another cardiac catheterization was perfomed to make sure the vessel was recovering well which showed that the stents were open. the catheters were inserted in your right radial artery for the second procedure and you should not flex your right wrist or carry anything in that hand for 48 hours. medication changes: 1. stop taking omeprazole 2. start taking ranitidine (zantac) instead to prevent heartburn 3. start taking clopidogrel (plavix) every day for at least 6 months and possibly longer. do not miss or stop taking plavix unless dr. tells you to. 4. start aspirin at 81 mg daily, take this with plavix and do not stop taking unless dr. tells you to. 5. do not take metformin until sunday . 6. take nitroglycerin as needed for chest pain. sit down, take one tablet under tongue and wait 5 minutes. if you still have chest apin, take another tablet under the tongue and wait 5 minutes. if you still have chest pain, call 911. call dr. for any chest pain as well. followup instructions: name: pa- address: , , phone: appointment: thursday 2:00pm name: , address: ,lower level, , phone: appointment: friday 1:20pm procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization left heart cardiac catheterization insertion of drug-eluting coronary artery stent(s) excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of four or more vascular stents diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation asthma, unspecified type, unspecified other and unspecified angina pectoris cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure long-term (current) use of anticoagulants other complications due to other cardiac device, implant, and graft accidents occurring in residential institution dissection of coronary artery 

Answer: The patient is high likely exposed to