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: this is a 71 year old man with hypertension and hyperlipidemia, presently with shortness of breath since 1 am on the day of admission. the patient describes one similar episode two years ago at which time he was admitted to and underwent cardiac catheterization. at that time he reports being told he needed coronary artery bypass grafting but declined and he has remained well at home since then. he denies any history of angina, although he does have chronic dyspnea on exertion and fatigue. no paroxysmal nocturnal dyspnea and no orthopnea until last night when he awoke at 1 am with shortness of breath. over the next several hours he woke up with shortness of breath and had to sit up to relieve the shortness of breath. finally he called emergency medical services at 6 am and was brought to the emergency room. in the emergency room the patient was found to be tachycardiac and markedly hypertensive with a systolic blood pressure greater than 200 and oxygen saturations less than 89% on room air. electrocardiogram initially showed sinus tachycardia with pr prolongation, evidence of an old inferior myocardial infarction and a question anterior myocardial infarction with diffuse st wave changes. at that time he was given aspirin, lasix, and nitroglycerin and subsequent became bradycardia with a heartrate in the 50s. electrocardiogram revealed sinus bradycardia with deep anterolateral t wave inversions, initial enzymes were negative. the patient does not have any lower extremity edema. medications on admission: medications at home include lipitor, zestril, atenolol and aspirin. allergies: he has no known drug allergies. past medical history: significant for coronary artery disease, status post myocardial infarction, question of an angioplasty at . congestive heart failure, hyperlipidemia, hypertension. social history: denies alcohol use, denies tobacco use. unemployed. married. lives at home. physical examination: afebrile. heartrate was 50 to 60. blood pressure 123/61, respiratory rate 17 and oxygen saturation 97% on room air. general, in no acute distress. neurologically appropriate. alert and oriented times three. head, eyes, ears, nose and throat, mucous membranes moist. oropharyngeal mucosa clear. neck, 6 to 8 cm of jugulovenous distension. cardiovascular, regular rate and rhythm. no murmurs, rubs or gallops. pulmonary, diffuse crackles bilaterally. abdomen, soft, nontender, nondistended with positive bowel sounds. extremities, no edema. 2+ pulses bilaterally. laboratory data: on admission sodium 141, potassium 4.1, chloride 110, carbon dioxide 26, bun 20, creatinine 1.4, glucose 133, creatinine kinase 224, mb 5, troponin less than .03. white blood count 12.3, hematocrit 40, platelets 203, ptt 13.1, inr 1.1. chest x-ray shows congestive heart failure without cardiomegaly. electrocardiogram, sinus rhythm, qs in 2 and f, st elevation in 3 and f, st depression in v5 and 6. echocardiogram done after admission shows an ejection fraction of 25% with global hypokinesis, posterior basal inferior akinesis, 3+ mitral regurgitation with an eccentric jet. hospital course: the patient was admitted to the medicine service, seen by the cardiology service and referred for cardiac catheterization. on , the patient was brought to the catheterization laboratory. please see the catheterization report for full details and summary. this catheterization showed an ejection fraction of 25%, left main with mild disease, left anterior descending with 50% proximal and 80% mid lesion. large diagonal with an 80% lower pole stenosis, the left circumflex was occluded, mid distal with an 80% obtuse marginal 1 and right coronary artery was occluded, mid distal and fills by collaterals. following cardiac catheterization, cardiothoracic surgery was consulted. the patient was seen by cardiothoracic surgery and was accepted for coronary artery bypass grafting. on , he was brought to the operating room at which time he underwent coronary artery bypass grafting times five. please see the operative report for full details. in summary, the patient had coronary artery bypass graft times five with left internal mammary artery to the left anterior descending, saphenous vein graft to the diagonal and a y graft to obtuse marginal 1 and obtuse marginal 3 and a saphenous vein graft to the posterior descending artery. he tolerated the surgery well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient had a mean arterial pressure of 48, a central venous pressure of 12, he was atrioventricularly paced at 84 beats/minute. he had neo-synephrine at 0.3 mcg/kg/min and propofol at 50 mcg/kg/min. the patient did well in the immediate postoperative period. his anesthesia was reversed and the sedation discontinued. the patient moved all extremities, although at that time he was unable to follow commands. he became very anxious and hypertensive. therefore he was resedated. on postoperative day #1, the patient was hemodynamically stable. the sedation was again weaned. following the discontinuation of his sedation, the patient awoke at which point he was agitated and thrashing about in bed, unable to follow commands. therefore he was resedated with precedex and another attempt was made to awaken and wean the patient while on a precedex drip. despite the precedex, the patient again awoke thrashing in bed, unable to follow commands with a systolic blood pressure in the 170s and heartrate in the 110s. he was again started on propofol and resedated. on postoperative day #2 another attempt was made to extubate the patient. he remained sedated with a precedex infusion. his blood gases were adequate with 5 of pressure support and 5 of positive end-expiratory pressure and he was successfully extubated. following extubation, the patient remained hemodynamically stable and his sedation was weaned to off. following the weaning of the patient's sedation he did continue to be somewhat agitated, consistently following commands. at that time psychiatry was consulted as was the stroke service. it was felt that the patient had a likely toxic metabolic encephalopathy and he was treated as such. over the next several days, the patient remained in the intensive care unit while a toxic metabolic workup was being completed. he remained somewhat lethargic with periods of confusion and agitation. he could not consistently follow commands. from a cardiopulmonary standpoint he remained hemodynamically stable with a productive cough and sating 95% on nasal cannula. head computerized axial tomography scan was done which showed old white matter disease with no new infarctions. on postoperative day #6, it was decided that the patient was stable and ready to be transferred to the floor where he could undergo further postoperative care and cardiac rehabilitation. once on the floor, the patient's activity level was increased with the assistance of the nursing staff and physical therapy. he continued to be somewhat confused neurologically although much less agitated and not combative. the patient remained on the floor for several days showing gradual improvement. he continued to followed by the neurology service who felt that this course was consistent with a toxic metabolic encephalopathy. the patient remained hemodynamically stable throughout this period. on postoperative day #13, it was felt that the patient was stable and ready to be transferred to the rehabilitation center for continuing postoperative care and cardiac rehabilitation. at the time of that decision the patient's physical examination was as follows: vital signs, temperature 98, heartrate 87 sinus rhythm, blood pressure 142/82, respiratory rate 20, oxygen saturation 96% on room air. weight preoperatively was 89.9 kg and the day prior to discharge is 86.1 kg. laboratory data revealed white count 13.5, hematocrit 32, platelets 476, sodium 140, potassium 4.0, chloride 107, carbon dioxide 20, bun 28, creatinine 0.8, glucose 84. on physical examination he was responsive, moves all extremities and follows commands, oriented times two. respiratory, scattered rhonchi. heartsounds, regular rate and rhythm, s1 and s2, no murmurs. sternum is stable. incision clean and dry, open to air. abdomen is soft, nontender, nondistended, normoactive bowel sounds. extremities are warm and well perfused with no edema. right leg incision was open to air, clean and dry. discharge medications: enteric coated aspirin 325 q.d. metoprolol 100 mg b.i.d. prilosec 40 mg q.d. atorvastatin 40 mg q.d. magnesium oxide 400 mg b.i.d. ferrous gluconate 300 mg q.d. vitamin d 500 mg b.i.d. zinc sulfate 220 mg q.d. captopril 50 mg t.i.d. condition on discharge: stable. follow up: he is to have follow up with dr. in three to four weeks after he is discharged from rehabilitation and follow up with dr. in four to six weeks. , m.d. dictated by: medquist36 procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures (aorto)coronary bypass of four or more coronary arteries diagnoses: subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension aortic valve disorders other and unspecified hyperlipidemia old myocardial infarction delirium due to conditions classified elsewhere 

Answer: The patient is high likely exposed to