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: dyspnea on exertion major surgical or invasive procedure: cabg x4 (lima to lad, svg to diag, svg to om, svg to plv) history of present illness: 62 year old male with the onset of dyspnea two years ago. he complains of worsening dyspnea on exertion over the last 6 months but improves quickly with rest. this can be associated with lightheadedness at times. he saw dr. for this and was found to be anemic. he was started on iron and has noticed some improvement since then. he saw dr. who arranged a stress test for him. the persantine thallium stress test demonstrated a partially reversible, medium sized, severe perfusion defect involving the pda territory; increased left ventricular cavity size; and mild systolic dysfunction with mid and distal inferior hypokinesis. he was referred for a cardiac catheterization and was found to have three vessel disease. he is now being referred to cardiac surgery for revascularization. past medical history: diabetes hypertension hyperlipidemia chronic renal failure, stage 3 ( creat=1.1, creat=1.8) complicated foot disease: right charcot foot and foot ulcers (bilateral) hypothyroidism anemia: iron deficiency obstructed sleep apnea (uses cpap) macular degeneration retina detachment s/p removal of basal cell on face () s/p laser eye surgery for hemmorage social history: lives with:wife occupation:currently not working but previously worked in plumbing and heating cigarettes: smoked no yes quit smoking 18 years ago with a history of smoking 2 ppd x6 years other tobacco use:denies etoh: denies illicit drug use: denies family history: father had a cabg at the age of 81 physical exam: pulse:72 resp:18 o2 sat:99/ra b/p right:189/97 left:177/90 height:5'8" weight:280lbs general: no acute distress skin: red nonraised rash bilateral groins with slight skin opening left groin into perineum. ulceration plantar aspect left foot open no erythema no drainage - being treated with wound gel right foot intact but multiple calluses chest with red raised areas - occurred after shaving for stress test, right cheek surgical scar from basal cell removal heent: pupils equal non reactive to light, eomi, decreased peripheral vision left eye. neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + obese extremities: warm , edema right +1 left +2 pitting varicosities: none neuro: alert and oriented x3 mae r=l strength, visual deficits as noted above pulses: femoral right: +1 left: +1 dp right: +1 left: +1 pt : +1 left: +1 radial right: tr band in place left: +1 carotid bruit right: no bruit left: no bruit pertinent results: conclusions the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. global systolic function is good (?inferior hypokinesis). there is abnormal septal motion c/w post op or ivcd or paced rhythm. the right ventricular cavity is mildly dilated with free wall hypokinesis. the aortic valve is grossly normal in morphology. no aortic regurgitation is seen. the mitral valve is normal mild to moderate (+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: suboptimal image quality. normal left ventricular cavity size and global systolic function. right ventricular cavity enlargement with free wall hypokinesis. pulmonary artery systolic hypertension. mild-moderate mitral regurgitation. moderate tricuspid regurgitation. compared with the pre-operative study of , the left ventricular cavity is smaller and the severity of mitral regurgitation, tricuspid regurgitation, and estimated pa systolic pressure are higher. electronically signed by , md, interpreting physician 08:21 05:06am blood wbc-9.4 rbc-3.37* hgb-10.3* hct-29.8* mcv-88 mch-30.5 mchc-34.5 rdw-14.3 plt ct-210 05:06am blood glucose-139* urean-66* creat-1.9* na-137 k-4.3 cl-103 hco3-26 angap-12 brief hospital course: admitted and underwent surgery with dr. . transferred to the cvicu in stable condition on titrrated phenylephrine and proofol drips. extubated the following morning and transferred to the floor to begin increasing his activity level. gently diuresed toward his preop weight. chest tubes and pacing wires removed per protocol. creatinine peaked at 3.2 and began to trend down until it reached his baseline of 2 at discharge. he experienced atrial fibrillation for which he was placed on amiodarone. he was placed on ultram for pain management as percocets caused him nausea. keflex was started for slight sternal erythema without drainage, leukocytosis, or a fever. by post-operative day six he was ready for discharge to rehab. all follow-up appointments were advised. medications on admission: insulin lispro protam & lispro (75-25) sixty (60) units levothyroxine 150 mcg tablet once a day. losartan 100 mg tablet once a day. metoprolol succinate 50 mg daily omeprazole 20 mg daily simvastatin 40 mg daily aspirin 81 mg once a day. cholecalciferol 1,000 unit once a day ferrous sulfate 300 mg daily omega-3 fatty acids 2 capsule daily multivitamin 1 tablet daily furosemide 40 mg daily nitroglycerin 0.4 mg sublingual prn nystatin 100,000 unit/g cream topical discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*1* 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*1* 4. omega-3 fatty acids capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*1* 5. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 6. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 7. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*1* 8. levothyroxine 75 mcg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*1* 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): take 400mg for one week, then taper to 400mg daily, then 200mg daily ongoing. disp:*120 tablet(s)* refills:*2* 11. cephalexin 250 mg capsule sig: two (2) capsule po q6h (every 6 hours) for 10 days: sternal erythema. disp:*80 capsule(s)* refills:*1* 12. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 13. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 14. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 14 days: adjust course per exam and creatinine. disp:*28 tablet(s)* refills:*1* discharge disposition: extended care facility: hospital - discharge diagnosis: coronary artery disease s/p cabg diabetes mellitus hypertension hyperlipidemia chronic renal failure, stage 3 ( creat=1.1, creat=1.8) complicated foot disease: right charcot foot and foot ulcers hypothyroidism anemia: iron deficiency obstructed sleep apnea (uses cpap) macular degeneration retina detachment discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, slight erythema but no drainage leg left - healing well, no erythema or drainage. edema 2+ discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr wed @ 1:15 pm 2a cardiologist: dr @ 11:10 am please call to schedule appointments with your primary care dr in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: venous catheterization, not elsewhere classified (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled personal history of tobacco use ulcer of other part of foot other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) other and unspecified angina pectoris personal history of other malignant neoplasm of skin long-term (current) use of insulin macular degeneration (senile), unspecified morbid obesity iron deficiency anemia, unspecified diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy arthropathy associated with neurological disorders body mass index 40.0-44.9, adult 

Answer: The patient is high likely exposed to