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: substernal chest pressure major surgical or invasive procedure: - cabgx4 on iabp (left internal mammary->left anterior descending artery, vein graft->ramus, vein graft->right coronary artery) - cardiac catheterization with placement of an iabp history of present illness: 78 yo white male (dob ) with recent onset chest heaviness and positive ett originally scheduled for outpatient cardiac catheterization was admitted to last pm with a prolonged episode of chest heaviness; ruled out for mi and now transferred painfree by dr. for diagnostic cardiac catheterization. past medical history: hyperlipidemia hypertension benign prostatic hypertrophy gastroesophageal reflux disease emphysema pneumonia cva -- no residual throat carcinoma ' s/p resection and xrt r nephrectomy s/p trauma 40 years ago social history: married with involved children; retired; lives in . 80 pack year history of smoking quitting in . drinks 3+ beers/day. family history: none noted physical exam: well appearing 78 yo white male in nad vs: 49 17 124/61 ht: 5'9" wt: 174 lbs lungs: clear heart: distant s1/s2; no murmurs/gallops abdomen: + bs; soft; non-tender; no masses extrem: no pedal edema pulses: c f dp pt 2+ no bruit 2+ no bruit 2+ 2+ left 2+ no bruit 2+ no bruit 2+ 2+ pertinent results: carotid u/s: bilateral calcified plaque in left and right carotid bulbs and internal carotid arteries. the velocity measurements demonstrate no significant stenosis in the left or right internal carotid arteries. cardiac cath: 1. coronary angiography in this right dominant system demonstrated three vessel disease. the lmca was heavily calcified with an ostial 70% plaque and a distal 80-90% plaque. the lad had a calcified plaque 80-90% at the ostium and was otherwise small and patent. the lcx had a heavily calcified ostial 80-90% plaque. the large ramus had an ostial 80-90% plaque as well. the rca an ostial 50% plaque followed by a slightly hazy plaque proximally. 2. resting hemodynamics revealed an elevated lvedp of 30 mmhg. nitroglycerin drip was started and lasix 20 mg iv given. note was made of systolic hypertension with sbp of 184. 3. left ventriculography was deferred. 4. an intraortic balloon pump was placed. echo: there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is mildly depressed (lvef= 45-50 %). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are moderately thickened (gradient not assessed). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is an anterior space which most likely represents a fat pad. video swallow: penetration and aspiration with sips of thin barium consistency. cxr: patient is status post cabg. right vascular sheath has been removed. there is interval improvement in bibasilar opacities. there is a small left pleural effusion. cardiac and mediastinal contours are stable. 04:00pm blood wbc-3.9* rbc-3.96* hgb-12.9* hct-36.5* mcv-92 mch-32.7* mchc-35.4* rdw-12.8 plt ct-214 03:07am blood wbc-9.3 rbc-3.07* hgb-9.9* hct-28.3* mcv-92 mch-32.4* mchc-35.1* rdw-13.5 plt ct-139* 07:10am blood wbc-7.9 rbc-3.06* hgb-9.6* hct-27.9* mcv-91 mch-31.3 mchc-34.4 rdw-14.1 plt ct-339# 04:00pm blood pt-12.2 ptt-24.3 inr(pt)-1.0 06:50am blood pt-17.0* ptt-24.9 inr(pt)-1.6* 07:10am blood pt-23.8* ptt-27.9 inr(pt)-2.4* 06:00am blood pt-31.3* inr(pt)-3.3* 12:50pm blood creat-1.0 07:10am blood glucose-101 urean-29* creat-1.5* na-144 k-4.8 cl-108 hco3-27 angap-14 01:43am blood calcium-8.5 phos-4.0 mg-2.5 brief hospital course: mr. was admitted to the on via transfer from for further management of his chest pain. he underwent a cardiac catheterization which revealed severe left main and three vessel disease. given the severity of his disease, an iabp was placed for cardiac perfusion. the cardiac surgical service was consulted and mr. was worked-up in the usual preoperative manner. a carotid duplex ultrasound was performed which showed bilateral calcified plaque in left and right carotid bulbs and internal carotid arteries. the velocity measurements demonstrated no significant stenosis in the left or right internal carotid arteries. an echo was also obtained which showed no significant valvular disease and an ejection fraction of 45-50%. on , mr. was taken to the operating room where he underwent coronary artery bypass grafting to four vessels. postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. on postoperative day one, his iabp was weaned and removed. on postoperative day two, he awoke neurologically intact and was extubated. thiamine and folate were given as he had a history of moderate to heavy alcohol use. haldol was used for episodes of delirium. on postoperative day three, mr. was transferred to the step down unit for further recovery. he was gently diuresed towards his preoperative weight. the physical therapy service was consulted for assistance with his postoperative strength and mobility. as mr. was having trouble swallowing his medications, the swallowing service was consulted. on exam, mr. was noted to have signs and symptoms of aspiration with all consistencies. swallowing study showed silent aspiration and a diet of ground solids and nectar thick liquids with no mixed consistencies was suggested. developed a fib and amiodarone/coumadin started. gram neg. rods found in on a radial art. line culture and treated with cipro per id consult. ent consult done for vocal cord eval. and will f/u as an outpatient. he appeared to be doing well on post-op day eight and was discharged with the appropriate follow-up appointments. medications on admission: proscar 5 mg daily doxazosin (cardura) 2 mg daily aspirin 325 mg daily metoprolol 12.5 mg (prescribed 25 mg but not tolerating) gabapentin 300 mg qpm mvi 1 daily fish oil 8000u vit d 400 iu calcium 1200 mg vit b6 daily vit e daily ranitidine 300 mg daily zetia 10 mg daily (stopped 2 days ago -- not tolerating, had been on zocor previously) discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. docusate sodium 50 mg/5 ml liquid : one hundred (100) mg po bid (2 times a day) for 1 months. disp:*6000 mg* refills:*0* 3. finasteride 5 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. doxazosin 1 mg tablet : two (2) tablet po hs (at bedtime). disp:*60 tablet(s)* refills:*2* 5. simvastatin 10 mg tablet : two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 6. ezetimibe 10 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. folic acid 1 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. amiodarone 200 mg tablet : two (2) tablet po bid (2 times a day) for 3 days: 400 mg for 3 days, then 200 mg until , the 200 mg daily ongoing per cardiologist. disp:*60 tablet(s)* refills:*0* 10. senna 8.6 mg tablet : two (2) tablet po hs (at bedtime). disp:*60 tablet(s)* refills:*0* 11. ferrous gluconate 300 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 12. ascorbic acid 500 mg tablet : one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 13. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). disp:*30 tablet,rapid dissolve, dr(s)* refills:*1* 14. therapeutic multivitamin liquid : five (5) ml po daily (daily). disp:*100 ml(s)* refills:*1* 15. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 16. warfarin 1 mg tablet : two (2) tablet po daily (daily): please take 0mg sat and 1mg sun - inr checked monday with results to dr for further dosing. disp:*30 tablet(s)* refills:*2* 17. outpatient lab work pt/inr for coumadin dosing, blood draws mon-wed-fri goal inr 2-2.5 for atrial fibrillation results to dr fax# 18. clindamycin hcl 150 mg capsule : two (2) capsule po q6h (every 6 hours) for 10 days. disp:*80 capsule(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 post-op atrial fibrillation pmh: hyperlipidemia, hypertension, benign prostatic hypertrophy, gastroesophageal reflux disease, emphysema, pneumonia, cva -- no residual, throat carcinoma ' s/p resection and xrt, r nephrectomy s/p trauma 40 years ago discharge condition: stable discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. please shower daily and pat incisons dry. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month. 7) call with any questions or concerns 8) please follow up with ent, you have an appointment scheduled for wednesday with dr 9) pt/inr for coumadin dosing, blood draws mon-wed-fri followup instructions: follow-up with dr. in 1 month. ( follow-up with cardiologist dr. in weeks. follow-up with pcp . in 2 weeks. dr (ent) office appt wednesday at 1050 am please call all providers to schedule appointments. pt/inr for coumadin dosing, blood draws mon-wed-fri goal inr 2-2.5 for atrial fibrillation results to dr fax# procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters implant of pulsation balloon diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux intermediate coronary syndrome pure hypercholesterolemia unspecified essential hypertension chronic airway obstruction, not elsewhere classified cardiac complications, not elsewhere classified atrial fibrillation bacteremia 

Answer: The patient is high likely exposed to