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: acute myocardial infarction. major surgical or invasive procedure: coronary artey bypass grafts x 4(lima-lad, svg-dg, svg-om1-om2) left heart catheterization, coronary angiography history of present illness: this 64 year old gentleman was admitted elsewhere with a nstemi. he had experienced a head spinning feeling on eve while he was sitting down. this lasted approximately 10 minutes. he was being workup up as out patient for vertigo. he experienced similar symptom the day of admission, lasting 5 minutes while he was standing. he had associated nausea and shortness of breath. he denied any chest pain, palpitations, abdominal pain or vomiting. . he does report chest pressure that has been occuring with exertion over the past 2 months. this pressure was particularly bad during the last 4 days while he was shoveling snow and working around the house. he described it as a crushing sensation which lasted approximately 30 minutes. and was diagnosed transfered here for possible intervention. . in the ed his vitals were t 97.2 bp 142/112 hr 70 rr 22 and glucose of 166. he received asa 325 mg, atorvastatin 80 mg, plavix 600 mg,a heparin bolus and drip and metoprolol 2.5 mg. he was started on integrillin bolus and drip in the ed. past medical history: hypertension insulin dependent diabetes mellitus dyslipidemia active obstructive sleep apnea degenerative disc disease social history: he lives at home with his wife. active for more than 30 years. used to smoke 2.5 packs per day. now down to 0.75 pack/day. heavy drinker in the past- etoh one week ago. family history: non contributory physical exam: admission: vs - bp 144/78 hr 86 rr 16 97% on 2lnc gen: wdwn middle aged male in nad. mood, affect appropriate. following commands. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 7 cm. cv: rr, normal s1, s2. ii/vi holosystolic murmur at llsb and apex. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. mild wheezes diffusely. no crackles. abd: obese, soft, ntnd. no hsm or tenderness. ext: no c/c/e. neuro: spontaneously moves all 4 ext. pertinent results: hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 06:15am 9.3 3.64* 11.3* 32.7* 90 31.1 34.6 13.8 480* basic coagulation (pt, ptt, plt, inr) plt ct 06:15am 480* chemistry renal & glucose glucose urean creat na k cl hco3 angap 06:15am 142* 14 1.1 140 4.8 99 33* 13 chemistry totprot albumin globuln calcium phos mg uricacd iron 06:15am 2.4 , m 64 radiology report chest (pa & lat) study date of 11:03 am , csurg fa6a sched chest (pa & lat) clip # reason: interval chnage medical condition: 64 year old man with cabg x4 final report history: cabg. pa and lateral radiographs of the chest demonstrate very mild elevation of the left hemidiaphragm, less conspicuous than seen on . there is persistent bibasilar atelectasis. no consolidation is identified. there is a small left-sided pleural effusion. when compared to the previous study, there is little interval change. dr. approved: sun 12:01 pm echocardiography report , (complete) done at 10:02:03 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 64 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: abnormal ecg. chest pain. coronary artery disease. hypertension. icd-9 codes: 402.90, 786.51, 440.0, 424.0 test information date/time: at 10:02 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw3-: machine: echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 55% to 60% >= 55% findings left atrium: normal la size. no spontaneous echo contrast in the body of the laa. no mass/thrombus in the laa. no spontaneous echo contrast is seen in the laa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra and extending into the rv. no spontaneous echo contrast in the raa. no asd by 2d or color doppler. left ventricle: normal lv wall thickness. normal lv cavity size. normal regional lv systolic function. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. simple atheroma in aortic root. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets. no as. no ar. mitral valve: mildly thickened mitral valve leaflets. moderate mitral annular calcification. no ms. mild (1+) mr. normal lv inflow pattern for age. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the patient received antibiotic prophylaxis. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. patient. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-cpb:1. the left atrium is normal in size. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no mass/thrombus is seen in the left atrium or left atrial appendage. no spontaneous echo contrast is seen in the left atrial appendage. 2. no atrial septal defect is seen by 2d or color doppler. 3. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. 4. right ventricular chamber size and free wall motion are normal. 5. there are simple atheroma in the aortic root. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 6. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. 7. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. dr. was notified in person of the results. post-cpb: on infusion of i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 12:33 , m 64 cardiology report c.cath study date of brief history: this 64 year old man with diabetes, hypertension, dyslipidemia, active , peripheral vascular disease (r>l calf claudication, h/o abnormal abis), presents with 2 episodes of vertigo at rest over the past 3 weeks, associated with dyspnea and nausea. a recent mri brain was negative for infarcts. mra neck revealed l external carotid artery stenosis. the last (index) episode occurred on the day of admission, and lasted 1 hour. cardiac biomarkers were elevated on admission (tni 0.69, ck 196, mb 5), without ekg changes. the patient also endorses 2 months of stable exertional chest discomfort precipitated by shoveling snow. indications for catheterization: 1. nstemi. procedure: left heart catheterization: was performed by percutaneous entry of the right femoral artery, using a 5 french angled pigtail catheter, advanced to the left ventricle through a 5 french introducing sheath. coronary angiography: was performed in multiple projections using a 5 french jl4 and a 5 french jr4 catheter, with manual contrast injections. left ventriculography: was performed in the 30 degrees projection, using 33 ml of contrast injected at 11 ml/sec, through the angled pigtail catheter. conscious sedation: was provided with appropriate monitoring performed by a member of the nursing staff. hemodynamics results body surface area: 2.13 m2 hemoglobin: gms % rest **pressures left ventricle {s/ed} 156/23 aorta {s/d/m} 156/75/83 **cardiac output heart rate {beats/min} 63 rhythm sinus left ventriculography: volumetric data: lv end diastolic volume index (nl 50-90 ml/m2). 42 lv end systolic volume index (nl 15-30 ml/m2). 16 lv stroke volume index (nl 35-75 ml/m2). 26 lv ejection fraction (nl 50%-80%). 62 qualitative wall motion: : 1. antero basal - normal 2. antero lateral - normal 3. apical - normal 4. inferior - normal 5. postero basal - normal other findings: mitral valve was normal. **arteriography results morphology % stenosis collat. from **right coronary 1) proximal rca diffusely diseased 2) mid rca diffusely diseased 2a) acute marginal diffusely diseased 3) distal rca diffusely diseased **arteriography results morphology % stenosis collat. from **left coronary 5) left main discrete 80 6) proximal lad diffusely diseased 7) mid-lad diffusely diseased 100 8) distal lad diffusely diseased 100 9) diagonal-1 diffusely diseased 10) diagonal-2 diffusely diseased 12) proximal cx discrete 60 13) mid cx discrete 90 13a) distal cx normal 14) obtuse marginal-1 normal technical factors: total time (lidocaine to test complete) = 23 minutes. arterial time = 18 minutes. fluoro time = 4.8 minutes. contrast injected: non-ionic low osmolar (isovue, optiray...), vol 88 ml, indications - renal premedications: fentanyl 25mcg iv versed 0.5mg iv anesthesia: 1% lidocaine subq. anticoagulation: other medication: integrilin 11.4mg/hr iv cardiac cath supplies used: - allegiance, custom sterile pack - , left heart kit 5fr , multipack comments: 1. selective coronary angiography of this left dominant system revealed multi-vessel and left main cad. the lmca had a distal 80% stenosis. the lad was occluded after d2, with distal lad filling via the conus branch of the rca. the lcx had an ostial 60% stenosis and mid 90% stenosis. the rca was non-dominant with diffuse disease. 2. limited resting hemodynamics demonstrated systemic arterial hypertension (145/68 mmhg) and mildly elevated left sided filling pressures (lvedp 23mmhg). there was no transaortic gradient on pullback of catheter from lv to aorta. 3. left ventriculography demonstrated normal lv wall motion and a calculated lvef of 60%. there was no mitral regurgitation. final diagnosis: 1. multi-vessel and left main coronary artery disease. 2. mild lv diastolic dysfunction. 3. normal lv systolic function. attending physician: , . referring physician: , . cardiology fellow: , y. attending staff: , p. brief hospital course: following admission he remained stable. a catheterization on revealed 80% distal left main and triple vessel disease. he was referrred for surgical revascularization. lv function was preserved. on he went to the operating room where bypass surgery was undertaken. he tolerated the operation well, weaning from bypass on low dose phenylephrine and propofol. he was easily extubated and weaned from pressors. he transferred to the floor on the day after surgery. he became hyperglycemic on the floor, necessitating transfer to the icu for insulin infusion. glucoses were brought under control and he was maintained on am glargine dosing with sliding scale coverage. he was again transferred to the floor on pod 4. was following his glucose management for uncontrolled blood sugars. he was euglycemic at discharge and was d/c'd on his home glucose management. he was diuresisng and was d/c'd to home on one week of lasix w/ potassium supplementation. he developed a pseudoaneurysm after catheterization which is being followed by the vascular surgical serce. he requires a follow up ultrasound in another week after discharge. medications on admission: atorvastatin 40 mg daily diovan/hctz 160/12.5 pentoxyfylline 400 mg metformin 500 mg norvasc 10 mg daily inspra 25 mg daily hiss - pt estimates 56 units qam and 26 units qpm discharge medications: 1. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 1 weeks. disp:*14 tab sust.rel. particle/crystal(s)* refills:*0* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 7 days. disp:*14 tablet(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. 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:*2* 5. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*75 tablet(s)* refills:*0* 8. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 7 days. disp:*14 tablet(s)* refills:*0* 9. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 10. levemire as directed 11. humalog per sliding scale discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease s/p coronary artery bypass grafts x4 insulin dependent diabetes hypertension hyperlipidemia degenerative disc disease obstructive sleep apnea discharge condition: good discharge instructions: no driving for 4 weeks and off all narcotics no lifting more than 10 pounds for 10 weeks shower daily, no baths or swimming no lotions, creams or powders to incisions report any redness of, or drainage fro mincisions report any weight gain greater than 2 pounds a day or 5 pounds a week report any fever greater than 100.5 take all medications as directed followup instructions: follow up femoral ultrasound of the right femoral artery in 2 weeks from to re-evaluate a-v fistula. sleep study - send home on cpap dr. in 4 weeks () wound clinic in 2 weeks dr. in weeks () dr. in 2 weeks please call for appointments md 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 angiocardiography of left heart structures injection or infusion of platelet inhibitor left heart cardiac catheterization transfusion of packed cells diagnoses: obstructive sleep apnea (adult)(pediatric) subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery tobacco use disorder hyposmolality and/or hyponatremia atherosclerosis of native arteries of the extremities with intermittent claudication atrial fibrillation other and unspecified hyperlipidemia peripheral vascular complications, not elsewhere classified cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled aneurysm of artery of lower extremity spondylosis of unspecified site, without mention of myelopathy benign essential hypertension 

Answer: The patient is high likely exposed to