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: sulfa (sulfonamides) / corgard / procainamide / cardura / aldomet / flexeril / minoxidil / timolol / reglan / isordil / atenolol / vioxx / hytrin / indapamide / primidone / normodyne / hydralazine attending: chief complaint: 67 year-old man, patient of dr. , with known cad referred for cardiac catheterization due to worsening symptoms. major surgical or invasive procedure: 1. coronary artery bypass grafting x3 with the left internal mammary artery to the left anterior descending artery, and reverse saphenous vein graft to the distal right coronary artery and the circumflex artery. 2. modified maze procedure using the cryoablation with resection of left atrial appendage. 3. endoscopic greater saphenous vein harvest of the left leg. 4. epiaortic duplex scan history of present illness: this 67 year old man has a history of difficult to control hypertension, cad and copd here with chest discomfort. over the past two to three months the patient has noticed a lot of chest discomfort, described as indigestion. it can occur up to four times a day and then not occur for an entire day. it has not seemed to correlate with food or activity and has responded to both rest and sl nitroglycerin. he denied any associated symptoms, no n/v, no diaphoresis, no ligtheadedness, never syncopized, no palpitation.s he has not undergone any recent stress testing and is now referred for cardiac catheterization to evaluate for a progression of his cad. in the patient underwent cardiac and renal angiography at . no significant renal artery stenosis was noted, although he did have coronary artery disease. the lmca had a 60% distal eccentric lesion. the lad had only mild diffuse disease. the rca had a 70% mid stenosis and a focal 80% ostial pda. there was moderately elevated right and left heart filling pressures with moderate pulmonary hypertension. . most recent testing: ett: 3 minutes 30 seconds modified protocol, 98% max phr, stopping due sob. no chest pain. imaging: no ischemia or mi. lvef 51%. . ros: denies orthopnea, pnd + intermittent le edema (wears compression stockings) + occasional palpitations, unrelated to activity + frequent lightheadedness associated with bending down or climbing stairs + bilateral calf cramping with walking one mile past medical history: hypertension, difficult to control diabetes chf pacemaker atrial fibrillation cri - baseline 1.8 gout cea (patient reports a left cea, ccc mentions right cea) glaucoma gerd copd pneumonia hemorrhoids social history: patient lives with his significant other ; patient previously smoked 3 packs a day. he quit in family history: sister s/p cabg at age 57. brother with cad in his 50's physical exam: avss aaox3 nad rrr ctab s/nt/nd warm no edema pertinent results: cxr: portable ap chest (two views): there is a left-sided pacemaker with leads terminating in the right atrium and right ventricle. the heart size is normal. the mediastinal contours are normal. there is no pulmonary vascular congestion. the lungs are clear. there is no pleural effusion or pneumothorax. . cath: 60% lm disease, 70% rca, 80%rpda (all are old and stable) and then a new 90% lad lesion . carotid u/s: impression: 1. 80-99% left ica stenosis. 2. widely patent right common and internal carotid arteries in this patient who is apparently status post right carotid endarterectomy. . echo: the left atrium is mildly dilated. the right atrium is moderately dilated. the estimated right atrial pressure is mmhg. there is moderate symmetric left ventricular hypertrophy. overall left ventricular systolic function is low normal (lvef 50%) secondary to hypokinesis of the interventricular septum. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. . stent to carotid artery: final diagnosis: 1. critical left internal carotid artery stenosis. 2. successful angioplasty and stenting of the left internal carotid artery using a 6.0/8.0x30mm acculink self expanding stent. . brief hospital course: mr. 67 year-old man with worsening chest pain and known cad who was referred for cardiac catheterization. he was found to have lm (60%), rca (70%) rpda 80%, (these are old) and new lad (90%) lesion. no intervention was performed and he was evaluated for cabg. . # cardiac: ischemia: patient was found to have 3 vessel disease during cath and no intervention was done. he was worked up for cabg. during this work up, his right internal carotid artery was found to be 80-99% stenosed although he was asymptomatic. he was taken back to the cath lab and had successful carotid artery stenting done in preparation for cabg. he was evaluated by neurology prior to stenting procedure. . while awaiting cabg, his blood pressure was controlled with his home medications of metoprolol, valsartan, lisinopril, imdur and labetolol gtt. his goal range of sbp was 140-160. (his high end sbp was 200 without labetolol gtt.) he was continued on aspirin and plavix and a statin. . rhythm - patient is s/p pace maker placement. patient has been in atrial fibrillation with good rate control. he was maintained on a heparin gtt and rate controlled with metoprolol and digoxin (home meds). . pump - patient was clinically euvolemic. echo showed lvh, with ef 50%. his home furosemide was given only on a prn basis. . # cri - old studies report no history of ras. his cri is likely secondary to his hypertension (at home he reports running around sbp 180's). his baseline cr is 1.8 and this remained stable. . # dm - he was maintained on his insulin ss and home standing nph for diabetes control. he was also maintained on his neurontin for neuropathy. . # gout - patient complains of feeling beginnings of gout symptoms on left foot. no evidence of clinical gout. he takes colchicine at home to help and was given a dose of colchicine . # ppx - bowel reg, heparin gtt, h2blocker . # full code . # communication - wife cardiac surgery discharge summery the patient was taken to the operating room on where he under wwent: 1. coronary artery bypass grafting x3 with the left internal mammary artery to the left anterior descending artery, and reverse saphenous vein graft to the distal right coronary artery and the circumflex artery. 2. modified maze procedure using the cryoablation with resection of left atrial appendage. 3. endoscopic greater saphenous vein harvest of the left leg. 4. epiaortic duplex scan postopeerativly he was admitted to the icu. his post operative course was complicated by acute reanl failure and rv dsyfunction. he underwent cardiac catheterization on pod1 where the acute marginal artery was found to be occluded. he underwent successful balloon angioplasty of this vessel and placement of an intra-aortic balloon pump. post-procedure the patient remained intubated and was receiving bp support. while in the icu the patient was in acute renal failure and received several days of cvvhd his maximum creatineane was 3.8 the pt was also placed of enteral feeding while in the icu. eventualy the pt was weaned of pressors and of the vent and successfully extubated. the patient also had reatun of renal function and was able to be weaned off dialysis. the patients post operative course was complicated by a fib for which he received amioderone and beta blocker therapy. at the time of discharge the patient had good pain control on po pain medications. he was in normal sinus rhythm and on an an amoiderone taper. his o2 sats were greater then 92% on 2l nc of suplemental oxygen. he was tolerating a regular diet and he had good blood sugar control on a regular insulin sliding scale. he had return of renal function. at the time of discharge his serum creatinine was 3.1 and he was makung urine without the aid of diuretics. at the time of discharge his hematocrit was stable he was a febrile and his white blood cell count was not elevated. the pt was evaluated by physical therapy and is able to ambulate with assistant however he would desaturate to 88% on ra with mobility. the patient will benefit from acute rehab. medications on admission: humalog 75/25 25-30 units every morning, 84-86 units every evening at 7pm diovan 160mg twice a day digitek .125mg daily every morning furosemide 40mg, two tablets every morning, two tablets at 12pm gabapentin 600mg one every morning imdur 60mg daily every morning lipitor 10mg daily every evening lisinopril 10mg daily every evening lopressor 50mg, two tablets twice a day minoxidil 2.5mg daily every evening norvasc 5mg daily every evening at 7pm kcl 10meq, two capsules three times a day ranitidine 150mg daily at 7pm coumadin 5mg, last dose on (had been taking 5/2.5/2.5 cycles) methazolamide 25mg, three times a day colchicine 0.6mg prn for gout advair inhaler prn albuterol inhaler prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*2* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). :*30 tablet, delayed release (e.c.)(s)* refills:*0* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. :*80 tablet(s)* refills:*0* 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*0* 5. warfarin 5 mg tablet sig: one (1) tablet po daily (daily): take one tablet daily or as directed by md. :*30 tablet(s)* refills:*0* 6. labetalol 200 mg tablet sig: four (4) tablet po tid (3 times a day). :*360 tablet(s)* refills:*0* 7. amiodarone 200 mg tablet sig: two (2) tablet po take one tablet two times per day for seven days then take one tablet one time per day. :*35 tablet(s)* refills:*0* 8. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). :*1 * refills:*2* 9. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). :*1 * refills:*0* 10. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). :*90 capsule(s)* refills:*0* 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). :*30 tablet, delayed release (e.c.)(s)* refills:*0* 12. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*0* discharge disposition: extended care facility: discharge diagnosis: cad hypertension, difficult to control diabetes chf pacemaker atrial fibrillation cri - baseline 1.8 gout cea (patient reports a left cea, ccc mentions right cea) glaucoma gerd copd pneumonia hemorrhoids discharge condition: stable discharge instructions: may shower over incisions and pat dry no lotions , creams or powders on any incision no driving for one month no lfting greater than 10 pounds for 10 weeks call for fever greater than 100.5, redness, or drainage followup instructions: see dr. or pcp weeks see dr. in weeks see dr. in 4 weeks procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries left heart cardiac catheterization diagnostic ultrasound of heart diagnostic ultrasound of heart diagnostic ultrasound of heart fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances excision or destruction of other lesion or tissue of heart, open approach implant of pulsation balloon nonoperative removal of heart assist system injection or infusion of nesiritide percutaneous angioplasty of extracranial vessel(s) percutaneous insertion of carotid artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia family history of ischemic heart disease acute myocardial infarction of unspecified site, initial episode of care fitting and adjustment of cardiac pacemaker 

Answer: The patient is high likely exposed to