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: the patient is a 55-year-old male with a history of diabetes mellitus type 2, and positive family history for coronary artery disease, who was seen in his primary care physician's office on the day prior to admission where he complained of shortness of breath and dizziness for the last several months. he also noted that his exercise tolerance was decreased in the last several months and he had dyspnea on exertion while climbing stairs. his primary care physician ordered cardiac stress echocardiogram where he exercised for five minutes and stopped due to fatigue and dyspnea. during his recovery, he had an intermittent vibrating feeling in his chest and it was noted that while at peak exercise rate to have electrocardiogram changes. echocardiogram results showed a regional left ventricular systolic dysfunction with hypokinesis of the distal half of septum and akinesis of the basal inferior wall. he was also noted on echocardiogram to have mild to moderate aortic stenosis, mild aortic regurgitation and trivial mitral regurgitation. after the results of this test, the patient was then referred to the emergency department where he was admitted symptom free for further work-up. past medical history: 1. diabetes mellitus type 2. 2. foot ulcer. 3. hypercholesterolemia. 4. hypertension. 5. status post appendectomy. social history: lives in . he is divorced. he has a remote tobacco use. he quit 30 years ago and reportedly did not smoke a lot. drinks alcohol socially on friday's. allergies: he has no known drug allergies. medications on admission: 1. enalapril 10 mg po q.d. 2. glyburide 10 mg po b.i.d. 3. metformin 1000 mg po b.i.d. 4. >........<112.5 mg po b.i.d. review of systems: noncontributory. physical examination: shows a well-developed, well-nourished male in no apparent distress. his vital signs were stable with a temperature of 97. heart rate of 80. blood pressure 142/80. respiratory rate 15. oxygen saturation 97% on room air. his head, eyes, ears, nose and throat shows pupils equal, round and reactive to light, extraocular movements intact. sclerae are anicteric. his neck is supple. he has jugular venous distention to 7 cm. his heart exam shows a regular rate and rhythm with a 3/6 systolic ejection murmur heard throughout and radiating to the carotids. his lungs are clear to auscultation bilaterally with no wheezes or crackles. his abdomen has positive bowel sounds, obese, soft, nontender, nondistended. his extremities show trace lower extremity edema bilaterally. he does have an old healed ulcer in his anterior tibia and no varicosities. his pulses are 2+ throughout and his neurological exam shows him to be alert and oriented times three, moving all extremities, and following commands and is subsequently nonfocal. labs on admission: white blood cell count 7.4, hematocrit 45.3%, platelet count 260,000. pt 12.5, inr 1.0, ptt 25.2, sodium 137, potassium 4.2, chloride 99, co2 28, bun 14, creatinine 1.6, blood glucose of 193. urinalysis was negative and a chest x-ray showed no infiltrate or congestive heart failure. his electrocardiogram shows normal sinus rhythm at 87 beats per minute with q waves in leads iii and v1. hospital course: on , he underwent cardiac catheterization which showed his left main to be short with likely diffuse disease. his left anterior descending with a proximal 70% lesion, a mid 90% lesion, and a second diagonal with a proximal 70% lesion and a distal lower pole 80% lesion with a diffusely diseased high first diagonal. his left circumflex shows a 50% stenosis proximally and 70% stenosis mid vessel and a 90% stenosis at the om1. the om1 is totally occluded. the om2 has a 70% stenosis with collaterals to the distal right coronary artery. his right coronary artery has proximal occlusion with heavily calcified vessels. his aortic valve had a 22 mm mean gradient. he was shown to have 1+ mitral regurgitation and an ejection fraction of about 30% with anterolateral and posterior basal hypokinesis. he was, therefore, recommended for possible coronary artery bypass grafting. because of the potential necessity to repair or replace the aortic valve, the patient did have a dental consult. it was recommended ideally that he have tooth #28 and #30 extracted prior to surgery, but if they were unable to delay, they recommended covering with antibiotics. it was also recommended that he undergo a comprehensive dental exam and to have further evaluation of tooth #28 and #30 and have #4 root fragment examined. the remainder of his preoperative course was uneventful and on , he was taken to the operating room and underwent aortic valve replacement with a #23 - bioprosthetic valve and a coronary artery bypass graft times three with a left internal mammary artery to the left anterior descending artery, saphenous vein graft to the posterior descending artery and a saphenous vein graft to the om. the surgery was performed by dr. , with dr. , and , pa-c assistance. the surgery was performed under general tracheal anesthesia with a cardiopulmonary bypass time of 173 minutes with a cross clamp time of 146 minutes. the patient tolerated the procedure well and was transferred to the intensive care unit with two atrial and two ventricular pacing wires, mediastinal, and a left pleural chest tube in normal sinus rhythm at 90 beats per minute on on levophed, milrinone and propofol drips. the patient was extubated on the morning of postoperative day number one without complication. he continued that morning to be on milrinone, levophed and insulin drips. by late that day, he was able to be weaned off the milrinone and to continue on the levophed drip. by postoperative day number two, he was started on gentle diuresis. his chest tubes remained in for increased drainage and he did remain in the intensive care unit. by postoperative day number three, it was felt that he was stable and ready to be transferred to the surgical floor. his chest tubes were discontinued without incident. later that afternoon, he was noted to have much more of a flat affect and was noted to not be talking. he had a neurology consult where it was recommended that he undergo an mri/mra of the head and also have his narcotics held and to receive a carotid ultrasound and continue to try to keep his blood pressure slightly elevated. on postoperative day number three, it was noted that his sugars continued to be elevated and consult was obtained. their recommendations included starting him on nph insulin and a sliding scale, and continuing his glyburide. in follow-up to his neurological consult, his mri did show multiple bilateral watershed infarcts that were suggestive of an intraoperative stroke or perioperative stroke. a carotid ultrasound was done and it was noted to be a normal study with no plaque seen. on postoperative day number four, he was transfused two units of packed red blood cells for a hematocrit of 25.3%. he did continue to progress slowly. following a further neurological follow-up, a psychiatric consult was also recommended and their feeling was that he was delirious due to low blood pressure and low oxygen saturations and possibly the aphasia he had experienced was related to the infarcts. their recommendations included continuing his effexor, checking tsh, and otherwise, he should continue to slowly improve. he did continue to improve slightly. his speech started to come back and adjustments were made to his insulin dosing. he continued to work with physical therapy and was noted to have some more improvement there too. on the morning of postoperative day number seven, he was complaining of visual changes and an ophthalmology consult was obtained. they felt that he had blurry vision in the right and optic disc edema and optic nerve power. there was concern for an ophthalmic artery occlusion and an mri was recommended. that mri was obtained and no new occlusion was seen. he was then seen at the eye clinic for a more thorough eye exam and that exam was consistent with interior ischemic optic neuropathy in the right eye and bilateral hypertensive retinopathy. it was then recommended that he follow-up as an outpatient with the a neurological ophthalmologist. on postoperative day number ten, his blood sugars were in better control on his new insulin regimen. his speech was back to baseline and though, he did still have visual deficits, he does feel comfortable with the decision to be discharged to home. he has passed to a level 5 with physical therapy and is otherwise stable and ready to be discharged to home. his discharge exam shows his lungs to be clear to auscultation bilaterally. his heart is regular rate and rhythm. his abdomen is soft, nontender, nondistended and his extremities show no edema. his incisions are clean, dry and intact, and his neurological exam is as described previously. his laboratories on the day of discharge include: white blood cell count 11.1, hematocrit 37%, platelet count 720,000, sodium 137, potassium 4.3, chloride 98, co2 28, bun 16, creatinine .7 and blood glucose of 114. his discharge chest x-ray show a small left effusion, otherwise, is clear and shows no sign of infiltrate or pneumothorax. discharge condition: he is to be discharged home in good condition. discharge medications: 1. colace 100 mg po b.i.d. prn. 2. enteric coated aspirin 325 mg po q.d. 3. glyburide 5 mg po q.d. 4. effexor 112.5 mg po b.i.d. 5. atenolol 25 mg po q.d. 6. lasix 40 mg po b.i.d. times seven days. 7. potassium 20 mg po b.i.d. times seven days. 8. metformin 1000 mg po b.i.d. 9. nph insulin 18 units q.a.m. with breakfast and 10 units subcutaneously q.p.m. 10. humalog insulin sliding scale. 11. lipitor 10 mg po q.d. follow-up: he should follow-up with dr. in one to two weeks. he should also follow-up with his cardiologist in two to three weeks and with dr. in four weeks. he has an appointment to see dr. , the neurological ophthalmologist on . primary procedure: coronary artery bypass grafting times three with a left internal mammary artery to left anterior descending artery, saphenous vein graft to om and a saphenous vein graft to the posterior descending artery with an aortic valve replacement with a number 23 - valve. discharge diagnoses: 1. coronary artery disease. 2. hypertension. 3. hypercholesterolemia. 4. diabetes. 5. interior ischemic optic neuropathy in the right eye and hypertensive retinopathy bilaterally. , m.d. dictated by: medquist36 d: 12:14 t: 14:19 job#: , 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 coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries open and other replacement of aortic valve with tissue graft transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension chronic airway obstruction, not elsewhere classified other chronic pulmonary heart diseases rheumatic heart failure (congestive) ulcer of other part of foot mitral valve insufficiency and aortic valve stenosis iatrogenic cerebrovascular infarction or hemorrhage diabetes with unspecified complication, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to