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: this 74-year-old gentleman presented to the cardiology service with history of intermittent chest pressure and dyspnea on exertion for approximately 4-5 weeks. he had an episode of chest pain on the day of admission. he said it did not radiate, but it is also not associated with any nausea, dizziness, vomiting, palpitations, diaphoresis. he said it usually happens when he is lying down while he is short of breath and is relieved by walking around and it seems to happen frequently to him and it lasts about 25 minutes. recently he complains of shortness of breath even with minimal walking in his house. past medical history: diabetes type 1. hypertension. hyperlipidemia. social history: he drinks approximately 1-2 drinks per day and has a 30 pack year history of tobacco. family history: noncontributory. he was admitted to the cardiology service for workup for his chest pain and was started on heparin, aspirin, beta-blocker, nitroglycerin. placed on telemetry to determine whether or not he would rule in or out for myocardial infarction. lisinopril was held because of his renal function. at the time of admission, over the next 48 hours, he was covered by the cardiology service in preparation for cardiac catheterization, which was determined when he had elevated troponins and ruled in for non-st-elevation myocardial infarction. creatinine preoperatively was 1.5. it is unknown what the patient's baseline creatinine was, but the patient was aware of chronic renal insufficiency and patient received hydration prior to going to cardiac catheterization and was covered by cardiology service, dr. . cardiac catheterization was performed on the , which revealed severe three-vessel disease with plaquing in the left main, heavily calcified lad with subtotal occlusions of first septal and diagonal 2. diagonal 1 had a 70 percent lesion. circumflex was totally occluded in the a-v groove with moderate plaquing in the om-3. the right coronary artery had proximal and ostial 80 percent lesions and was totally occluded in the mid portion. patient also had moderate-to-severe lv diastolic heart failure. his lvedp was 23 as well as moderate pulmonary artery hypertension and mitral regurgitation. patient was referred to dr. . past surgical history: also includes appendectomy at age 6. allergies: he had no known drug allergies. medications at the time he was seen: 1. glyburide 1.25 mg by mouth daily. 2. lipitor 10 mg by mouth daily. 3. hydrochlorothiazide 12.5 mg by mouth daily. 4. multivitamin by mouth daily. 5. lisinopril 10 mg by mouth daily. 6. aspirin 325 mg by mouth daily. physical examination: on exam, he is 6 feet tall, 109 kg or 240 pounds with a temperature of 96.6, blood pressure 118/62, in sinus rhythm at 76, respiratory rate 20, and saturating 94 percent on room air. he was sitting upright in bed in no distress. he is alert and oriented times three and appropriate. he had no carotid bruits. he had diminished breath sounds at the right base and fine rales at the left base. his heart has regular rate and rhythm with s1, s2 tones and no murmurs, rubs, or gallops. his abdomen is soft, round, nontender, and nondistended with positive bowel sounds. extremities were warm and well perfused with no peripheral edema. no varicosities noted, but some superficial spider veins. he had 2 plus bilateral radial pulses, 1 plus bilateral dorsalis pedis pulses, 2 plus pt pulse on the right, and a 1 plus pt pulse on the left. preoperative labs: white count is 7.8, hematocrit 29.5, platelet count 261,000. sodium 139, k 4.3, chloride 105, bicarb 25, bun 31, creatinine 1.4 with a blood sugar of 137. pt 12.9, ptt 28.7, inr 1.0. alt 17, ast 17, alkaline phosphatase 38, amylase 36, total bilirubin 0.6. urinalysis was negative. preoperative ekg showed sinus rhythm at 71 with pvcs, a left atrial abnormality, and a question of both anteroseptal old myocardial infarction and an old inferior wall myocardial infarction. additional laboratory work done showed a calcium of 9.0, magnesium 2.0, hemoglobin a1c at 5.8 percent. preoperative chest x-ray showed background copd with probable mild chf and small effusions. please refer to the x-ray final report dated . preoperative cta of the chest showed no evidence of pulmonary embolism as well as bilateral pleural effusions and increased septal thickening consistent with interstitial edema from mild lv congestive heart failure. it also noted calcified coronaries and aortic atherosclerotic disease. please refer to the final report dated . on , the patient underwent coronary artery bypass grafting times four by dr. with a lima to the lad, vein graft to the pda, vein graft to the om, vein graft to the diagonal. he also underwent mitral valve repair with a 30 mm annuloplasty band. he was transferred to cardiothoracic icu in stable condition on a propofol drip at 10 mcg/kg/minute, levophed drip at 0.03 mcg/kg/minute, milrinone drip at 0.1 mcg/kg/minute, and an insulin drip at 2 units/hour. on postoperative day one, he was on a lidocaine drip for premature ventricular contractions. remained on levophed, which was weaned during the day, milrinone drip at 0.25, lidocaine drip at 1 mg, and insulin drip at 5 units/hour. postoperatively, his white count was 11.1, hematocrit 29.4, platelet count 138,000. bun 34, creatinine 1.6. he remained sedated and intubated on ventilatory support. on postoperative day two, the patient was extubated, remained on milrinone drip, and natrecor was started at 0.01 for his heart failure. he remained on a lidocaine drip at 1. aspirin was started and he also began iv lasix diuresis. he received some ativan for agitation. his creatinine rose slightly to 1.8. preoperative echocardiogram estimation of his ejection fraction was 15 percent. patient was seen by cardiology everyday for assistance with his congestive heart failure management. he was also seen by the clinical nutrition team. patient was started on carvedilol beta-blockade, transitioned off his natrecor. he was weaned off the levophed and milrinone and remained on the natrecor drip at 0.01. diuresis continued. creatinine decreased slightly to 1.6. he was also seen by electrophysiology service. at that point, he was off all his drips. the patient was awake and alert on exam, and was also seen by physical therapy for initial evaluation, though he remained in the icu. on postoperative day four, he was hemodynamically stable on no drips. receiving iv lasix and carvedilol. creatinine continued to improve to 1.4. white count dropped to 9.8. hematocrit was stable at 29. foley was discontinued. a line was also discontinued. he remained in cardiothoracic icu an additional day pending resolution of his atn and to monitor him closely for ectopy. he was restarted on his lisinopril and seen by case management in preparation for moving out to the floor. on the 15th, the patient was transferred out to 2 to begin work with physical therapy. he was seen again by the ep fellow to evaluate him for workup for possible icd in approximately one month postoperatively, also pending whether or not his ejection fraction improved. patient was also evaluated by the chf service from cardiology. on postoperative day six, the patient did have one run of nonsustained v-tach and continued on all of his oral medications. his exam was unremarkable and incisions were clean, dry, and intact. he had positive bowel sounds. had 1 plus peripheral edema. decision was made that the patient would follow up with ep postoperatively in one month. patient was strongly encouraged to work with his incentive spirometer and improve his pulmonary toilet as well as increasing his by mouth intake in all preparation for his probable discharge to home. the following day the patient also had four beats of nonsustained v-tach. he was completely asymptomatic and was waiting clearance so that he can do his physical therapy. his creatinine rose slightly from 1.3 to 1.4. he received additional magnesium repletion. patient was also seen by dr. of electrophysiology service and patient went to the ep laboratory on the 18th for a study and received an icd implant. on postoperative day nine, patient continued to be in sinus rhythm, but had frequent atrial and ventricular ectopic beats status post the icd being placed. the new pacer site was clean, dry, and intact. his heart rate was irregular. as previously noted, he was saturating 96 percent on 2 liters with a blood pressure of 112/52. his carvedilol was changed to toprol xl per recommendations of electrophysiology service with plans to hopefully discharge him if he remains stable for the next 24 hours. his ep device was also interrogated one day prior to discharge. on the 20th, the day of discharge, patient was hemodynamically stable in sinus rhythm at 60, blood pressure 123/61, respiratory rate of 18, and saturating 95 percent on room air. he is alert and oriented. he had a nonfocal neurologic examination. his lungs were clear bilaterally. incisions were clean, dry, and intact with trace peripheral edema. he was discharged to home with vna services on . discharge diagnoses: status post coronary artery bypass grafting times four with mitral valve repair. icd placement. non-insulin dependent-diabetes mellitus. hypertension. hyperlipidemia. discharge medications: 1. lisinopril 5 mg by mouth daily. 2. iron 150 mg by mouth daily. 3. vitamin c 500 mg by mouth twice a day. 4. lipitor 10 mg by mouth daily. 5. amiodarone 400 mg by mouth once a day. 6. glyburide 1.25 mg by mouth once a day. 7. lasix 40 mg by mouth once a day times 10 days. 8. metoprolol 50 mg by mouth daily. 9. coumadin 5 mg by mouth once a day for two days, then patient is to check with his physician after laboratory draw prior to his next dose. 10. keflex 500 mg by mouth four times a day for seven days. 11. potassium chloride 10 meq by mouth twice a day for 10 days. 12. percocet 5/325 one tablet by mouth as needed pain every four hours. follow-up instructions: the patient was instructed to followup at the ep device clinic on the on at 11:30 a.m. he is also instructed to followup with dr. , his surgeon for a postoperative surgical visit in one month postoperatively and he was also instructed to followup with dr. , phone number in weeks. patient was instructed to be in contact with his primary care physician, . for followup of coumadin dosing with inr blood draws by the vna service. again, the patient was discharged home with vna services on . , m.d. dictated by: medquist36 d: 10:51:01 t: 11:31:21 job#: procedure: (aorto)coronary bypass of three coronary arteries 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 diagnostic ultrasound of heart catheter based invasive electrophysiologic testing implantation or replacement of automatic cardioverter/defibrillator, total system [aicd] transfusion of packed cells open heart valvuloplasty of mitral valve without replacement injection or infusion of nesiritide diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified paroxysmal ventricular tachycardia other and unspecified hyperlipidemia unspecified disorder of kidney and ureter 

Answer: The patient is high likely exposed to