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 is a 79-year-old male, with a history of coronary artery disease and known left carotid artery blockage, hyperlipidemia, and hypertension, who was seen in the emergency department on . the patient states that he had had chest pain last evening lasting approximating 5 minutes after exertion. the patient describes the chest pain as burning, substernal, no radiation, no nausea, vomiting, no diaphoresis, no shortness of breath. the patient stated that the pain was relieved after 5 minutes after taking a nitroglycerin tablet. the patient states that he has often had this pain at night after exerting himself. the patient states that this pain has been unchanged. the patient denies orthopnea or lower extremity swelling. the patient reports that he has had a stress test in the past. upon review, it was noticed that the patient was exercised for 10 minutes using a modified protocol and was stopped due to fatigue. at peak exercise, there was approximately 2.0-2.5 mm down-sloping st depression in anterior and lateral leads, and slightly less in the inferior leads. these changes were noted in the presence of a baseline abnormal ecg of right bundle branch block and left ventricular hypertrophy with prominent t wave abnormalities. this exercise stress test was essentially unchanged from an earlier test performed in . previous medical history: 1. coronary artery disease. 2. hyperlipidemia. 3. hypertension. 4. benign prostatic hypertrophy. 5. gastroesophageal reflux disease. 6. asthma. 7. allergic rhinitis. 8. left carotid blockage. medications on admission: 1. enteric-coated aspirin 325 mg po bid. 2. atenolol 50 mg qd. 3. nitroglycerin sublingual. allergies: no known drug allergies. social history: the patient lives with his wife, is a nonsmoker, heavy alcohol usage. physical exam: the patient was afebrile, 98.3, pulse 57, blood pressure 165/72, respiratory rate 20, 95% on room air. in general, he was alert and oriented, in no apparent distress, very pleasant. cardiovascular - regular rate and rhythm, ii/vi systolic ejection murmur noted at the left lower sternal border. lung exam was clear to auscultation bilaterally with a long expiratory phase. abdominal exam - soft, nontender, nondistended, positive bowel sounds. extremities - no edema. distal pulses were palpated. neck exam - no jvp, no bruits, no masses were discernible. rectal exam - guaiac negative, enlarged prostate. labs on admission: cbc - white count 7.7, hematocrit 47.2, platelets 189. chemistry - sodium 141, potassium 4.5, chloride 104, bicarb 31, bun 23, creatinine 1.2, pt 13.2, ptt 25.2, inr 1.1. the patient had a set of cardiac enzymes sent off. ck was 106, troponin 0.02. chest x-ray: cardiomegaly, no consolidation, flattened diaphragm, no chf noted. ekg: sinus rhythm in the 50s, left ventricular hypertrophy, right bundle branch block, normal axis. hospital course: the patient was admitted to the medicine service for a rule out evaluation for myocardial infarction. the patient had serial enzymes done with the ck decreasing from 106 to 80 to 72. his troponin initially at 0.02 decreased to 0.01. the patient was planned to have a stress test and follow-up the results. on hospital day #3, the patient complained of having chest pain, , with substernal tightness. an ekg done at that time showed st depression in v1 and v2. the patient's pain was relieved after 3 sublingual nitrogen tablets and 1 mg morphine. the patient's blood pressure was systolic 120s-140. heart rate 80. after this episode, the patient was evaluated by the department of cardiology which noted that the patient was now with unstable angina. it was advised that the patient undergo angiography, carotid duplex, and cardiac catheterization. a set of enzymes was sent-off following this episode. ck came back at 102, ck-mb 6, troponin 0.17. on , the patient underwent an mibi stress test, during which the patient developed chest pain. the patient's chest pain was resolved status post 3 sublingual nitrogen tablets and iv morphine. stress test showed st depression in leads v1 through v3. the patient was started on a heparin drip and referred to cardiothoracic surgery service. also on , the patient underwent a carotid duplex which showed a right internal carotid stenosis of 70-79%, and a left internal stenosis of less than 40%. the patient underwent a cardiac catheterization which noted that the patient had three-vessel disease. on , the patient underwent coronary artery bypass grafting x 4 with the lima to the left anterior descending, svg to o1, svg to the pda to the om1. the surgery was performed by dr. , and there were on complications noted, and the patient tolerated the procedure well. postoperatively, the patient remained intubated, was a-paced, and placed on a levophed drip for pressure support. following a brief stay in the pacu, the patient went to the csru where the patient arrived at a paced rate of approximately 90 beats per minute. the patient was noted to have labile blood pressure requiring iv nitroglycerin and iv levophed drips in order to keep his systolic blood pressure between 120 and 140. the patient remained intubated with plans to extubate when the patient was stable. initial attempts to extubate were unsuccessful, but the patient was weaned to a pressure support of 5 and 5, with 40% fio2. on postoperative day #1, another attempt was made to extubate the patient, but the patient went into pulmonary edema, and subsequently was placed on simv. the patient was noted to have rales and rhonchi bilaterally, and had symptoms of a frothy pink sputum, with a respiratory acidosis. cardiovascularly, the patient was noted to have frequent pvcs with runs of bigeminy. a swan catheter was placed with no effects. the patient continued to be maintained on levophed and nitroglycerin to maintain his systolic blood pressure between 120 and 140. the patient also underwent several episodes of ectopy, though his cardiac index remained greater than 2.0. from a respiratory standpoint, the patient continued to have thick yellow secretions and rhonchorous-sounding lungs. his sp02 was maintained at 95%, and the vent was able to correct his respiratory acidosis. his secretions improved after administration of 40 mg iv lasix. the decision was made to keep the patient on the vent overnight with plans to extubate on . a chest x-ray was done to evaluate the patient's increased secretions and decreased breath sounds. this revealed no pulmonary edema, but questionable developing consolidation. as a precaution, the patient was placed on levofloxacin for a questionable developing nosocomial pneumonia. the patient was also evaluated by electrophysiology for the patient's continued ventricular ectopy and sinus node dysfunction. it was determined at that time that the patient did not need a permanent pacemaker placed at that time. on postoperative day #2, the patient was weaned off simv down to cpap with his initial pressure support at 15 which was weaned down to 5. as a result of this successful weaning, the patient was extubated and placed on a face mask of 40% fio2. the patient was able to maintain his o2 saturations at 99% with no stridor, but still slightly coarse breath sounds. from a cardiovascular standpoint, the patient went back into a st rate of 150s, with a stable blood pressure. the patient continued to have frequent pvcs, bigeminy, trigeminy, occasional couplets. the patient was started on lopressor 12.5 mg po, and bolused with amiodarone, and placed on an amiodarone drip. the patient's blood pressure remained labile, still requiring a nitroglycerin drip. additionally, the patient received 1 unit of packed red blood cells for a low hematocrit. additionally on this day, the patient was evaluated by physical therapy who was able to successfully get the patient out of bed which he tolerated well. the patient was continued to be weaned off his oxygen, and was able to maintain o2 sats greater than 94% on 4 liters nasal cannula. on postoperative day #3, the patient continued to do well with a continued weaning of his nitroglycerin support while able to maintain his blood pressure between 120 and 140. the patient was also diuresed with iv lasix and remained on an amiodarone drip. the patient went into atrial fibrillation with his pulse reaching as high as into the 140s, but later went down to 106-118 with a stable systolic blood pressure. the patient denied any discomfort at this time. the patient was continued on his iv amiodarone which later converted his arrhythmia into normal sinus rhythm. this amiodarone was switched from iv to po without any difficulty. from a respiratory standpoint, the patient was able to be weaned down to 2 liters nasal cannula and was able to maintain his saturation at greater than 98%. his breath sounds had begun to clear-up though still remained slightly diminished in the bases. no nebulizers were needed today. the patient's activity was increased. he was out of bed and was able to ambulate with assistance. on postoperative day #4, , the patient did very well from a cardiovascular standpoint. he remained in normal sinus rhythm with rare pvcs. the patient's systolic blood pressure remained greater than 100. on postoperative day #6, the patient was transferred from the csru down to far-2. the patient did very well and was continued to be anticoagulated for his atrial fibrillation. the patient was placed on coumadin at this time. the patient's amiodarone was decreased from 400 to 400 qd. the patient was encouraged to be out of bed and ambulate. the patient was continued to be on a heparin infusion of 1,150 u/h and given 3 mg of coumadin q hs. despite this, the patient did go into atrial fibrillation on , but the patient remained asymptomatic and maintained his blood pressure at 116/66. the patient was given 50 mg po lopressor and 400 mg po amiodarone at that time. following the administration of medication, the patient converted out of atrial fibrillation to a normal sinus rhythm. during the patient's further postoperative course, the patient continued to do well. he remained in normal sinus rhythm without a need for further pharmaceutical intervention. the patient was maintained on his heparin drip to keep a vtt of approximately 40-60. the patient's coumadin doses ranged between 3 and 5 mg per evening. the patient worked extensively with physical therapy. it was noted that the patient, while he had good mobility and good flexibility, was in very poor condition and was easily desaturating down to the 88-89% o2 while on room air and exercising. the patient had a steady gait and could balance, but was easily winded. as a result of this, it was determined that the patient would need to go to a rehabilitation facility following discharge for further conditioning. this dictation will be continued in a further addendum when final placement of the patient has been determined. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours (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 left heart cardiac catheterization diagnostic ultrasound of heart injection or infusion of other therapeutic or prophylactic substance other conversion of cardiac rhythm transfusion of packed cells transfusion of other serum diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome congestive heart failure, unspecified atrial fibrillation pulmonary collapse occlusion and stenosis of carotid artery without mention of cerebral infarction chronic obstructive asthma, unspecified postherpetic polyneuropathy 

Answer: The patient is high likely exposed to