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: no known allergies / adverse drug reactions attending: chief complaint: intermittent chest pain and shortness of breath major surgical or invasive procedure: coronary artery bypass grafting x3 to left internal mammary artery to left anterior descending artery, bypass from the ascending aorta to the obtuse marginal branch of the circumflex artery using reverse autologous saphenous vein graft and bypass from ascending aorta to the diagonal artery branch of left anterior descending artery using reverse autologous saphenous vein graft history of present illness: 55 year old rican male who emigrated to us in -primarily spanish speaking but understands and speaks english relatively well. he is transferred to today from after a positive stress test in the setting of increasing episodes of chest pain over the last month with minimal activity. the patient has a family history significant for premature coronary artery disease. the cath was done with plavix at lgh. the cath showed that the patient has left main coronary artery disease. the patient was subsequently transferred to medical center. since the patient had plavix, a decision was made to postpone the procedure until the plavix is washed out. past medical history: hypertension, asthma, gerd cva in - ? residual social history: race: rican last dental exam: edentulous lives with: sister contact: phone # occupation:disabled (previous forklift driver) cigarettes: smoked no yes hx: other tobacco use: marijuana -occas. onset age 17 heavy use until 1 year ago now occasional etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: marijuana, cocaine-heroine inhaled. denies ivda. stopped illicit drug use one year ago after cva. family history: family history:premature coronary artery disease father mi < 55 died of cancer age 60 mother < 65 physical exam: physical exam-admission pulse:58 resp: 18 o2 sat: 100% b/p right:146/93 left: height: 5' 11" weight: 69.2 kg general: nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender +bs extremities: warm , well-perfused edema -none varicosities: none neuro: grossly intact pulses: femoral right: cath site- small hematoma left:+2 dp right: +2 left:+2 pt : +2 left:+2 radial right: +2 left:+2 carotid bruit right: left: pertinent results: labs-admission: 05:28pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.5 leuk-neg 05:28pm urine color-straw appear-clear sp -1.008 07:50pm pt-11.1 ptt-31.2 inr(pt)-1.0 07:50pm plt count-142* 07:50pm wbc-7.1 rbc-4.43* hgb-14.2 hct-41.5 mcv-94 mch-32.0 mchc-34.1 rdw-12.3 07:50pm hcv ab-positive* 07:50pm hbsag-negative hbs ab-negative hbc ab-negative 07:50pm %hba1c-5.5 eag-111 07:50pm albumin-4.5 magnesium-2.2 07:50pm lipase-34 07:50pm alt(sgpt)-28 ast(sgot)-26 alk phos-74 amylase-126* tot bili-0.6 07:50pm glucose-92 urea n-19 creat-1.0 sodium-138 potassium-4.0 chloride-102 total co2-23 anion gap-17 11:41pm ck-mb-1 ctropnt-<0.01 11:41pm ck(cpk)-102 labs-discharge: 04:20am blood wbc-7.6 rbc-3.08* hgb-10.0* hct-29.2* mcv-95 mch-32.4* mchc-34.1 rdw-12.6 plt ct-292 04:20am blood plt ct-292 04:20am blood glucose-102* urean-17 creat-0.8 na-135 k-4.3 cl-98 hco3-27 angap-14 04:20am blood calcium-9.1 phos-3.4 mg-2.2 tte left atrium: no spontaneous echo contrast is seen in the laa. right atrium/interatrial septum: normal interatrial septum. left ventricle: overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. simple atheroma in descending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. trivial mr. tricuspid valve: physiologic tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: conclusions: pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. post-cpb: the patient is in sr, on no inotropes. preserved biventricular systolic fxn. aorta intact. trace mr, no ai. radiology report ct chest w/o contrast study date of 12:42 pm reason for this examination: eval rul nodule, eval for source of infection wet read: jksd 5:10 pm final report findings: a 5-mm nodule at the right lung apex (4:37) corresponds with the nodule seen on the prior chest x-rays. an additional 3-mm pulmonary nodule in the right middle lobe is also present (4:84). there is paraseptal emphysema, predominantly in the upper lobes bilaterally, with prominent apical bullae. there are small bilateral pleural effusions with adjacent atelectasis. there is no evidence of pulmonary infection. linear atelectasis is noted within the lingula. the airways are clear. patient is status post cabg. there are small retrosternal fluid collections, many of which contain small air-fluid levels. other than expected mild stranding within the subcutaneous fat, the chest wall subcutaneous fat remains preserved. there is no presternal fluid collection. this examination is not tailored for subdiaphragmatic evaluation. a small calcified granuloma is noted within the right lobe of the liver. otherwise, the non-contrast appearance of the upper abdomen is within normal limits. bone windows: patient is status post recent sternotomy. there is no evidence of dehiscence or sternal wire fractures. there is no erosion of the bone. there are no osseous lesions concerning for metastatic disease. impression: 1. 5-mm right apical and 3-mm right middle lobe pulmonary nodules. six-month followup chest ct is recommended. 2. moderate paraseptal emphysema with prominent apical bullae. 3. no evidence of pneumonia. small bilateral pleural effusions with adjacent atelectasis. 4. multiple small retrosternal fluid collections, some with air-fluid levels, not unexpected in this recently post-surgical patient. no sternal dehiscence or evidence of sternal wire fracture. no presternal fluid collection. radiology report chest (portable ap) study date of 2:03 pm final report the right ij line has been removed. the lungs are hyperinflated, suggesting background copd, with prominent bullous change in the upper lobes bilaterally. there are multiple sternal wires, similar in configuration to . no obvious break in the sternal wires is identified. mediastinal clips consistent with cabg are present. he cardiomediastinal silhouette is stable compared with one day earlier, with mild-to-moderate cardiomegaly and an unfolded aorta. slight patchy opacity at the left base is overall unchanged. left pleural effusion is smaller. doubt chf. again seen is the nodular opacity at the right lung apex, impression: 1. copd and cardiomegaly. 2. patchy opacity left base, essentially unchanged. 3. small nodule at right lung apex again seen. please see recommendation for ct, described on prior cxr report. brief hospital course: the patient was admitted to the hospital and brought to the operating room on where the patient underwent coronary artery bypass grafing x3 please see operative report for details. in summary he had: coronary artery bypass grafting x3 to left internal mammary artery to left anterior descending artery, bypass from the ascending aorta to the obtuse marginal branch of the circumflex artery using reverse autologous saphenous vein graft and bypass from ascending aorta to the diagonal artery branch of left anterior descending artery using reverse autologous saphenous vein graft. his bypass time was 76 minutes with a crossclamp time of 62 minutes. the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, phenylephrine was sucessfully weaned off. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor on pod #1 for further recovery. chest tubes and pacing wires were discontinued per cardiac surgery protocol. the patient was evaluated by the physical therapy service for assistance with strength and mobility. the remainder of his hospital course was uneventful, by the time of discharge on pod6*the patient was ambulating freely, the wound had small amount od bloody drainage from mid incision, and pain was controlled with oral analgesics. the patient was discharged home with visiting nurses in good condition with appropriate follow up instructions. medications on admission: lisinopril 10 daily, atenolol 25 daily, hctz 25 daily, asa 325 daily, omeprazole 20 daily, spiriva, discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. 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* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 6. keflex 500 mg capsule sig: one (1) capsule po three times a day for 10 days. discharge disposition: home with service facility: discharge diagnosis: coronary artery disease with worsening angina secondary diagnosis: hypertension asthma gerd cva - ? residual discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with tylenol incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. trace edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments: wound care clinic phone: date/time: 10:30 surgeon: , md phone: date/time: 1:00 cardiologist: dr. on @ 11:30am please call to schedule appointments with: primary care dr. in weeks ***chest ct w/pulmonary nodules-recommend f/u ct in 6 months*** **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** md procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnoses: other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux intermediate coronary syndrome unspecified essential hypertension hematoma complicating a procedure asthma, unspecified type, unspecified personal history of tobacco use abnormality of gait other and unspecified hyperlipidemia cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure family history of ischemic heart disease solitary pulmonary nodule 

Answer: The patient is high likely exposed to