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: ace inhibitors attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: - cardiac catheterization - 1. urgent coronary artery bypass graft x4; left internal mammary artery to left anterior descending artery and saphenous vein grafts to diagonal obtuse marginal and posterior descending arteries. 2. endoscopic harvesting of the long saphenous vein. 3. mitral valve repair with a size 28 cg future complete band. history of present illness: mr. is a 62 y/o m with pmh notable for dmii and htn who presents at the request of dr. due to worsening exertional chest pressure and doe. . the patient reports that in he began to note shortness of breath and chest pressure when walking more than 30 feet or a flight of stairs blocks. in , while in on a buisiness trip, he developed positional chest pain and was diagnosed with pericarditis. had a (-) stress test but developed fib during exercise. discharged on a course of nsaids and sotalol for arrhythmic control (nl ef on echo). . seen by cardiologists in where he had a cta done that showed no pe. a repeat stress test was indeterminate. the patient continued to have cp and dyspnea with exertion over the subsequent year. he was seen at in where a nucler stress test revealed anterior ischemia. he opted not to have an intervention at . . the patient was referred to dr. due to persistence of symptoms. . direct admit to cardiology on . vs on arrival were 97.0 173/102 108 20 94%ra. the patient reported that he could reproduce his symptoms with any exertion however denied any cp, palp or sob while lying in bed. . ros: (+) as per hpi. otherwise denies n/v/d, fever/chills, changes in bowel or bladder habits, ha or changes in vision. past medical history: coronary artery disease mitral regurgitation diabetes hypertension hyperlipidemia cholelithiasis social history: the patient lives at home with his wife. works as a vp at a consulting firm. no etoh, smoking or other recreational drug use. family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: on admission: vs: 97.0 173/102 108 20 94%ra general: lying in bed in nad heent: perrla, eomi, anicteric, mmm, op clear neck: supple, no jvd cv: tachycardic, s1 and s2, no m/r/g lung: ctab, no w/r/r abdomen: soft, nt/nd, bsx4 extremities: no edema neuro: awake, alert and oriented. moving all extremities. pertinent results: on admission: 10:57am blood wbc-8.8 rbc-5.10 hgb-14.9 hct-44.4 mcv-87 mch-29.2 mchc-33.5 rdw-13.2 plt ct-293 10:57am blood pt-11.2 ptt-29.9 inr(pt)-1.0 10:57am blood glucose-159* urean-6 creat-0.7 na-138 k-4.0 cl-103 hco3-25 angap-14 01:33pm blood alt-16 ast-20 ck(cpk)-72 alkphos-65 amylase-59 totbili-0.5 dirbili-0.1 indbili-0.4 10:57am blood calcium-9.3 phos-3.0 mg-2.0 01:33pm blood vitb12-90* 06:36am blood folate-15.7 01:33pm blood %hba1c-7.4* eag-166* studies: catheterization report coronary angiography: right dominant lmca: diffuse 40-50% lad: proximal calcific 60-80%. diagonal with diffuse proximal 60% lcx: origin 60%, proximal 70% at small om1, 50% at slightly larger (1.5 mm om2) and 80% origin moderate (2.5 mm) om3. occluded avg cx. rca: totally occluded proximally. collaterals fill pda and distal rca back to mid vessel. . intra-op tee conclusions prebypass no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with mild distal anterior wall hypokinesis.. overall left ventricular systolic function is normal (lvef>55%). the remaining left ventricular segments contract normally. the right ventricular cavity is mildly dilated with normal free wall contractility. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. post-bypass biventricular systolic function remains normal. a ring prosthesis is visualized in the mitral position. there is trace residual mr. evidence of . the remaining study is unchanged from prebypass. 04:17am blood wbc-10.9 rbc-3.83* hgb-10.9* hct-33.9* mcv-89 mch-28.6 mchc-32.2 rdw-13.9 plt ct-259 04:25am blood wbc-10.2 rbc-3.95* hgb-11.5* hct-34.4* mcv-87 mch-29.1 mchc-33.4 rdw-13.6 plt ct-265 04:17am blood pt-33.8* inr(pt)-3.3* 04:25am blood pt-20.5* inr(pt)-1.9* 04:37am blood pt-14.0* inr(pt)-1.3* 01:26pm blood pt-12.6* ptt-34.8 inr(pt)-1.2* 06:05am blood pt-11.4 ptt-50.5* inr(pt)-1.1 04:17am blood glucose-110* urean-14 creat-0.9 na-132* k-4.4 cl-97 hco3-27 angap-12 04:25am blood glucose-114* urean-15 creat-0.9 na-137 k-3.9 cl-99 hco3-29 angap-13 04:37am blood glucose-118* urean-16 creat-0.9 na-135 k-4.2 cl-99 hco3-27 angap-13 04:17am blood calcium-8.2* phos-3.0 mg-2.0 04:25am blood calcium-8.1* phos-3.0 mg-2.3 brief hospital course: mr. is a 62 year-old gentleman with no known coronary artery disease who presented with chest pain and dyspnea with even mild exertion. found to have 3-vessel coronary disease and underwent bypass surgery. hopsital course --------------- the patient was directly admitted to the cardiology floor due to cp and dyspnea with exertion. he underwent cardiac catheterization that showed 3-vessel coronary disease. no intervention was performed and the patient was transferred back to the cardiology floor to await bypass surgery. on the cardiology floor, the patient was initially hypertensive and started on a nitro drip while metoprolol was uptitrated. also uptitrated atorvastatin. the patient began to have intermittent chest pain at rest and was placed on a heparin drip. on , he was taken to the operating room where he underwent coronary artery bypass grafting to four vessels and a mitral valve repair with ring. please see operative note for details. postoperatively he was taken to the intensive care unit for monitoring. over the next several hours, he awoke neurologically intact and was extubated. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. he had a brief episode of post-op a-fib which converted to sinus rhythm with amiodarone. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. afib returned intermittently. coumadin was initiated. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 6 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to lifecare of in good condition with appropriate follow up instructions. medications on admission: - benicar 40mg daily - aspirin 81mg daily - metformin 1000mg - amaryl 1mg twice daily - lipitor 10mg daily - sotalol 80mg twice daily (stopped 2 days prior to procedure) - glargine 15-20 units at night discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 5. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 6. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): 400mg x 1 week, then 400mg daily x 1 week, then 200mg daily until further instructed. 7. metformin 500 mg tablet extended release 24 hr sig: two (2) tablet extended release 24 hr po daily (daily). 8. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 9. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 10. olmesartan 20 mg tablet sig: one (1) tablet po daily (). 11. glimepiride 1 mg tablet sig: one (1) tablet po daily (). 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 13. furosemide 40 mg tablet sig: one (1) tablet po once a day for 7 days. 14. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po once a day for 7 days. 15. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 16. insulin glargine 100 unit/ml solution sig: fifteen (15) subcutaneous at bedtime: 15 units glargine hs. 17. insulin lispro 100 unit/ml solution sig: one (1) subcutaneous four times a day: per attached sliding scale. 18. warfarin 1 mg tablet sig: one (1) tablet po once daily at 4 pm: dose daily for goal inr 2-2.5, dx: afib. discharge disposition: extended care facility: life care center of discharge diagnosis: coronary artery disease mitral regurgitation diabetes hypertension hyperlipidemia cholelithiasis discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage edema - none discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) please call with any questions or concerns *females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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 surgeon: dr. date/time: 1:15 cardiologist: dr. date/time: 1:40 please call to schedule appointments with your primary care dr. , in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** md procedure: (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 open heart valvuloplasty of mitral valve without replacement diagnoses: pneumonia, organism unspecified anemia, unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome mitral valve disorders unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation other b-complex deficiencies other and unspecified hyperlipidemia surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of insulin long-term (current) use of anticoagulants calculus of gallbladder without mention of cholecystitis, without mention of obstruction examination of participant in clinical trial 

Answer: The patient is high likely exposed to