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: sulfa (sulfonamide antibiotics) attending: chief complaint: chest pain and dyspnea on exertion major surgical or invasive procedure: cardiac cath coronary artery bypass grafting x4 with left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to the posterior descending artery, obtuse marginal artery and first diagonal artery. history of present illness: 75 year old male reports a history of intermittent chest discomfort, often in the setting of a meal and light exertion. this has been present for the past seven to eight years but fairly infrequent. prior stress tests have revealed mild inferolateral ischemia and he has been treated with medical management through the years. he reports that over the past year his symptoms have been more noticeable and frequent, occurring at least daily. he describes substernal chest pain/pressure accompanied by shortness of breath with very little exertion. he was now referred for left heart catheterization for further evaluation. upon catheterization he was found to have left main and three vessel diseae and is now being referred to cardiac surgery for revascularization. past medical history: coronary artery disease s/p coronary artery bypass graft x 4 past medical history: hyperlipidemia hypertension complete heart block s/p dual chamber pacemaker paroxysmal atrial fibrillation, newly diagnosed bph s/p prostate surgery gerd/hiatal hernia arthritis left finger amputation from a traumatic accident right detached retina, s/p surgery social history: lives with:wife contact: (wife) phone # occupation:works one day a week as an inspector for construction projects. cigarettes: smoked no yes hx:quit 40 years ago, smoked ppd x20 years other tobacco use:denies etoh: previously drank several six packs of beer on a weekend. he quit 7-8 years ago illicit drug use:denies family history: premature coronary artery disease- mother had a valve replacement in her late 40's. brother with a coronary stent in his mid 60's. physical exam: pulse:64 resp:13 o2 sat:97/ra b/p right:150/78 left:142/76 height:5'9" weight:245 lbs general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally l upper chest pacer, well healed heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right: p left: p dp right: p left: p pt : p left: p radial right: p left: p carotid bruit right: no left: no pertinent results: cardiac cath: 1. selective coronary angiography in this right dominant system demonstrated severe 3vd and left main disease. the lmca had an 80% distal lesion. the lad had a long 70% lesion in the mid-vessel and a 60% origin lesion in the major first diagonal. the lcx had a 100% proximal lesion with good filling of the major om via right to left collaterals. the rca had a 60% proximal lesion, 60% mid-lesion, serial 60% distal lesionsx2, and a 60% pda lesion. 2. limited resting hemodynamics revealed a normal systemic arterial blood pressure with a central aortic pressure of 104/56 mmhg. . carotid u/s: mild plaque in the proximal internal carotid arteries, but no hemodynamically significant stenoses on either side. flow in the vertebral arteries is prograde on both sides. . echo: pre-bypass: the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results on mr. before bypass. post-bypass: normal biventricular function. intact thoracic aorta. no valvular findings. mild mr. other valvular findings. . 05:56am blood wbc-7.3 rbc-3.36* hgb-10.4* hct-30.8* mcv-92 mch-31.1 mchc-33.9 rdw-13.6 plt ct-188 05:34am blood wbc-8.2 rbc-3.20* hgb-9.9* hct-29.4* mcv-92 mch-30.9 mchc-33.6 rdw-13.7 plt ct-132* 05:56am blood glucose-96 urean-20 creat-0.9 na-141 k-3.9 cl-102 hco3-28 angap-15 05:34am blood glucose-107* urean-16 creat-0.9 na-137 k-4.0 cl-102 hco3-30 angap-9 brief hospital course: mr. a cardiac cath on which revealed severe left main and three vessel disease. he was referred for surgery and usual surgical work-up. on he was brought to the operating room where he a coronary artery bypass graft x 4. please see operative note for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. pacer was interrogated by ep. 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. 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 4 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to the rehab in good condition with appropriate follow up instructions. medications on admission: metoprolol succinate 50 mg daily nitroglycerin 0.4 mg prn omeprazole 20 mg daily aspirin 81 mg daily vitamin b-12 250 mcg daily magnesium oxide 250 mg daily puffs inhalation q6h (every 6 hours) as needed for dyspnea. 10. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 11. furosemide 40 mg tablet sig: one (1) tablet po twice a day for 10 days. 12. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po twice a day for 10 days. discharge disposition: extended care facility: nursing and rehab center discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 past medical history: hyperlipidemia hypertension complete heart block s/p dual chamber pacemaker paroxysmal atrial fibrillation, newly diagnosed bph s/p prostate surgery gerd/hiatal hernia arthritis left finger amputation from a traumatic accident right detached retina, s/p surgery discharge condition: alert and oriented x3 nonfocal ambulating, deconditioned incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage leg -left - healing well, no erythema or drainage. edema, 1+ left, none on right 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 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: 1:30 please call to schedule appointments with your cardiologist: dr. 2-3 weeks 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** 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 left heart cardiac catheterization artificial pacemaker rate check diagnoses: other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux intermediate coronary syndrome unspecified essential hypertension atrial fibrillation personal history of tobacco use hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other and unspecified hyperlipidemia long-term (current) use of anticoagulants obesity, unspecified fitting and adjustment of cardiac pacemaker hip joint replacement arthropathy, unspecified, site unspecified body mass index 36.0-36.9, adult 

Answer: The patient is high likely exposed to