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: patient recorded as having no known allergies to drugs attending: chief complaint: unstable angina major surgical or invasive procedure: coronary artery bypass graft x 4 (lima to lad, svg to om, svg to ramus, svg to pda) cardiac catheterization history of present illness: 58 y/o male with mulitple cardiac risk factors who presented to outside hosptial with unstable angina/bilateral arm pain. ecg showed small st depressions, but was ruled out for an mi. he then had a stress mibi which was postive for symptoms and st depressions. also revealed small reversible inferior defect and old fixed defect. patient was then transferred to for cardiac cath. cath revealed three vessel coronary artery disease, 80% distal left main stenosis, and 70-80% instent restenosis of the rca. cardiac surgery was then consulted for surgical revascularization. past medical history: coronary artery disease s/p s/p nstemi w/ ptca/stenting to rca in and again in hypertension hypercholesterolemia diabetes mellitus peripheral neuropathy chronic renal insufficiency social history: lives with wife. retired, previously worked as electrical lineman. now runs catering service. previous 15 pack year smoker, quit 30 years ago. etoh: drinks time per week. family history: cad in sister and father physical exam: vs: 60 140/80 heent: eomi, perrl, nc/at, op benign neck: supple, from, -jvd lungs: ctab -w/r/r heart: rrr, +s1/s2, -c/r/m/g abd: soft, nt/nd, +bs ext: warm, well-perfused, 2+ pulses, -edema neuro: a&o x 3, mae, non-focal pertinent results: cardiac cath : 1. coronary angiography revealed a right dominant system status post rca stenting. the lmca showed a complex 80% distal stenosis with involvement of the lad and lcx ostia. the lad showed a 70% ostial stenosis with 70% stenosis of the d1. the lcx showed an ostial 80% stenosis with diffuse disease, including a 50% midsegment stenosis. the rca showed sequential 80% and 70% instent restenoses within the most proximal rca stent, with milder 20-30% restenosis of the mid and distal stents. echo : overall left ventricular systolic function is normal (lvef>55%). the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen in suboptmal views (cannot exclude). there is a trivial/physiologic pericardial effusion. head ct scan : there is no evidence of intra- or extra-axial hemorrhage. the ventricles, cisterns, and sulci are unremarkable, without effacement. there does seem to be a slice through the suprasellar cistern, which is missing, limiting evaluation but the other slices suggest no abnormality. there is no mass effect, hydrocephalus, or shift of the normally midline structures. the -white matter differentiation appears preserved. carotid ultrasound : significant amount of plaque at the origins of the bilateral internal carotid arteries, associated with luminal narrowing estimated between 80 and 99% in diameter on both sides. eeg : abnormal eeg due to the presence of diffuse background slowing and superimposed bursts of generalized mixed frequency delta and theta slowing. no focal or epileptiform features were seen. common causes of encephalopathy include medications, metabolic causes, and infectious processes. brain mri : the diffusion images demonstrate subtle areas of slow diffusion in the right frontal cortical region with a small area of subcortical acute infarct in the right frontal lobe. a similar small area of signal abnormality is seen on diffusion images in the left parietal cortical region. the findings are suggestive of acute infarcts. there is no mass effect, midline shift, or hydrocephalus seen. there are no chronic territorial infarcts visualized. there is no evidence of significant subcortical white matter ischemic disease seen. 06:00am blood wbc-7.1 rbc-3.09* hgb-9.9* hct-28.0* mcv-90 mch-31.9 mchc-35.3* rdw-14.1 plt ct-167 06:00am blood glucose-122* urean-34* creat-1.9* na-140 k-4.0 cl-101 hco3-28 angap-15 09:35am blood %hba1c-6.9* -done -done 06:00pm blood triglyc-235* hdl-35 chol/hd-3.8 ldlcalc-52 brief hospital course: as mentioned in the hpi, patient was transferred from osh for cardiac catheterization. after cardiac catheterizaion - see above results, cardiac surgery was consulted for surgical revascularization. patient had usual work-up along with an echocardiogram - see above results. plavix was stopped on . patient was consented for surgery and brought to the operating room on . he underwent a coronary artery bypass graft x 4. please see op note for surgical details. following surgery patient was transferred to the csru in stable condition on a neo-synephrine drip. within 24 hours, he awoke neurologically intact. mechanical ventilation was weaned and patient was extubated. beta blockers and diuretics were initiated. patient was gently diuresed towards pre-op weight. his creatinine peaked to 2.3 on postoperative day two. he required foley reinsertion at that time for urinary retention but did not become oliguric. mr. experienced altered mental status, along with fluctuations in level of alertness and incoherent speech. the neurology service was consulted to evaluate for potential embolic etiology and/or seizure. a head ct scan on showed no evidence of intracranial hemorrhage or of acute territorial infarction. carotid ultrasound was notable for bilateral carotid disease, report stating that there was a significant amount of plaque at the origins of the bilateral internal carotid arteries, associated with luminal narrowing estimated between 80 and 99% in diameter on both sides. an eeg on was deemed abnormal due to the presence of diffuse background slowing and superimposed bursts of generalized mixed frequency delta and theta slowing. no focal or epileptiform features were seen. findings were suggestive of an encephalopathy. narcotics were avoided and blood sugar managment was optimized. he was also transfused to maintain hematocrit near 30%. mri imaging of the brain on was notable for findings suggestive of small acute cortical and subcortical infarcts in the right frontal lobe and possibly in the left parietal lobe. there was no evidence of mass effect or hydrocephalus. there was no indication for warfarin anticogulation. over several days, his neurological symptoms improved as did his renal function. he continued to make clinical improvements with medical therapy and made steady progress with physical therapy. he remained in a normal sinus rhythm. he responded nicely to diuresis and was tolerating room air by discharge. he was cleared for discharge to home on postoperative day five. at discharge, his bp was 130/70 with a hr in the 80's. room air saturations were 99% and all wounds were clean, dry and intact. given his carotid disease, his goal sbp was between 120-140 to ensure adequate cerebral perfusion. also at discharge, he was voiding without difficulty. medications on admission: asa 325mg qd plavix 75mg qd lipitor 20mg qd lisinopril 20mg qd lopressor 25mg glyburide 2.5mg qd glucophage 1000mg discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 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. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 4. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 5. glyburide 2.5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home with service facility: home services discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 hypertension hypercholesterolemia diabetes mellitus acute on chronic renal insufficiency postoperative stroke with ?encephalopathy bilateral carotid disease discharge condition: good discharge instructions: can take shower. wash incisions with water gentle soap. gently pat dry. do not apply lotions, creams, or ointments to incisions. do not bath. do not drive for 1 month. do not loft greater than 10 pounds for 2 months. make follow-up appointments and take all medications. if you notice any redness or drainage from incisions, please contact office immediately followup instructions: provider: , . follow-up appointment should be in 1 month provider: , . follow-up appointment should be in 3 weeks provider: , follow-up appointment should be in 2 weeks 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 transfusion of packed cells continuous intra-arterial blood gas monitoring diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome pure hypercholesterolemia unspecified essential hypertension diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes personal history of tobacco use percutaneous transluminal coronary angioplasty status other nervous system complications occlusion and stenosis of carotid artery without mention of cerebral infarction old myocardial infarction unspecified disorder of kidney and ureter other complications due to other cardiac device, implant, and graft family history of ischemic heart disease 

Answer: The patient is high likely exposed to