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: transferred from outside hospital for coronary and carotid cath major surgical or invasive procedure: carotid cath coronary cath history of present illness: 64 yr old hypertensive, diabetic male with cad s/p cabg ' and b/l carotid disease transferred from osh after an episode of chest pain and aphasia. he was in his usoh until when at noon he developed substernal chest "burning" while sitting at his office. he noticed that his speech was slurred and "the words wouldn't come out." when his wife called him she noted that his words "made no sense" "he was saying nonsense." she thought he might have been hypoglycemia and gave him some coke, after which his symptoms improved. they called ems and were taken to hospital. a head ct was (-) for bleed and trop-i+ 0.87. ck 200. he received 2 doses of 1 mg/kg lovenox and was transferred to . he had lad stent in . a few days later, he has rca stented and has myoclonic jerk, not seizure in the cath lab per neurology attending ros: (-) sob/palp/edema/n/v/weakness/numbness/ha. past medical history: ##cad s/p cabg in with ef 50% by lvg. he has chest pain with lifting boxes. lima>>lad, svg>>diag - ett thal for 2 minutes with hr 130, 2 mm horizontal lateral st depressions. ##non-insulin dependent diabetes mellitus x 10 years. ##hypertension ##hypercholesterolemia ##stroke/tia with no residual defects. carotid u/s in with right ica occlusion and left 80-99% stenosis. followed by dr. (cardiology) and dr. (vasc ). ## b/l claudication social history: quit smoking 25 years ago. no etoh. works as a mechanic. lives with wife. 2 adopted children. family history: mother mi at 60 physical exam: temp: afebrile bp:120/82 hr:60 rr:12 o2:99 ra gen: nad, a/o x 3 heent: pearla. eomi. op w/o lesions. cv: rr. soft ii/vi systolic murmur at llsb. jvd flat. sternotomy incision c/d/i. pulm: cta b/l abd: s/nt/nd ext: no edema. s/p vein graft incision c/d/i. 1+dp/pt neuro: motor at all flexors/extensors. sensation: gi to light touch and pinprick. intact. ftn intact. cnii-xii: gi pertinent results: at osh: na:138, k:4.3, bun:20, cr:1.4, inr:0.9, wbc:10.1 hgb:14.6, plt:171 ecg: nsr at 56. qs in iii, f. j-pt elevation in v1, v2, ii, f. lateral twi (dynamic). nl axis/intervals. cxr: no cp processes : chronic right occipital cortical infarct, chronic deep white matter infarction due to small vessel disease, small lacunar infarct in left thalamus. cath : 1. significant native coronary artery disease. 2. severe bilateral internal carotid artery disease. 3. arterial disease in the left subclavian and bilateral vertebrals 4. successful placement of self-expanding stent in left ica. 5. successful employment of accunet distal embolic protection. 6. self-limited, brief myotoclonus event. comments: 1. limited coronary angiography demonstrated a right dominant system with left main and severe native vessel disease. the lmca had an ostial 60% lesion. the proximal and midvessel lad had diffuse calcific disease. the distal lad filled via a lima which was not selectively engaged. the d1 branch was totally occluded. the lcx had mild diffuse disease. the rca and bypass grafts were not successfully engaged. 2. limited resting hemodynamics revealed a central blood pressure of 132/57 mmhg and a left cfa pressure of 101/67 mmhg. the mean gradient was 3 mmhg. 3. retrograde access of the left common femoral artery was obtained for selective carotid, vertebral, and coronary angiography. the thoracic aorta had a type i arch. the bilateral subclavian arteries had mild proximal disease. the left subclavian artery had a 50% lesion in the origin with a peak to peak gradient of 20 mmhg. 4. the right vertebral artery was small and diminutive with a total occlusion at the base of the skull before entering the brain. the left vertebral artery was large and was noted to have a 60% origin lesion and filled the basilar and the cerebellar arteries. the contralateral pca filled from the vertebral but the ipsilateral (left) pca was not seen. 5. the right common carotid artery was without disease but the ica was totally occluded. the left common carotid artery was without disease but the ica had diffuse tubular 80% disease. the left ica filled the ipsilateral aca and mca as well as the contralateral aca and mca via a large acom. 6. successful placement of a x 40 mm acculink stent in the left ica postdilated with a 4.5 mm balloon. final angiography demonstrated no residual stenosis, no angiographically apparent dissection, and normal flow (see ptca comments). 7. transient, self-limited myoclonic event during postdilation which was though not likely to represent seizure activity. 8. successful perclose of the left femoral arteriotomy site at the conclusion of the procedure without complications. cath at osh : "multiple tight stenoses of the proximal lad and proximal d1. proximal d2 occluded. rca proximally occluded. lima to lad patent, svg to diag could not be visualized and was presumed occluded. left carotid patent, right carotid occluded." cardiac cath 1. three vessel coronary artery disease. 2. rotation atheterectomy of the proximal lad. 3. unsuccessful attempt at ptca/stenting of the d1. comments: 1. selective coronary angiography revealed a right dominant system. the rca was not injected. the svgs and the lima were not injected. the lmca had a 60% ostial stenosis. the proximal lad 80% calcific stenosis. the distal lad was filling via a lima (there was competitive flow). the d1 had a 80% calcific stenosis at the origin. the lcx had mild diffuise disease. 2. unsuccessful attempt at ptca/stenting of the d1 due to inability to cross despite using multiple wires. rotational atherectomy was performed in the lad in an attempt to modify the lad lesion and allow crossing inro the d1 (see ptca comments). carotid series : reason: known carotid atherosclerosis, pre-op for stenting. findings: duplex evaluation was performed of both carotid arteries. significant plaque was identified on the right. there is no flow in internal carotid artery including power doppler technique. of note there is no study for comparison. on the left, significant mostly soft appearing homogeneous plaque is identified in the internal carotid artery. of note it appears to extend fairly distally in the cervical internal carotid artery. on the right, peak systolic velocities are 52, 72 in the cca, eca respectively. on the left, in the internal carotid artery the peak systolic over diastolic velocity is 361/123. in the remainder of the vessel the peak systolic velocities are 54, 584 in the cca, eca respectively. the ica-cca ratio is 6. this is consistent with an 80-99% stenosis. 05:48pm glucose-97 urea n-18 creat-1.2 sodium-143 potassium-4.0 chloride-105 total co2-28 anion gap-14 05:48pm alt(sgpt)-32 ast(sgot)-29 ck(cpk)-168 05:48pm calcium-9.3 phosphate-3.2 magnesium-1.8 05:48pm wbc-7.5 rbc-4.46* hgb-14.0 hct-40.8# mcv-92 mch-31.4 mchc-34.3 rdw-13.0 05:48pm plt count-195# 05:48pm pt-13.2 ptt-32.6 inr(pt)-1.1 brief hospital course: 64 y.o. male with cad status post cabg, history of tia with bilateral carotid stenosis presents s/p episode of chest pain and aphasia with borderline elevation in tn-i and non-specific ant/lateral st-t wave changes. he was admitted for coronary and carotid cath.patient had cardiac catheterization on and was discovered to have severe bilateral internal carotid artery disease and also arterial disease in the left subclavian and bilateral vertebrals. successful placement of self-expanding stent in left ica and successful employment of accunet distal embolic protection. patient was admitted briefly to ccu for observation overnight. he did well and has no neurological events. his blood pressure was kept between 120-140. he did well and was discharged the following day medications on admission: glipizide xl 5, fish oil 1000mg, ca 600 , mvi, garlic pill 1250, loratadine, asa 325, atenolol 50, metformin 1000mg, nexium 40 daily, lisinopril 5 tid, lipitor 20, zetia 10, doxazosin 4. coumadin was d/c'd 3 months ago discharge medications: 1. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). disp:*60 tablet, chewable(s)* refills:*2* 4. multivitamin capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 5. omega-3 fatty acids 120-180-1.8 mg-mg-unit capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 6. fexofenadine hcl 60 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 7. glipizide 5 mg tab, sust release osmotic push sig: one (1) tab, sust release osmotic push po daily (daily). disp:*30 tab, sust release osmotic push(s)* refills:*2* 8. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*9* 9. atorvastatin calcium 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: coronary artery disease carotid artery stenosis discharge condition: stable discharge instructions: please return to the hospital or call your doctor if you have chest pain/shortness of breath/dizziness/blur vision or if there are any concerns at all please take all your prescribed medication followup instructions: please call dr. , tomorrow to schedule an appointment procedure: left heart cardiac catheterization left heart cardiac catheterization coronary arteriography using a single catheter coronary arteriography using a single catheter percutaneous angioplasty of extracranial vessel(s) percutaneous insertion of carotid artery stent(s) diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension chronic airway obstruction, not elsewhere classified atherosclerosis of native arteries of the extremities with intermittent claudication aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes personal history of tobacco use other and unspecified hyperlipidemia old myocardial infarction unspecified disorder of kidney and ureter occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction aphasia examination of participant in clinical trial myoclonus 

Answer: The patient is high likely exposed to