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: latex attending: chief complaint: chest pain major surgical or invasive procedure: coronary artery bypass grafting x4 with left internal mammary artery to left anterior descending coronary artery; reverse saphenous vein single graft from the aorta to the ramus intermedius coronary artery; reverse saphenous vein single graft from the aorta to the first obtuse marginal coronary artery; reverse saphenous vein single graft from the aorta to the distal right coronary artery history of present illness: 73 yo m without cardiac history who presented to outside hospital ed with substernal chest pain during the night. patient took tums thinking it was his usual gerd, but it did not help initially. the next day his pcp instructed him to go to the ed where his trop was 0.1 with ekg showing std in inferior and lateral leads. he was transferred to for cardiac catheterization where he was found to have lm and 3vd. we are asked to evaluate for surgical revascularization. past medical history: gastro-esophageal reflux disease benign positional vertigo cervical pinched nerve social history: -dentist -tobacco history: none, no history -etoh: none, history of social use (occasional drink) -illicit drugs: none, no history family history: no family history of early mi or sudden cardiac death; otherwise non-contributory. physical exam: on admission to floor: vs: t= 97.6 bp= 182/93 hr= 70 rr= 18 o2 sat=99%ra general: wdwn male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple, no jvd. cardiac: rr, normal s1, s2. no r/g. no s3 or s4. +sem @ rusb lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. abd aorta not enlarged by palpation. extremities: no c/c/e skin: no stasis dermatitis, ulcers, scars, or xanthomas pulses: radial, dp strong and symmetric pertinent results: echocardiography report , (complete) done at 1:54:04 pm final referring physician information , c. , status: inpatient dob: age (years): 73 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: coronary artery disease. hypertension. shortness of breath. for cabg. icd-9 codes: 402.90, 786.05, 786.51 test information date/time: at 13:54 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2010aw1-: machine: aw1 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.5 cm <= 4.0 cm left ventricle - septal wall thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.3 cm <= 5.6 cm left ventricle - systolic dimension: 4.3 cm left ventricle - fractional shortening: *0.19 >= 0.29 left ventricle - ejection fraction: 40% >= 55% left ventricle - stroke volume: 51 ml/beat aorta - annulus: 2.1 cm <= 3.0 cm aorta - sinus level: 2.9 cm <= 3.6 cm aorta - sinotubular ridge: 2.2 cm <= 3.0 cm aorta - ascending: *3.5 cm <= 3.4 cm aorta - arch: 3.0 cm <= 3.0 cm aortic valve - peak velocity: 1.1 m/sec <= 2.0 m/sec aortic valve - mean gradient: 7 mm hg aortic valve - lvot vti: 18 aortic valve - lvot diam: 1.9 cm aortic valve - valve area: *1.9 cm2 >= 3.0 cm2 mitral valve - mva (p t): 3.7 cm2 mitral valve - e wave: 0.7 m/sec mitral valve - a wave: 0.7 m/sec mitral valve - e/a ratio: 1.00 findings left atrium: mild la enlargement. no mass/thrombus in the laa. no spontaneous echo contrast is seen in the laa. good (>20 cm/s) laa ejection velocity. left ventricle: normal lv wall thickness. normal lv cavity size. mildly depressed . right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. mildly dilated descending aorta. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. no as. trace ar. mitral valve: no ms. physiologic mr (within normal limits). tricuspid valve: physiologic tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. physiologic (normal) pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. results were personally reviewed with the md caring for the patient. conclusions pre cpb: the left atrium is mildly dilated. no mass/thrombus is seen in the left atrium or left atrial appendage. no spontaneous echo contrast is seen in the left atrial appendage. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is mildly depressed (= 40 %). right ventricular chamber size and free wall motion are normal. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets, there is limited excursion of the left coronary cusp. there is no aortic valve stenosis. trace aortic regurgitation is seen (between left and noncoronary cusps). physiologic mitral regurgitation is seen (within normal limits). dr. was notified in person of the results. post cpb: the aortic contours are intact. there is no change in the baseline trivial mr. is improved to > 50%; the rvef continues to be within normal limits. 04:30am blood wbc-7.7 rbc-3.10* hgb-10.1* hct-27.8* mcv-90 mch-32.7* mchc-36.4* rdw-14.8 plt ct-206 04:30am blood pt-14.2* inr(pt)-1.2* 04:30am blood glucose-110* urean-27* creat-1.0 na-136 k-3.8 cl-97 hco3-28 angap-15 brief hospital course: mr. is a 73 year-old male with no significant past medical history who presented with chest pain, found to have nstemi, was taken for cardiac catheterization which revealed multi-vessel coronary disease. on he underwent coronary artery bypass grafting times x4 (left internal mammary artery to left anterior descending coronary artery; reverse saphenous vein from the aorta to the ramus intermedius coronary artery; reverse saphenous from the aorta to the first obtuse marginal coronary artery; reverse saphenous vein from the aorta to the distal right coronary artery)performed by dr. . please see the operative note for further details. he tolerated this procedure well and was transferred to the surgical intensive care unit in critical but stable condition, intubated and sedated. he awoke neurologically intact and was extubated without difficulty. all drips were weaned off and he was started on beta-blocker/statin/aspirin, and diuresis. all lines and drains were discontinued in a timely fashion. pod#1 he went into postoperative atrial fibrillation. it was treated with amio and increased beta-blocker. he had a few episodes of converting back into nsr but most of his postoperative course he remained in atrial fibrillation/flutter. overdrive pacing with his epicardial wires was attempted and failed. anticoagulation was started with coumadin, inr goal >2.0. pod#3 he was transferred to the step down unit for further monitoring. physical therapy was consulted for evaluation of strength and mobility. the remainder of his hospital course was essentially uneventful. prior to his discharge, coumadin dosing/inr monitoring was arranged with his pcp, .. he was cleared by dr. for discharge to home with vna on pod 7. all follow up appointments were advised. medications on admission: prilosec 20 mg tums discharge medications: 1. 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* 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 5. warfarin 2 mg tablet sig: one (1) tablet po once a day for 1 doses: dose to change daily for goal inr , dr. to manage. disp:*60 tablet(s)* refills:*2* 6. outpatient lab work labs: pt/inr for coumadin please use hemosence machine for each inr goal inr for afib first draw results to phone fax the office of dr. fax (. plan confirmed with from dr. office 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 8. 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. disp:*120 tablet(s)* refills:*2* 9. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). 10. furosemide 20 mg tablet sig: one (1) tablet po once a day for 10 days. disp:*10 tablet(s)* refills:*0* 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 10 days. disp:*10 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: primary: coronary artery disease secondary: hypertension hyperlipidemia gastroesophageal reflux disease benign positional vertical discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. 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 until follow up with surgeon 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. on at 1pm cardiologist:dr on at 9am please call to schedule appointments with your primary care dr. , w **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin goal inr for afib first draw tuesday results to the office of dr. fax (. plan confirmed with from dr. office procedure: venous catheterization, not elsewhere classified (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 other surgical extraction of tooth diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation atrial flutter other and unspecified hyperlipidemia dental caries, unspecified benign paroxysmal positional vertigo 

Answer: The patient is high likely exposed to