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: statins-hmg-coa reductase inhibitors / norvasc / beta-blockers (beta-adrenergic blocking agts) attending: chief complaint: epigastric burning and shortness of breath with exertion major surgical or invasive procedure: cardiac catheterization coronary artery bypass grafting time four: left internal mammary artery grafted to left anterior descending, reverse saphenous vein graft to the posterior descending artery, marginal branch, diagonal branch. history of present illness: this is a 56 yo male with history of hypertension, hyperlipidemia, and strong family history of cad who reports shortness of breath and abdominal discomfort for the past six month. the patient underwent abdominal ultrasound and ct to workup his abdominal discomfort. this revealed a right renal mass, which is likely cancerous. the patient was schedule to have this resected at hospital in . he was referred for cardiac catheterization as part of preoperative surgical clearance. past medical history: - hypertension - hyperlipidemia - type ii diabetes mellitus - right renal mass 3cm, presumed cancerous-schedule for surgical resection at hospital on - history of kidney stones - anxiety/depression/panic attacks for past 6 months - history of duodenal ulcer as child - chronic back pain d/t pinched nerve- r leg goes numb with prolonged standing - benign prostatic hypertrophy - history of testicular cancer - s/p surgery for undescended testicle age 10 - s/p removal of testicle social history: pt is single, lives alone in ct. works as mail carrier. prior heavy etoh, none in 25 years. occasional cigars 3-4x/ week family history: mother with mi at age 42. brother with cardiac stent age 45 physical exam: pulse:93 resp: 18 o2 sat: 97% ra b/p right:195/94 left:213/100 height:5'6" weight:300 lbs general: obese male in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom thick neck chest: lungs clear bilaterally anteriorly heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema 1+ le varicosities: none neuro: grossly intact pulses: femoral right:1+ left:1+ dp right:1+ left:1+ pt :1+ left:1+ radial right:2+ left:2+ carotid bruit: none pertinent results: wbc-11.0 rbc-4.47* hgb-12.8* hct-38.5* rdw-14.6 plt ct-230 pt-11.7 ptt-25.2 inr(pt)-1.0 glucose-186* urean-19 creat-0.6 na-141 k-4.1 cl-105 hco3-25 alt-20 ast-11 alkphos-76 amylase-37 totbili-0.2 %hba1c-8.1* triglyc-178* hdl-40 chol/hd-5.4 ldlcalc-138* cardiac catheterization: 1. selective coronary angiography in this right dominant system demonstrated three vessel disease. the lmca had an 80% stenosis in the distal portion of the vessel. the lad had a 80% proximal stenosis, a 70 mid vessel stenosis and a 80% distal vessel stenosis. the cx had a 70% stenosis in the proximal portion of the vessel. the rca had an 80% stenosis in the distal portion of the vessel and there was diffuse plaquing all throughout the rca. 2. limited resting hemodynamics reveal elevated left sided filling pressures with an lvedp of 20 mmhg. there was no transaortic valve gradient on pullback from the lv to the aorta. the central aortic pressure was 153/85 mmhg. echocardiogram: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. transmitral doppler and tissue velocity imaging are consistent with grade i (mild) lv diastolic dysfunction. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the number of aortic valve leaflets cannot be determined. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. there is an anterior space which most likely represents a fat pad. impression: mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function. mild diastolic lv dysfunction. no significant valvular disease seen chest ct scan: in the left lobe of the thyroid, a 2.5 cm nodule is seen. this nodule should be further worked up with ultrasonography. otherwise, there are no abnormalities in the upper mediastinum. generally, in the mediastinum, no enlarged lymph nodes are seen. extensive coronary calcifications. there is no evidence of pleural effusions or other pleural pathology. in the lung parenchyma, in the right apex (3, 9), a 3-4 mm nodule is seen. otherwise, there is no evidence of nodular lung lesions, notably no evidence of lesions suspicious for metastasis. the airways are patent. no evidence for airway lesions. at the left lateral margin of the spleen (2, 58) a small calcification is seen. small gallbladder stone (2, 62). 2-mm right renal calculus (2, 68). the bone windows show moderate degenerative vertebraldisease, but no evidence of bone destruction. carotid ultrasound: there is antegrade right vertebral artery flow. there is antegrade left vertebral artery flow. right ica stenosis <40%. left ica stenosis <40%. brief hospital course: mr. was admitted and underwent cardiac catheterization which revealed severe three vessel coronary artery including left main lesion - see result section for further details. cardiac surgery was consulted and further preoperative evaluation was performed. this was highlighted by an echocardiogram, chest ct scan and carotid ultrasound - see result section for additional details. the echocardiogram showed only mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function, mild diastolic lv dysfunction, and no significant valvular disease. carotid ultrasound showed minimal disease of both internal carotid arteries. chest ct scan revealed a thyroid nodule and right upper lobe nodule, but there was no evidence of lesions suspicious for metastasis. he remained pain free on medical therapy and was eventually cleared for surgery. on , dr. performed coronary artery bypass grafting surgery. please see operative note for details. following surgery, he was brought to the cvicu for invasive monitoring. within 24 hours, he awoke neurologically intact and was extubated without incident. he maintained stable hemodynamics and weaned from pressor support without difficulty. on postoperative day one, he transferred to postop floor to begin increasing his activity level. chest tubes and pacing wires removed per protocol. his calcium channel blockers were uptitrated (beta blockade was not started as her is allergic to this class of drugs). he was started on kefzol for serosanguinous sternal drainage without erythema or a sternal click. he was cleared for discharge to home on pod #5 with ten days of keflex and strict sternal precautions. his lantus dose was increased to 45 units at bedtime in response to elevated blood sugars and an admission hemoglobin a1c of 8.1. dr. has recommended to mr. and his urologist that he not undergo his renal mass surgery for six weeks after his bypass surgery. he was requested to make all followup appts as per discharge instructions. medications on admission: metformin 1000mg diltiazem sr 180mg daily asprin 81mg daily (on hold for renal surgery) lantus 40units at bedtime benicar hct 40- 12.5mg, 1 tab daily glipizide 20mg daily flomax .4mg daily cymbalta 90mg daily percocet 7.5-325mg prn back pain (takes daily) 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. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). disp:*30 capsule, sust. release 24 hr(s)* refills:*2* 3. 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* 4. duloxetine 30 mg capsule, delayed release(e.c.) sig: three (3) capsule, delayed release(e.c.) po daily (daily). disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 5. oxycodone 10 mg tablet sustained release 12 hr sig: three (3) tablet sustained release 12 hr po q12h (every 12 hours) as needed for pain. disp:*30 tablet sustained release 12 hr(s)* refills:*0* 6. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. diltiazem hcl 90 mg tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 8. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. oxycodone 5 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 10. lasix 40 mg tablet sig: one (1) tablet po once a day for 14 days. disp:*14 tablet(s)* refills:*2* 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 14 days. disp:*14 tab sust.rel. particle/crystal(s)* refills:*2* 12. insulin glargine 100 unit/ml solution sig: forty five (45) units subcutaneous at bedtime. disp:*qs * refills:*2* 13. glipizide 10 mg tablet extended rel 24 hr (b) sig: two (2) tablet extended rel 24 hr (b) po once a day. disp:*60 tablet extended rel 24 hr (b)(s)* refills:*2* 14. keflex 500 mg capsule sig: one (1) capsule po four times a day for 10 days: sternal drainage. disp:*40 capsule(s)* refills:*2* discharge disposition: home with service discharge diagnosis: coronary artery disease, s/p cabg hyperlipidemia hypertension diabetes mellitus type ii obesity right renal mass, most like malignant thyroid nodule discharge condition: good discharge instructions: 1)no driving for one month 2)no lifting more than 10 lbs for at least 10 weeks from the date of surgery 3)please shower daily. wash surgical incisions with soap and water only. 4)do not apply lotions, creams or ointments to any surgical incision. 5)please call cardiac surgeon immediately if you experience fever, excessive weight gain and/or signs of a wound infection(erythema, drainage, etc...). office number is . 6)call with any additional questions or concerns. followup instructions: dr. in weeks, call for appt dr. in weeks, call for appt dr. in weeks, call for appt 6 wound check next friday , make appt prior to discharge f/u with your kidney surgeon- no surgery for 6 weeks procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization coronary arteriography using a single catheter angiocardiography of right heart structures diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome congestive heart failure, unspecified unspecified essential hypertension diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) malignant neoplasm of kidney, except pelvis dysthymic disorder other and unspecified hyperlipidemia morbid obesity personal history of malignant neoplasm of testis chronic diastolic heart failure nontoxic uninodular goiter 

Answer: The patient is high likely exposed to