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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: left heart catheterization coronary artery bypass grafting x5 with left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to the posterior descending artery and diagonal artery, and sequential reverse saphenous vein grafts to the first and second obtuse marginal artery. history of present illness: 62 year old male presented to ed with complaints of frequent exertional shoulder discomfort and burping. two weeks ago he noted sudden onset of sharp left shoulder pain with mild exertion and occasionally radiated to the left elbow which resolved with rest. last week he noted increased frequency of burping, chest/epigastric discomfort again usually with mild exertion though at least one time at rest, again accompanied by acid tasted in mouth and shoulder pain. at labs notable for positive troponin to 1.86. ekg showed sinus, <1mm stds in inferolateral leads, poor r wave progression and was transferred to for further evaluation. upon cardiac catheterization he was found to have three vessel disease and is now being referred to cardiac surgery for revascularization. past medical history: coronary artery disease hypertension hyperlipidemia cva years ago w/o residual deficits ?pyloric stenosis s/p repair as infant neck fracture right wrist fracture right ankle fracture past surgical history: left knee surgery social history: lives with wife. 3 sons. in finance at prudential center. smokes an occasional cigar. history of heavy smoking for 15 years (up to 5ppd) but quit at 33. drinks 3-5 drinks/night when out on business, no history of abuse. family history: father died of stroke at 57. mother healthy at 87. brother died in 40s of sudden death, not thought to be cardiac, ?related to dm physical exam: admission exam: vitals: 162/83 60 20 98%ra 90.8kg general: well-appearing, pleasant, nad heent: perrl, eomi neck: no carotid bruits, no jvd lungs: ctab, no w/r/r heart: rrr, normal s1 s2, no mrg abdomen: soft, nt, nabs, no organomegaly extremities: no c/c/e, 2+ dp/pt/femoral, no bruits neurologic: a+ox3 pertinent results: cardiac cath : site sys mean hr ao 138 73 85 51 . coronary angiography: right dominant lmca: distal 20% lad: mid vessel 50-60% distal to a very large diagonal which has origin and proximal 60% lcx: proximal 40% with om1 diffuse proximal 60%. total occlusion mid vessel before large om2 and small lpl which fill via left to left collaterals. rca: mild proximal disease with subtotal occlusion of the distal rca with collaterals from the lca filling the pda. . assessment & recommendations 1. secondary prevention cad 2. asa 81 mg po qd 3. hold further antiplatelet agents. 4. iv heparin till ck-mb peaks. 5. secondary prevention cad. 6. csurg consult. . intra-op tee conclusions prebypass no atrial septal defect is seen by 2d or color doppler. right ventricular chamber size and free wall motion are normal. lvef aproximately 55%.there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no 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 at 830 am. no transgastric views obtained. history of surgery on pylorus. post bypass patient is av paced and receiving an infusion of phenylephrine. biventricular systolic function is unchanged. mild mitral regurgitation persists. aorta is intact post decannulation. rest of the examination is unchanged . 06:01am blood wbc-9.2 rbc-3.88* hgb-11.9* hct-35.2* mcv-91 mch-30.8 mchc-33.9 rdw-12.9 plt ct-304 10:03am blood wbc-8.8 rbc-3.77* hgb-11.8* hct-34.5* mcv-91 mch-31.4 mchc-34.3 rdw-13.1 plt ct-244# 06:01am blood glucose-101* urean-18 creat-0.8 na-138 k-4.4 cl-100 hco3-29 angap-13 10:03am blood glucose-135* urean-17 creat-0.8 na-140 k-4.0 cl-100 hco3-32 angap-12 brief hospital course: medicine course: 62m with htn, hl here with exertional epigastric chest discomfort and shoulder pain, positive troponin, and ecg changes concerning for nstemi. cardiac cath revealed 3vd, scheduled for cabg . . # coronaries: patient presented with atypical chest symptoms initially felt to be gi in nature but are exertional and reproducible and now associated with positive troponin and lateral st depressions on ecg, consistent with true nstemi. patient was taken to the cath lab where diagnositc cath showed a right dominant system with 3 vessel coronary disease including lmca: distal 20%; lad: mid vessel 50-60% distal to a very large diagonal which has origin and proximal 60%; lcx: proximal 40% with om1 diffuse proximal 60%; total occlusion mid vessel before large om2 and small lpl which fill via left to left collaterals; rca: mild proximal disease with subtotal occlusion of the distal rca with collaterals from the lca filling the pda. due to the nature of his diseae the patient was reffered to cardiac surgery for coronary artery bipass grafting. he was placed on aspirin and heparin gtt as well as high dose atorvastatin for primary prevention in the preoperative period. paient's troponin was initially elevated, but never had an elevation in his ck-mb. . surgical course: the patient was brought to the operating room on where the patient underwent cabg x 5 w dr. . overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. 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. 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 5 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged home in good condition with appropriate follow up instructions. medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. lisinopril 10 mg po daily 2. simvastatin 20 mg po daily 3. aspirin 81 mg po daily 4. fish oil (omega 3) 1000 mg po daily discharge medications: 1. aspirin 81 mg po daily 2. fish oil (omega 3) 1000 mg po daily 3. lisinopril 20 mg po daily hold for sbp<100 rx *lisinopril 20 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*0 4. simvastatin 20 mg po daily 5. acetaminophen 325-650 mg po q4h:prn pain/temp 6. metoprolol tartrate 37.5 mg po bid hold for hr < 55 or sbp < 90 and call medical provider. *metoprolol tartrate 25 mg 1.5 tablet(s) by mouth once a day disp #*7 tablet refills:*0 7. oxycodone-acetaminophen (5mg-325mg) tab po q4h:prn pain rx *endocet 5 mg-325 mg tablet(s) by mouth every four (4) hours disp #*40 tablet refills:*0 8. furosemide 20 mg po daily duration: 1 weeks rx *furosemide 20 mg 1 tablet(s) by mouth once a day disp #*7 tablet refills:*0 9. potassium chloride 20 meq po daily duration: 1 weeks rx *klor-con 20 meq 1 packet by mouth once a day disp #*7 tablet refills:*0 discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease hypertension hyperlipidemia cva years ago w/o residual deficits ?pyloric stenosis s/p repair as infant neck fracture right wrist fracture right ankle fracture past surgical history: left knee surgery discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage edema: trace discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 **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: wound check at cardiac surgery office , phone: date/time: 10:30 surgeon dr. , 1:00 cardiologist dr. , md phone: date/time: 2:20 please call to schedule the following: primary care dr. , t. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization (aorto)coronary bypass of four or more coronary arteries diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension other and unspecified hyperlipidemia personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits chronic total occlusion of coronary artery 

Answer: The patient is high likely exposed to