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: tetracycline attending: chief complaint: coronary artery disease major surgical or invasive procedure: : coronary artery bypass grafting x4, with the left internal mammary artery to the left anterior descending artery, and reverse saphenous vein grafts to the second obtuse marginal artery, and sequential reverse saphenous vein graft to the posterior descending artery and the posterior left ventricular branch artery. history of present illness: 53 year old male with reports of chest burning associated with shortness of breath relieved with rest. this has been ongoing for the past six months. he completed a persantine stress test on . there were no chest pain symptoms or ischemic ecg changes with the persantine infusion. imaging revealed a previous large infarct or scar in the inferior and inferolateral wall extending from the base to the mid lv with a small amount of peri-infarct ischemia at the base of the inferolateral wall. there was mild hypokinesis of the basal inferior wall and the lvef was 46%. he was referred for cardiac catheterization. he was found to have coronary artery disease and is now being referred to cardiac surgery for revascularization. past medical history: hypertension hyperlipidemia lv dysfunction coronary artery disease perpherial vascular disease gout ? sleep apnea past surgical history: stents x 3 left internal iliac and common femoral stents x 2 right le social history: lives with:wife contact: (wife)phone #(home), (cell) occupation:propane truck driver cigarettes: smoked no yes current smoker, 1-1.5 ppd x30 years other tobacco use:denies etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use:denies family history: premature coronary artery disease- father died from mi at 72 physical exam: pulse:18 resp:53 o2 sat:18 admission b/p right:132/79 left:130/75 height:6'5" weight:107 kgs general: nad, aaox3 skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right: palp left: palp dp right: palp left: palp pt : palp left: palp radial right: palp left: palp carotid bruit right: none left: none pertinent results: echocardiogram left atrium: normal la and ra cavity sizes. right atrium/interatrial septum: normal ra size. normal interatrial septum. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness and cavity size. lv wall motion: regional left ventricular wall motion findings as shown below; remaining lv segments contract normally. right ventricle: normal rv chamber size and free wall motion. aorta: normal diameter of aorta at the sinus, ascending and arch levels. focal calcifications in descending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: moderate to severe (3+) mr. to the eccentric mr jet, its severity may be underestimated (coanda effect). tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. regional left ventricular wall motion: conclusions prebyass. large (4.9 by 2.1 cm basal inferior aneurysm consistent with prior inferior mi. the posteromedial papillary muscle is restrictive and this is the mechanism for the posteriorly directed mr jet which hugs the wall of the la (coanda effect) and appears to be consistent with moderate to severe mr with a vena contracta of 5.5cm which potentially underestimates the degree of mr. pulm venous flow reversal. other valves are essentially normal and no other segmental wall motion abnormalities. the left atrium and right atrium are normal in cavity size. left ventricular wall thicknesses and cavity size are normal. the remaining left ventricular segments contract normally. lvef = 40-45%. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. moderate to severe (3+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). there is no pericardial effusion. lateral mitral annular tissue doppler of 8.5 cm/sec consistent with normal diastolic function. mild descending thoracic aortic atherosclerotic plaque. intact ias. no clot in laa. normal coronary sinus cardiac catheterization: date: place: lmca: normal lad: mid 90% stenosis, d2 ostial 80% stenosis lcx: om1 mid 40% stenosis, om2 mid 60-70% stenosis, om3 mid 60-70% stenosis rca: ostial 100% stenosis 09:43am blood wbc-7.0 rbc-3.61* hgb-9.9* hct-30.3* mcv-84 mch-27.5 mchc-32.8 rdw-14.8 plt ct-245# 06:40am blood wbc-9.2 rbc-4.01* hgb-10.8* hct-33.0* mcv-82 mch-27.0 mchc-32.9 rdw-15.3 plt ct-147* 04:29am blood wbc-14.4* rbc-4.33* hgb-11.2* hct-36.6* mcv-85 mch-26.0* mchc-30.7* rdw-15.1 plt ct-185 05:20am blood pt-16.8* inr(pt)-1.6* 07:50am blood pt-13.6* inr(pt)-1.3* 06:32am blood pt-12.5 inr(pt)-1.2* 04:29am blood pt-12.2 ptt-30.5 inr(pt)-1.1 05:20am blood glucose-105* urean-23* creat-1.1 na-135 k-4.0 cl-96 hco3-27 angap-16 07:50am blood na-135 k-4.1 cl-97 06:32am blood na-133 k-4.2 cl-97 06:40am blood glucose-141* urean-23* creat-1.0 na-134 k-4.3 cl-100 hco3-26 angap-12 brief hospital course: the patient was brought to the operating room on where the patient underwent coronary artery bypass grafting x4, with the left internal mammary artery to the left anterior descending artery, and reverse saphenous vein grafts to the second obtuse marginal artery, and sequential reverse saphenous vein graft to the posterior descending artery and the posterior left ventricular branch artery. 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 and statin were initiated. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. pod2 he had an episode of rapid atrial fibrillation and converted to sinus rhythm with amiodarone. he remained hemodynamically stable. his ace was restarted. respiratory he was titrated off oxygen with aggressive pulmonary toilet and nebs. he was gently diuresed with a normal renal function and good urine output. he 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 with vna services in good condition with appropriate follow up instructions. medications on admission: atenolol 50 mg daily hydrochlorothiazide 12.5 mg daily indomethacin 50 mg lisinopril 30 mg daily nitroglycerin 0.4 mg tablet, 1-3 tablets sublingually prn simvastatin 40 mg daily aspirin 325 mg daily multivitamin one tablet daily discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po once a day for 2 weeks. disp:*28 tablet extended release(s)* refills:*0* 5. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily) for 2 weeks. disp:*14 patch 24 hr(s)* refills:*0* 6. bupropion hcl 75 mg tablet sig: two (2) tablet po bid (2 times a day) for 2 weeks. disp:*56 tablet(s)* refills:*0* 7. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 8. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): 2 tabs x 5days the 2tabs qd x7days then 1 tab qd. disp:*60 tablet(s)* refills:*1* 9. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 10. simvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* 11. furosemide 40 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 13. warfarin 2 mg tablet sig: as directed tablet po once a day: 5mg on then as directed by dr. . disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: coronary artery disease lv dysfunction hypertension hyperlipidemia perpherial vascular disease, s/p stents x 3 left internal iliac and common femoral, right le x 2 gout sleep apnea discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with dilaudid 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 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 cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: wound care nurse phone: date/time: 10:30 in the building , md phone: date/time: 1:00 in the follow-up with dr. /dr. ( at 1:30 at 112a , please call your pcp . for a follow-up appointment in weeks. inr check on and results called to: dr. 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 angiocardiography of left heart structures left heart cardiac catheterization diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery tobacco use disorder mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension gout, unspecified atrial fibrillation peripheral vascular disease, unspecified systolic heart failure, unspecified other and unspecified hyperlipidemia other and unspecified angina pectoris examination of participant in clinical trial aneurysm of heart (wall) 

Answer: The patient is high likely exposed to