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: aspirin / ciprofloxacin / penicillins attending: chief complaint: chest pain major surgical or invasive procedure: : cardiac catheterization history of present illness: 80yo male with known cad (s/p cabg in , stent 3', cabg 6'), dm, and htn who presents with crescendo chest pain. patient reports 7/10 chest pain radiating to left armpit and down back of left arm without associated symptoms while he was moving boxes. it is the same characteristic chest pain as the one that occured with mi in . pain is usually brought on by exertion and is relieved by rest or by nitro patch. pt was free of chest pain for 10 years after initial cabg, however chest pain recurred in '. at the time, the pain only occured once every four months and was in severity. since then it has become progressively more frequent and more severe requiring further intervention. pt received a cardiac catheterization for chest pain in and at the time, all the bypass grafts were reported to be widely patent. since then, the patient has moved to and in the last month, in the setting of moving from nj to , the patient has experienced 2 episodes of chest pain with exertion in one week. this particular admission was prompted by an episode of chest pain that was more severe than before and did not resolve with nitro patch. the patient denies associated sx of diaphoresis, nausea, vomiting, shortness of breath, lightheadedness. past medical history: 1. cad s/p cabg in ' at presbytarina in , s/p stent in 3', and another cabg in 6' at heart center in d.c. 2. dmii 3. htn 4. neuorpathy in foot bilaterally 5. carotidendarterectomy in ' (r) and ' (l) social history: pt is a retired computer programmer who recently moved to with his wife to be closer to his children. tob: 1ppd x35years but quit in etoh: one beer/week for 30 years illicit drug use: denies family history: mother - mi at age of 72 father - brain tumor brother - 1st mi at age 50 brother - kidney failure physical exam: p/e on admission: vs: bp: 157/49 hr: 66 rr: 16 sao2: 100% ra gen: male in no acute distress lying in bed the news paper. heent: r pupil 3mm, l pupil 2mm, both non-reactive, anicteric, mmm neck: no jvd appreciated, no lad cv: rrr, s1, s2, no murmurs, rubs, or gallops abd: obese, bs+, soft, nt, nd, liver span 8cm, slighly pulsating liver ext: no clubbing, cyanosis, edema, dp +2 bilaterally neuro: cn ii-xii grossly intact. strength: in grip, biceps, triceps, quads, hamstring, calf, toes reflex: 0 to +1 biceps and forearm, +1 knee jerk and absent ankle jerks bilaterally pe on admission to ccu (): vitals 97.6 110-143/38-50 (110/50) 52-72 97%ra fs 119-163-111 i/o 24h: > weight (): 79.1 gen: pleasant, nad heent: mmm neck: supple, no jvd cv: regular, 4/6 systolic murmur left upper and lower sternal border as well as rusb. lungs: clear abd: soft +bs non tender ext: w/wp, poor foot hygeine, 2+ dp pulses, trace pitting mid shin edema to mid shin bilaterally; 5/5 strength neuro: aox3; attentive pertinent results: 04:00pm wbc-6.2 rbc-4.28* hgb-12.0* hct-35.0* mcv-82 mch-28.1 mchc-34.4 rdw-13.4 04:00pm plt count-180 04:00pm pt-13.0 ptt-25.9 inr(pt)-1.1 04:00pm glucose-162* urea n-32* creat-1.2 sodium-139 potassium-3.9 chloride-102 total co2-27 anion gap-14 04:00pm ck(cpk)-52 04:00pm ck-mb-notdone ctropnt-<0.01 lipid panel lipid/cholesterol triglyc 146 hdl 31 chol/hd 3.4 ldlcalc 46 ldlmeas 61 ecg: normal sinus rhythm at 63; lad, normal p wave, inverted p in v2, very small q in i, marginally wide qrs in ii, ? 1mm upsloping st elevation in v2 (no comparisons with old ecg could be made as we await arrival of medical records from various hospitals) : cardiac cath "final diagnosis: 1. severe distal branch three vessel coronary artery disease. 2. mild focal systolic left ventricular dysfunction. comments: 1. coronary angiography of this right dominant system revealed severe distal branch three vessel coronary artery disease. the left main coronary artery demonstrated mild in-stent restenosis and plaquing up to 30%. the lad revealed proximal diffuse plaquing with competitive flow beyond the mid lad after d2 distal to a 70% stenosis. the lcx was totally occluded proximally. the rca demonstrated a proximal tubular subtotal occlusion followed by mid total occlusion. 2. bypass graft venography revealed a patent svg-om1-om2 graft that supplied a small om1 with a distal bifurcation lesion of 70% and the upper pole of the om2 which filled the lower pole via retrograde flow through an 80% stenosis. retrograde perfusion of the av groove lcx and up the om1 via a diffuse subtotal occlusion in the proximal om1 was also noted. the svg-pda contained a 30% proximal stenosis and anastamosed to a small branch of the pda which was diffusely diseased. 3. angiography of the arterial conduit revealed a proximal 20% stenosis of the lima-d1-lad. the diagonal demonstrated aneurysmal dilitation. the conduit supplied a small segment of the mid lad and the recanalized total occlusion of the apical lad. 4. the left subclavian demonstrated mild proximal plaquing without flow-limitation or pressure gradient. 5. limited resting hemodynamics upon entry revealed normal left sided filling pressures (lvedp was 8 mm hg). mild central hypertension was noted (aortic systolic pressure 140 mm hg). there was no significant gradient across the aortic valve upon pullback of the catheter from the left ventricle to the ascending aorta. 6. left ventriculography revealed a contrast calculated ejection fraction of 63%. focal left ventricular dysfunction was present with posterobasal hypokinesis. no significant mitral regurgitation was noted." brief hospital course: a/p: 80yo male with known, cad, dm, htn who presents with crescendo angina. usually cp is brought on by exercise and resolves with rest/nitro, however this am, pain did not resolve with nitro prompting admission. 1. chest pain pt was started on a nitro gtt at time of admission as pt continued to complain of slight chest pressure. the nitro gtt was titrated to pain free state while keeping sbp >100. cardiac enzymes were cycled and were negatives x3. the patient was optimized with toprol xl 50mg once daily, altace 10mg once daily, asa 325mg, lipitor 80mg once daily and cardiac cathed on . the cath showed severe distal branch three vessel coronary artery disease and a mild focal systolic left ventricular dysfunction. (the details of the cath report can be found under pertinent results). the patient was titrated off nitro gtt and started on nitro paste as a bridge to long acting nitrates and remained pain free. however on the am after the cath, the patient was found to have diastolic pressure of 38 prompting removal of the nitro paste. subsequently the patient's diastolic pressure returned to the base line of 40s-50s. sbp were all within normal limits during this time although slightly lower than baseline. 2. asa allergy: due to the patient's aspirin allergy, the patient has been on plavix since admission. after cath, the patient was transferred to the ccu for desensitization to asa trial, allergy was consulted. the desensitization trial was successful and the patient was discharged after having taken several doses of asa in house without incident. 3. htn: pt was continued on his hypertensive regimen in addition to the cardiac regimen listed above. this included diltiazem 240mg qhs, triamtrine and terazosyn 5mg qhs. 4. dm: this has not been an active issue during admission. the patient was continued on his home regimen of metformin 500mg once daily. 5. dispo: pt is independent at home with good family support. pt was discharge home without services hemodynamically stable and without chest pain. medications on admission: altace 10mg once daily diltiazem 240mg qhs terazosyn 5mg qhs metformin 500mg once daily triamcinalone/hctz (triamtrine) 37.5-25 once daily zocor 20mg qhs toprol xl 50mg once daily folgard 800mg once daily saw - for urination urge discharge medications: 1. terazosin hcl 5 mg capsule sig: one (1) capsule po hs (at bedtime). disp:*30 capsule(s)* refills:*2* 2. simvastatin 10 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). disp:*60 tablet(s)* refills:*2* 3. metoprolol succinate 50 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po qd (once a day). disp:*30 tablet sustained release 24hr(s)* refills:*2* 4. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*0* 5. diltiazem hcl 240 mg capsule, sustained release sig: one (1) capsule, sustained release po qhs (once a day (at bedtime)). disp:*40 capsule, sustained release(s)* refills:*2* 6. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) sublingual prn as needed for chest pain. disp:*30 tablets* refills:*0* 7. aspirin ec 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 8. isosorbide dinitrate 10 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 9. lisinopril 5 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 10. metformin hcl 500 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: cad secondary: dm, htn, asa desensitization discharge condition: fair. discharge instructions: please follow up with your pcp. if you experience any discomfort/chest pain please stop what you are doing and call your pcp. followup instructions: primary care: please follow up with your pcp 2 weeks of discharge. cardiology: please follow up with your cardiologist within 2 months of discharge. procedure: coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization other and unspecified coronary arteriography diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled coronary atherosclerosis of autologous vein bypass graft hematoma complicating a procedure hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other complications due to other cardiac device, implant, and graft unspecified hereditary and idiopathic peripheral neuropathy 

Answer: The patient is high likely exposed to