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: codeine attending: chief complaint: chest tightness major surgical or invasive procedure: coronary angiography () coronary artery bypass graft x4 (left internal mammary artery > left anterior descending, saphenous vein graft > diagonal, saphenous vein graft > obtuse marginal, saphenous vein graft > posterior descending artery) history of present illness: 69 y old m with hx of htn, dm, hyperlipidemia, cad s/p bare metal stent to proximal left circumflex in , s/p angiography in with mild-moderate diffuse left main disease (not hd significant), 40% distal stenosis of lad, s/p stress-mibi in with 2-3mm horizontal st depression in inferior lateral leads at peak exercise, with nuclear portion showing reversible, small/mod perfusion defect involving the lad territory presenting now w/ episodic chest tightness over the past several weeks. chest tightness occurs "at random times" and not necessarily with activity, lasts about 60 minutes, then resolving sponteously. he has not taken anything for it (including nitroglycerine). pt stopped exercising about one year ago b/c he has "51 years left to live according to the book of genesis, chapter 6, verse 5" and so since he has to "spend of the remaining 51 years sleeping" he wants to spend it doing the things he enjoys. pt is able to walk several blocks without sob, and can walk up a flight of stairs without having to stop. also denies pnd, orthopnea, ankle edema, palpitations, syncope or presyncope. pt has been slightly more fatigued over the past few months, and had "some" weight gain. he was seen today in regular follow-up by dr. in clinic and who admitted pt directly into hospital for coronary angiography. . of note, pt has hx of reckless behaviors, affective instability and is currently being treated for presumed bipolar disorder (most recent episode depressed). he has not felt that his mood has excessively elevated lately and has not had a decreased need for sleep, or spent an unusual amt of money. past medical history: diabetes mellitus type ii hyperlipidemia hypertension sleep apnea, on cpap hx of irregular heart beat (pt reported) - states has had this for 50 years - appears to have had wenckeback during recovery at most recent stress test, sinus brady noted on several occasions presumed bipolar disorder - most recent episode was depression with si) hx of rheumatic fever as a child hx of heart murmur since childhood social history: works as a real estate developer. no tobacco or alcohol use ever. family history: there family history of premature coronary artery disease; mother had fatal mi at age 55. no sudden death. physical exam: vs - afebrile, bp 162/69, hr 58, rr 18, sao2 97% fs: 148 gen: wdwn middle aged male in nad. oriented x3. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: no jvd cv: pmi located in 5th intercostal space, midclavicular line. rr, soft i-ii/vi holosystolic murmur beat heard at lusb, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: small ventral hernia. soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. . pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: 09:50pm glucose-132* urea n-19 creat-1.5* sodium-141 potassium-3.9 chloride-106 total co2-28 anion gap-11 09:50pm estgfr-using this 09:50pm alt(sgpt)-27 ast(sgot)-21 ld(ldh)-175 alk phos-87 tot bili-0.3 09:50pm calcium-8.9 phosphate-3.6 magnesium-2.5 09:50pm wbc-7.0 rbc-4.58* hgb-13.4* hct-40.0 mcv-87 mch-29.3 mchc-33.6 rdw-14.4 09:50pm plt count-143* coronary angiography: ulcerating lesion in lmca with 70% stenosis,moderate diffuse disease in lad, lcx with widely patent stent; the av groove lcx is smnall and diffusely diseased after the large om2; rca moderate diffuse disease with 70% pda stenosis. echocardiogram: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. chest x-ray: small pleural effusions, probably unchanged; stable moderate-to- marked cardiomegaly. brief hospital course: pt was admitted to the cardiology service on 3 () at for diagnosis and treatment of the chest discomfort. pt was monitored on telemetry, and noticed to have type 1 2nd degree heart block with ventricular rate down into high 20s during leep and in the 50s while awake. pt was asymptomatic at all times. pt had unremarkable labs on admission including nl electrolytes and negative cardiac enzymes. on the morning after admission pt was taken to coronary angiography () demonstarting an ulcerating lesion in lmca with 70% stenosis, moderate diffuse disease in lad, lcx with widely patent stent, a small lcx and diffusely diseased after the large om2, rca with moderate diffuse disease with 70% pda stenosis. an immediate ct surgery consult was placed, and plans were put in order for pt to receive a cabg the following day. cardiac surgical workup was unremarkable and he was cleared for surgery. on , dr. performed coronary artery bypass grafting surgery. for surgical details, please see seperate dictated operative note. following the operation, he was brought to the cvicu for invasive monitoring. within 24 hours, he was extubated and awoke neurologically intact. he maintained stable hemodynamics and transferred to the sdu on postoperative day two. he continued to experience type ii(mobitz i, wenkebach). all nodal agents were therefore discontinued. he otherwise continued to make clinical improvements with diuresis and displayed steady progress with physical therapy. medical therapy was optimized and he was cleared for discharge on postoperative day 5. by discharge, his wenkebach had decreased in frequency. medications on admission: aspirin 81 mg glipizide 10 mg metformin 2.5 mg vytorin (ezetimibe/simvastatin) ?dose avapro ?dose lamictal 100mg qhs discharge medications: 1. lamotrigine 100 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). disp:*30 tablet(s)* refills:*0* 2. 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:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 5. vytorin 10-40 10-40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 6. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 7. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 9. glipizide 5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 10. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 10 days. disp:*10 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease s/p cabg x4 wenckebach (av nodal blocking medications discontinued) diabetes mellitus type 2 hypertension elevated cholesterol sleep apnea on cpap rheumatic fever as child bipolar disorder discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns please call cardiologist or go to emergency room for palpitations or heart racing please continue to check blood glucoses at home and follow up with dr if bg > 200 followup instructions: please call to schedule all appointments dr in 4 weeks () dr in 1 week () dr in weeks () dr as previously instructed for diabetes follow up wound check appointment 2 as instructed by nurse () provider: . phone: date/time: 2:40 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 left heart cardiac catheterization 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 other and unspecified hyperlipidemia unspecified sleep apnea 

Answer: The patient is high likely exposed to