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: patient recorded as having no known allergies to drugs attending: chief complaint: chest tightness major surgical or invasive procedure: four vessel coronary artery bypass grafting utilizing the left internal mammary artery to diagonal artery, with vein grafts to left anterior descending, first obtuse marginal and second obtuse marginal arteries. history of present illness: this is a 49 year old male with new onset chest tightness with minimal exertion. subsequent stress test was positive for ischemia and cardiac catheterization revealed severe two vessel coronary artery disease. he was evaluated and cleared to proceed with surgical revascularization. past medical history: coronary artery disease dyslipidemia history of kidney stones, s/p lithotripsy social history: denies tobacco. occasional etoh. no history of alcohol abuse. employed as a machinist. lives alone. family history: father with mi, s/p cabg in his 40's. physical exam: 146/77 59 5'3" 177lbs general: no acute distress heent: unremarkable neck: supple with full range of motion chest: lungs clear bilaterally heart: rrr, normal s1s2. abdomen: soft and nontender without rebound or guarding extremities: warm and well perfused discharge exam: vs: 98.9, 125/84, 77sr, 20 94%ra gen: nad, wg, wn heent: unremarkable chest: lctab cv: rrr, no murmur or rub abd: +bs, soft, non-tender, non-distended ext: warm, trace edema incisions: sternotomy- c/d/i without erythema or drainage, healing nicely, evh- c/d/i pertinent results: 05:12am blood wbc-9.5 rbc-3.51* hgb-10.5* hct-28.7* mcv-82 mch-29.8 mchc-36.5* rdw-14.4 plt ct-178 06:30am blood wbc-12.4* rbc-3.80* hgb-11.3* hct-31.4* mcv-83 mch-29.6 mchc-35.9* rdw-14.7 plt ct-184 03:26pm blood wbc-7.0 rbc-3.28*# hgb-9.9*# hct-26.4*# mcv-81* mch-30.1 mchc-37.4* rdw-14.0 plt ct-165 05:12am blood urean-17 creat-1.2 k-4.4 03:29pm blood urean-18 creat-1.3* k-4.3 06:30am blood glucose-138* urean-16 creat-1.6* na-139 k-4.6 cl-104 hco3-30 angap-10 05:00pm blood urean-15 creat-1.0 cl-113* hco3-23 06:30am blood mg-2.0 03:06am blood mg-1.9 echocardiography report , (complete) done at 1:55:38 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 49 m hgt (in): 63 bp (mm hg): 147/77 wgt (lb): 177 hr (bpm): 70 bsa (m2): 1.84 m2 indication: intra-op tee for cabg icd-9 codes: 786.05, 440.0 test information date/time: at 13:55 interpret md: , md, md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw05-: machine: echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 55% >= 55% findings right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: normal lv wall thickness, cavity size, and global systolic function (lvef>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. no as. no ar. mitral valve: no ms. mild (1+) mr. tricuspid valve: physiologic tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. see conclusions for post-bypass data the post-bypass study was performed while the patient was receiving vasoactive infusions (see conclusions for listing of medications). conclusions pre-bypass: no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. there is no aortic valve stenosis. no aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine and is in sinus rhythm. 1. biventricular function is unchanged 2. aorta appears intact post decannulation. 3. other findings are unchanged i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, md, interpreting physician 15:59 ?????? caregroup is. all rights reserved. brief hospital course: mr. was admitted, taken directly to the operating room and underwent coronary artery bypass grafting surgery by dr. . for surgical details, please see operative note. following the operation, he was brought to the cvicu for invasive monitoring. within 24 hours, he awoke neurologically intact and was extubated without incident. he was transfered to the telemetry floor where he continued to progress. physical therapy was consulted to work on strength and conditioning. chest tubes and pacing wires were discontinued without incident. by post-operative day 5 the patient was found suitable for discharge to home with vna services. medications on admission: atenolol 25 qd simvastatin 40 qd aspirin 81 qd fish oil mvi discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 1 months. disp:*60 tablet(s)* refills:*0* 4. 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* 5. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 6. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. furosemide 20 mg tablet sig: one (1) tablet po once a day for 1 weeks. disp:*7 tablet(s)* refills:*0* 8. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease, s/p cabg dyslipidemia discharge condition: good discharge instructions: ) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month or while taking narcotics for pain. 7) call with any questions or concerns. followup instructions: dr. in weeks, call for appt dr. in weeks, call for appt dr. in weeks, call for appt procedure: venous catheterization, not elsewhere classified (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome other and unspecified hyperlipidemia family history of ischemic heart disease personal history of urinary calculi 

Answer: The patient is high likely exposed to