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 pain major surgical or invasive procedure: cabgx4(lima-lad,svg-diag,svg-om,svg-pda) history of present illness: 60 year old male with h/o hl who presented with exertional chest pain and sob, now s/p cardiac catheterization found 3 vessel disease. he awaits cabg, as well as evaluation of new onset of vision post-cath. he reports exertional cp and doe for the past month. cardiac catheterization showed 3 vessel dz with 80% mid lad lesion involving diagonal, 99% lcx lesion with slow flow, 80% mid-rca lesion, 70% distal-rca lesion, clean lmca. after his cath, he began complaining of blurry vision. seen by the neurology team and underwent urgent head ct. past medical history: cad hyperlipidemia ? tia - unable to talk for few moments ( mri done did not follow up with neurologist umbilical hernia social history: lives with wife . : caucasian occupation: teacher tobacco: 15 pack year history - quit 25 years ago etoh: rare illicit drugs: denies family history: paternal grandfather died of mi at age 71. no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: physical exam on arrival to floor from cath lab: vs: 144/75 85 18 98%2l general: oriented x (able to say name, that he is in the hospital, states he "can't remember" which hospital or date). heent: ncat. sclera anicteric. perrl, eom appear intact although patient not entirely cooperative with exam. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of 7cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, mildly tender to palpation in epigastrium with complaints of nausea on palpation. no hsm. bs+ extremities: no c/c/, trace ankle edema. catheterization site c/d/i without femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: 1+ dp pulses neuro: cn ii-xii appear intact, although eom difficult to assess and reports blurry vision. difficulty focusing eyes on object. strength appears in bue and ble although patient with some difficulty following directions. reflexes symmetric bilaterally in the patellas pertinent results: admission labs: 02:50pm wbc-5.0 rbc-4.77 hgb-13.7* hct-39.4* mcv-83 mch-28.7 mchc-34.7 rdw-13.1 02:50pm plt count-249 02:50pm pt-12.3 ptt-29.0 inr(pt)-1.0 02:50pm %hba1c-5.9 eag-123 02:50pm albumin-4.3 02:50pm alt(sgpt)-24 ast(sgot)-22 alk phos-51 tot bili-0.4 02:50pm glucose-95 urea n-13 creat-0.9 sodium-139 potassium-3.8 chloride-103 total co2-27 anion gap-13 discharge labs: 05:00am blood wbc-8.9 rbc-3.89* hgb-11.2* hct-33.0* mcv-85 mch-28.9 mchc-34.0 rdw-13.2 plt ct-220 05:00am blood plt ct-220 03:07pm blood pt-13.2 ptt-28.9 inr(pt)-1.1 05:00am blood glucose-134* urean-15 creat-0.9 na-135 k-4.2 cl-98 hco3-29 angap-12 05:00am blood alt-65* ast-55* ld(ldh)-197 alkphos-127 amylase-56 totbili-0.4 studies: cardiac catheterization: 1. coronary angigoraphy in this right-dominant system demonstrated three-vessel disease. the lmca had no angiographically apparent disease. the lad had a proximal 80% stenosis involving the first diagonal branch. the lcx had a subtotal occlusion at the bifurcation with a large obtuse marginal branch, which had a proximal 90% stenosis. the rca had a hazy 80% mid-vessel stenosis and a 70% stenosis in its distal portion. 2. limited resting hemodynamics revealed mild left-sided volume overload, with an lvedp of 27 mm hg. there was mild systemic arterial hypertension with an sbp of 157 mm hg. 3. using ultrasound, the common femoral artery was identified. it was patent. needle puncture into the common femoral under real-time ultrasound guidance was achieved. hard copies of the images are stored in the patient's chart for documentation purposes. final diagnosis: 1. three vessel coronary artery disease. 2. left ventricular diastolic dysfunction. ecg: sinus rhythm. consider left atrial abnormality. otherwise, normal tracing. since the previous tracing of there is probably no significant change. ct brain perfusion: 1. no evidence of an acute infarct. if there is further clinical concern and no contraindications, mri is more sensitive for detection of infarct. 2. unremarkable cta of the head and neck, without evidence of hemodynamically significant stenosis, dissection or aneurysm. 3. normal ct perfusion without evidence of focal area of abnormality. 4. periapical lucency surrounding a left mandibular first premolar, which has been endodontically treated. correlation with the patient's prior dental history is recommended. mri head: 1. no evidence of acute intracranial pathology. 2. scattered foci of t2 and flair hyperintensity are a nonspecific finding, but may represent the sequela of chronic microangiopathy. carotid ultrasound: there is less than 40% stenosis within the internal carotid arteries bilaterally eeg: this is an abnormal routine eeg due to poorly sustained alpha rhythm with generalized theta activity suggestive of a mild to moderate encephalopathy. medications, toxic/metabolic disturbances, and infections are common causes. no epileptiform discharges or electrographic seizures were seen during this recording. tte: the left atrium is elongated. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. tee: pre bypass the left atrium is moderately dilated. the left atrium is elongated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is mildly depressed (lvef= 40 %). the right ventricle displays mild global free wall hypokinesis. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. dr. was notified in person of the results in the operating room at the time of the study. post bypass the patient is being a paced. biventricular systolic function is improved with left ventricular ejection fraction now near 50%. valvular function is unchanged. the thoracic aorta appears intact. ecg: sinus rhythm. since the previous tracing there is no significant change. radiology report chest (portable ap) study date of 8:56 am medical condition: 60 year old man s/p cabg reason for this examination: r/o ptx findings: as compared to the previous radiograph, the chest tubes have been removed. the nasogastric tube and the right central venous access line have also been removed. presence of a minimal left pneumothorax cannot be excluded. no evidence of tension. borderline size of the cardiac silhouette with moderate retrocardiac atelectasis. no newly appeared focal parenchymal opacity suggesting pneumonia. normal and unchanged size of the cardiac silhouette. brief hospital course: 60 yo male with h/o hl who is s/p catheterization for exertional cp, found to have 3 vessel disease and referred for cabg. cad: was found to have 3 vessel disease on cardiac catheterization on admission. he had been plavix loaded prior to the procedure and therefore cabg was delayed for plavix washout. he was continued on metoprolol, statin, and full-dose aspirin. he was taken for cabg please see or report for details, in summary had coronary bypass grafting x4 with left internal mammary to left anterior descending artery, to diagonal artery, saphenous vein graft to obtuse marginal artery, saphenous vein graft to posterior diagonal artery. his bypass time was 71 minutes with a crossclamp of 57 minutes. he tolerated the operation well and post-operatively was transferred to the cardiac surgery icu in stable condition. he remained stable ihn the immediate post-op period, woke from anesthesia and was extubated later that day. on pod1 he was transferred from the icu to the stepdown floor. all tubes lines and drains were removed per cardiac surgery protocol. once on the floor he worked with the nursing and physical therapy staff to increase his activity and on pod 4 he was discharged home with visiting nurses. scant serous drainage was noted on the inferior portion of sternal dressing, however, none was expressed on exam. the patient was afebrile with a stable sternum and normal white blood cell count. dr. evaluated the patient (on-call for dr. , and cleared him for discharge to home with keflex. medications on admission: metoprolol 25mg po bid simvastatin 80mg po daily asa 325mg po daily calcium carbonate 600mg po bid fiber 0.52g - 5 capsules po daily mvi 1 tab po bid discharge medications: 1. simvastatin 80 mg tablet sig: one (1) tablet po once a day. 2. calcium carbonate 600 mg (1,500 mg) tablet sig: one (1) tablet po twice a day. 3. fiber 0.52 g capsule sig: five (5) capsule po once a day. 4. multivitamin tablet sig: one (1) tablet po once a day. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 6. 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:*2* 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 9. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 7 days: for sternal drainage. disp:*28 capsule(s)* refills:*0* 10. furosemide 20 mg tablet sig: one (1) tablet po once a day for 1 weeks. disp:*7 tablet(s)* refills:*0* 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 1 weeks. disp:*7 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: coronary artery disease s/p coronary bypass grafting x4 with left internal mammary to left anterior descending artery, to diagonal artery, saphenous vein graft to obtuse marginal artery, saphenous vein graft to posterior diagonal artery. pmh: hyperlipidemia, ? tia - unable to talk for few moments (mri done did not follow up with neurologist), umbilical hernia psh: parathyroid removal, anoscopy, hemorrhoidectomy x2 and pudendal nerve block cad s/p cabg x4 pmh: hyperlipidemia, ? tia - unable to talk for few moments (mri done did not follow up with neurologist), umbilical hernia psh: parathyroid removal, anoscopy, hemorrhoidectomy x2 and pudendal nerve block discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. sternal wound: healing well-no drainage or eryhtema incisional pain managed with oral analgesics 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: please call to schedule appointments with your surgeon: dr. in 4 weeks primary care dr , m. in weeks cardiologist dr in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** 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 unspecified essential hypertension personal history of tobacco use other and unspecified hyperlipidemia other encephalopathy diarrhea headache other specified visual disturbances 

Answer: The patient is high likely exposed to