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: indocin / doxycycline attending: chief complaint: chest pain major surgical or invasive procedure: off pump 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: 63 year old amle with increasing chest pain over the last 2 weeks with worsening dyspnea on exertion. troponin negative but cardaic catherization revealed 3 vessel coronary artery disease with in stent restenosis past medical history: coronary artery disease hypertension diabetes mellitus type 2 hyperlipidemia depression obesity knee arthritis gastroesophegeal reflux disease social history: retired etoh occasional tobacco denies lives alone family history: none physical exam: admission skin unremarkable heent unremarkable neck supple full rom chest clear to ausculation bilat heart rrr abdomen soft, nt, nd +bs ext warm well perfused +2 edema, pulses palpable neuro grossly intact discharge vitals 98.4, 112/64, 99 sr 18, ra sat 94% wt 130.7 neuro a/o x3 nonfocal pulm cta decreased bilat bases heart rrr no m/r/g abd soft, nt, nd + bs bm ext warm, pulses palpable +1 le edema inc sternal cdi sternum stable, left evh cdi pertinent results: 11:00am blood hct-25.1* 06:45am blood wbc-6.3 rbc-2.64* hgb-8.9* hct-24.8* mcv-94 mch-33.9* mchc-36.0* rdw-14.6 plt ct-174 04:44pm blood wbc-5.8 rbc-3.52* hgb-11.7* hct-32.0* mcv-91 mch-33.1* mchc-36.5* rdw-14.6 plt ct-163 06:45am blood plt ct-174 12:26am blood pt-12.3 ptt-33.4 inr(pt)-1.1 11:24am blood pt-14.2* ptt-31.8 inr(pt)-1.3* 04:44pm blood plt ct-163 02:55am blood fibrino-490*# 06:45am blood glucose-163* urean-18 creat-1.0 na-137 k-4.2 cl-103 hco3-27 angap-11 04:44pm blood glucose-157* urean-19 creat-1.0 na-139 k-4.1 cl-102 hco3-27 angap-14 04:44pm blood alt-21 ast-27 ld(ldh)-309* alkphos-63 amylase-94 totbili-0.8 04:44pm blood lipase-33 04:36pm blood mg-2.4 04:44pm blood %hba1c-6.4* radiology final report chest (pa & lat) 2:12 pm chest (pa & lat) reason: evaluate for effusion medical condition: 63 year old man s/p cabg reason for this examination: evaluate for effusion history: evaluate for pleural effusion. findings: in comparison with study of , there is again generalized enlargement of the cardiac silhouette in a patient with intact sternal sutures. the area behind the heart shows some increased opacification posteriorly. this could reflect any combination of pleural effusion, atelectasis, and even pneumonia. to assess for the degree of pleural effusion, lateral decubitus view would be most helpful. dr. approved: tue 9:48 am cardiology report ecg study date of 2:44:10 pm sinus rhythm. modest inferior st-t wave changes which are non-specific. borderline first degree a-v block. compared to tracing of there is no significant diagnostic change. read by: , intervals axes rate pr qrs qt/qtc p qrs t 77 190 98 388/417 46 18 -6 echocardiography report , (complete) done at 10:30:36 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 63 m hgt (in): 72 bp (mm hg): 126/66 wgt (lb): 280 hr (bpm): 53 bsa (m2): 2.46 m2 indication: intraoperative tee for off-pump cabg icd-9 codes: 440.0, 424.0 test information date/time: at 10:30 interpret 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 #: 2007aw2-: machine: 2 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *5.8 cm <= 5.6 cm left ventricle - systolic dimension: 4.0 cm left ventricle - fractional shortening: 0.31 >= 0.29 left ventricle - ejection fraction: 45% >= 55% aorta - annulus: 2.3 cm <= 3.0 cm aorta - sinus level: 3.4 cm <= 3.6 cm aorta - sinotubular ridge: 2.2 cm <= 3.0 cm aorta - ascending: *3.6 cm <= 3.4 cm aorta - descending thoracic: *2.8 cm <= 2.5 cm findings right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. normal interatrial septum. no asd by 2d or color doppler. left ventricle: moderate symmetric lvh. mildly depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. mildly dilated ascending aorta. simple atheroma in ascending aorta. complex (>4mm) atheroma in the aortic arch. mildly dilated descending aorta. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. trivial mr. tricuspid valve: mildly thickened tricuspid valve leaflets. physiologic tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. physiologic (normal) pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-revascularization: 1. no atrial septal defect is seen by 2d or color doppler. 2. there is moderate symmetric left ventricular hypertrophy. overall left ventricular systolic function is mildly depressed (lvef= 45 %). there is hypokinesis to akinesis of the apical segments and inferior wall. 3. right ventricular chamber size and free wall motion are normal. 4. the ascending aorta is mildly dilated. there are simple atheroma in the ascending aorta. there are complex (>4mm) atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. no aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. post-revascularization: 1. during revascularization, and clamping of coronary vessels there was noted wall motion abnormalities and increase in mitral regurgitation; wall motion abnormalities and mitral regurgitation have resolved to pre-revascularization. 2. biventricular function is maintained. overal lvef is 45% with inferior hypokinesis and apical hypokinesis. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician brief hospital course: transferred in from outside hospital, evaluation for cardiac surgery. on he was brought to the operating room where he underwent an off pump coronary artery bypass graft x 4. please see operative report for surgical details. he tolerated the procedure well and was transferred to the cvicu for invasive monitoring in stable condition. in the first 24 hours he awoke neurologically intact and was extubated. on post-op day one he had short burst of atrial fibrillation that was controlled with beta blockers. he remained in sinus rhythm. on post operative day 2 he was transfused for hematocrit 21.3 with post transfusion hematocrit 25. he was transferred to the floor for the remained of his care. physical followed patient during post-op course for strength and mobility. he continued to make steady process and was ready for discharge to rehab post-op day four. medications on admission: ativan trazadone diovan propanolol aspirin prilosec plavix pravachol vicodin gemfibrozil actos metformin relafen discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. metoprolol succinate 100 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po daily (daily). 3. lorazepam 0.5 mg tablet sig: two (2) tablet po hs (at bedtime) as needed for anxiety. 4. ferrous gluconate 300 (35) mg tablet sig: one (1) tablet po daily (daily). 5. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 8. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 9. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 10. pravachol 40 mg tablet sig: one (1) tablet po once a day. 11. furosemide 40 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 5 days. 12. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours) for 5 days. 13. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 14. pioglitazone 45 mg tablet sig: one (1) tablet po daily (daily). 15. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 16. aspirin ec 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). discharge disposition: extended care facility: tcu discharge diagnosis: coronary artery disease s/p offpump cabg post operative atrial fibrillation hypertension diabetes mellitus hyperlipidemia depression obesity knee arthritis gastroesophageal reflux disease myocardial infarction 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 followup instructions: please call to schedule all appointments dr in 4 weeks () dr after discharge from rehab dr after discharge from rehab md procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux intermediate coronary syndrome congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation other and unspecified hyperlipidemia surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation old myocardial infarction acute systolic heart failure osteoarthrosis, localized, not specified whether primary or secondary, lower leg 

Answer: The patient is high likely exposed to