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: no known allergies / adverse drug reactions attending: chief complaint: chest tightness major surgical or invasive procedure: coronary bypass grafting x4: the left internal mammary artery to left anterior descending artery; and reverse saphenous vein graft to the posterior descending artery, and the 2 branches of the 1st obtuse marginal artery history of present illness: 62 year old male was seen in clinic on , at which time he was complaining of progressive worsening of chest tightness with exertion. he noted symptoms typically with walking up hills as well as stairs or during periods of stress that he would develop chest pressure which became severe enough to cause him to stop. this always resolved within a few seconds of stopping activity. during a stress echocardiogram on he was found to have 1-1. depressions in inferolateral leads. he had a concomitant echocardiogram which showed an ef of 40-45% with 1-2+ eccentric mitral regurgitation and anterior basal and apical hypokinesis with no evidence of any wall motion abnormalities with exercise in the setting of what was determined to be a suboptimal study. he was referred for coronary angiography. he was found to have three vessel disease and is being referred to cardiac surgery for revascularization. past medical history: coronary artery disease s/p myocardial infarction with lad infarction in with placement of four stents in the lad chronic systolic heart failure hypertension hyperlipidemia anemia with recently found grade 4 internal hemorrhoids cataracts, bilateral s/p hernia repair, left social history: lives with companion contact: (companion) c: occupation:architectural consultant cigarettes: smoked no yes other tobacco use:denies etoh: 1-2 drinks/day illicit drug use:denies family history: mother - colon ca. father - prostate cancer physical exam: pulse:64 resp:16 o2 sat:100/ra b/p right:129/71 left:136/67 height:5'8" weight:182 lbs general: awake, alert, nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade _none_ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _none_ varicosities: none neuro: grossly intact pulses: femoral right: palp left: palp dp right: palp left: palp pt : palp left: palp radial right: palp left: palp r radial art puncture site c/d/i, no bleed/hematoma carotid bruit right: none left: none pertinent results: echo: pre-bypass: no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with moderate hypokinesis of the mid septum and anterior wall, and severe hypokinesis of the apex, distal septum, and distal anterior walls. overall left ventricular systolic function is mildly depressed (lvef= 40-45 %). the remaining left ventricular segments contract normally. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. there are three aortic valve leaflets. there is no aortic valve stenosis. trace aortic regurgitation is seen originating between the non- and left coronary cusps. there is some mild calcification of the edge of the noncoronary cusp. the aortic regurgitation jet is eccentric. trivial to mild mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results at time of surgery. post-bypass: the patient is in sinus rhythm. the patient is on a phenylephrine infusion. biventricular function is unchanged. mitral regurgitation is unchanged. tricuspid regurgitation is unchanged. the aorta is intact post-decannulation. . 09:20am blood wbc-5.9 rbc-3.09* hgb-10.4* hct-28.1* mcv-91 mch-33.6* mchc-37.0* rdw-12.2 plt ct-107* 03:27pm blood wbc-7.6# rbc-2.56* hgb-8.4* hct-23.6* mcv-92 mch-32.7* mchc-35.5* rdw-11.7 plt ct-111* 09:20am blood plt ct-107* 09:20am blood pt-12.7* inr(pt)-1.2* 03:27pm blood plt ct-111* 03:27pm blood plt ct-111* 03:27pm blood pt-18.2* ptt-27.3 inr(pt)-1.7* 03:27pm blood fibrino-148* 09:08am blood glucose-112* urean-13 creat-0.9 na-136 k-4.0 cl-97 hco3-33* angap-10 05:28pm blood urean-17 creat-0.8 na-137 k-4.0 cl-109* hco3-24 angap-8 09:08am blood calcium-8.6 phos-2.2*# mg-2.0 02:09am blood calcium-7.9* mg-2.0 pa and lateral chest film, at 11:28 clinical indication: 62-year-old, postop day 4 status post cabg, evaluate for effusion. comparison to at 15:29. pa and lateral views of the chest are submitted dated at 11:28. impression: status post median sternotomy with stable postoperative appearance to the cardiac and mediastinal contours given patient rotation on the current examination. there are persistent streaky linear opacities at the left base with likely associated small pleural effusion. interval resolution of the pulmonary edema. probable tiny but stable left apical pneumothorax. right lung is grossly clear. brief hospital course: mr. was a same day admit and on he was brought to the operating room where he underwent a coronary artery bypass graft x 4. please see operative note for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. later this day he was weaned from sedation, awoke neurologically intact and extubated. on post-op day one he was started on beta-blockers and diuretics and gently diuresed towards his pre-op weight. later this day he was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. he continued to make good progress and worked with physical therapy for strength and mobility. on post-op day four he was discharged home with vna services and the appropriate follow-up appointments. of note he was not resumed on lisinopril as betablockers had been titrated and blood pressure was not sufficient, will need to evaluate on the outpatient setting. medications on admission: atenolol 50 mg daily lipitor 40 mg daily lisinopril 20 mg daily nitroglycerin 0.4 mg tablet, sublingual - 1 tablet sublingually for chest pain, repeat every 5 minutes times 2. 911 for continued pain aspirin 81 mg daily ferrous sulfate 325 mg multivitamin 1 tablet daily discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. atorvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*1* 3. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever or pain. 4. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 6. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 7. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po bid (2 times a day). 8. multivitamin tablet sig: one (1) tablet po daily (daily). 9. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*1* 10. ace inhibitor please note that you have not been restarted on your lisinopril due to blood pressure this will be reevaluated when you come in for wound check next week discharge disposition: home with service facility: homecare discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 chronic systolic heart failure hypertension hyperlipidemia anemia with recently found grade 4 internal hemorrhoids cataracts, bilateral s/p hernia repair, left discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with dilaudid incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema: none 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 and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments wound check: at 10:15 cardiac surgery surgeon: dr. (on at 1:00p cardiologist: dr. at 2:40p please call to schedule appointments with: primary care: 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 diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia old myocardial infarction chronic systolic heart failure 

Answer: The patient is high likely exposed to