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: vasotec attending: chief complaint: chest pain major surgical or invasive procedure: cardiac cath coronary artery bypass graft x4(lima>lad, svg>diag, svg>om, svg>pda) talon closure history of present illness: 73 year old male with a history of hypertension, hyperlipidemia, diabetes mellitus and previous nqwmi x2 in s/p cath in ' revealed no flow limiting cad. patient recently saw dr. for his annual surveilance appointmentand had a stress echo which revealed anterior and probable inferior ischemia. patient states for the past 6-8 months he occasionally c/o soreness in his chest that is accompanied by dyspnea on exertion. these symptoms occur only while lifting heavy objects. the pain lasts for minutes and subsides. he a cardiac cath today which revealed 80% left main and three vessel disease and was referred for surgical revascularization. past medical history: coronary artery disease non-q wave myocardial infarction x 2 in s/p cath with non-flow limiting cad hypertension dyslipidemia diabetes mellitus type 2 sleep apnea (c-pap) obesity memory loss arthritis neuropathy tias no residual hemorrhoids social history: occupation: retired last dental exam: n/a lives with: wife : caucasian tobacco: quit 17years ago etoh: rare family history: denies premature cad. both parents died from cva's. physical exam: pulse: 71 resp: 16 o2 sat: 98 b/p right: left: height: 5'7" weight: 264 lbs general: well-developed, well-nourished obese male lying supine in bed in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally anterior heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm x, well-perfused edema varicosities: superficial, but was unable to assess with pt. standing neuro: grossly intact pulses: femoral right: 1+ left: cath site dp right: 2+ left: 2+ pt : 2+ left: 1+ radial right: 2+ left: 2+ carotid bruit: none bilaterally pertinent results: cardiac cath: 1. selective coronary angiography of this right dominant system demonstrated severe three vessel disease. the lmca had an 80% stenosis distally. the lad had an 80% stenosis proximally. the lcx had moderate disease. the rca had an 80% stenosis proximally and a 70% stenosis distally. 2. limited resting hemodynamics revealed an elevated left ventricular enddiastolic pressure of 30 mmhg. the mean systemic arterial blood pressure was 98 mmhg (phasic 146/72 mmhg). carotid u/s: right ica with stenosis <40%. left ica with stenosis <40% . echo: the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is moderately depressed (lvef= 35 %) with global hypokinesis and regional akinesis of the inferior and infero-lateral segments (c/w cad). 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 aortic valve leaflets are moderately thickened. there is at least mild aortic valve stenosis (valve area 1.2-1.9cm2). no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. radiology report chest (portable ap) study date of 4:14 pm chest (portable ap) clip # final report history: chest tube removal. findings: in comparison with study of , the monitoring and support devices have been removed except for a residual right ij sheath. following chest tube removal, there is no evidence of pneumothorax. the degree of atelectasis at the left base has decreased. dr. 09:45am pt-15.6* ptt-44.8* inr(pt)-1.4* 09:45am plt count-129* 09:45am wbc-4.5 rbc-3.57* hgb-11.8*# hct-34.8* mcv-98 mch-32.9* mchc-33.8 rdw-14.6 09:45am %hba1c-7.5* 09:45am albumin-3.5 cholest-97 09:45am alt(sgpt)-56* ast(sgot)-44* alk phos-78 amylase-83 tot bili-0.7 09:45am glucose-171* urea n-16 creat-0.7 sodium-144 potassium-3.6 chloride-110* total co2-22 anion gap-16 06:21pm urine blood-neg nitrite-neg protein-neg glucose-tr ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 06:05am blood wbc-8.7 rbc-3.34* hgb-11.1* hct-32.4* mcv-97 mch-33.1* mchc-34.2 rdw-14.8 plt ct-111* 06:05am blood plt ct-111* 08:45am blood glucose-148* urean-19 creat-0.9 na-138 k-3.9 cl-102 hco3-27 angap-13 brief hospital course: mr. a cardiac cath on which revealed 80% left main and three vessel coronary artery disease. do to extent of his disease, he was admitted for bypass surgery. he surgical work-up while awaiting plavix wash-out. on he was brought to the operating room where he a coronary artery bypass x4 . please see operative report for surgical details. in summary he had: coronary artery bypass grafting x4 with left internal mammary artery graft to left anterior descending and reversed saphenous vein graft to the marginal branch, reversed saphenous vein graft to diagonal branch, and reversed saphenous vein graft to posterior descending artery. his bypass time was 84 minutes with a crossclamp time of 65 minutes. he tolerated the operation well and following surgery he was transferred to the cvicu for invasive monitoring in stable condition. he was hemodynamically stable in the immediate post operative period, he was weaned from sedation, awoke neurologically intact and extubated later that afternoon. on pod#1 he was transferred from the cardiac surgery icu to the stepdown unit. all tubes lines and drains were removed according to cardiac surgery protocols. once on the stepdown unit mr activity was gradually advanced, and his medications were titrated to effect. the remainder of his post operative course was uneventful. he was discharged to rehabilitation on post-operative day four. medications on admission: captopril 12.5 mg (0.5 tablet ), carvedilol 6.25 mg , plavix 75 mg qd, glyburide 10 mg , lovastatin 10 mg qd, metformin 1,000 mg , humulin r 0-75 units tid with meals, nph insulin 75 units tid, nitroglycerin 0.4 mg sl prn, acetaminophen 650 mg tablet by mouth twice a day twice a day, aspirin 325 mg qd, cinnamon bark qd, kefir 8oz in am and 8oz in pm yogurt based drink, multivitamin, fish oil 1,000mg qd discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 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:*2* 3. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. glyburide 5 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 5. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. lasix 40 mg tablet sig: one (1) tablet po once a day for 10 days: or as clinically appopriate. disp:*10 tablet(s)* refills:*2* 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 9. omega-3 fatty acids capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 10. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. disp:*30 ml(s)* refills:*0* 11. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. disp:*30 suppository(s)* refills:*0* 12. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 13. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 10 days: or clinically appropriate. disp:*20 tab sust.rel. particle/crystal(s)* refills:*0* 14. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). disp:*30 * refills:*2* discharge disposition: extended care facility: house nursing & rehabilitation center - discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x4 (lima>lad, svg>diag, svg>om, svg>pda) talon closure past medical history: non-q wave myocardial infarction x 2 in s/p cath with non-flow limiting cad hypertension dyslipidemia diabetes mellitus type 2 sleep apnea (cpap) obesity memory loss arthritis neuropathy tias no residual hemorrhoids discharge condition: good discharge instructions: no lifting greater than 10 pounds for 10 weeks no driving for one month and off all narcotics shower daily and pat incisions dry; no baths or swimming no lotions, creams or powders on any incision call for fever, redness, drainage, or weight gain of 2 pounds in 2 days or 5 pounds in one week followup instructions: dr. (surgeon) in 4 weeks dr. (cardiologist) in weeks dr. (pcp) in weeks procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization coronary arteriography using a single catheter angiocardiography of right heart structures diagnoses: obstructive sleep apnea (adult)(pediatric) 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 long-term (current) use of insulin old myocardial infarction morbid obesity personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits mononeuritis of unspecified site 

Answer: The patient is high likely exposed to