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: history of present illness: this is a 61 year old male with a past medical history significant for hypercholesterolemia, recovering alcoholic, last drink was , major depression, transgenderism who presented with a several week history of new onset chest discomfort. he has had at least four to six episodes which have occurred at rest or with minimal exertion. he also has associated symptoms of dyspnea on exertion with one flight of stairs. he denies claudication, no paroxysmal nocturnal dyspnea nor orthopnea, no lower extremity edema. no prior history of stroke. no prior history of coronary artery disease. he is a nonsmoker. workup by his primary care physician ultimately lead to a catheterization on which is his date of admission. this revealed a 50 to 60% distal left main disease, 60 to 70% stenosis at the origin of the left anterior descending with a distal severe serial stenosis as well as circumflex disease at the av groove bifurcation with a 90% lesion there as well as a 40% posterior descending artery lesion. overall he had normal left ventricular function. past medical history: hypercholesterolemia, transgenderism, major depression, questionable hiatal hernia with associated gastroesophageal reflux disease, no history of hypertension, no prior myocardial infarction, no documented coronary artery disease prior to this admission. no history of diabetes or stroke. he does have a history of benign colonic polyps, and a right breast mass and also prior smoking history. past surgical history: surgical history noted for periodontal surgery, status post polypectomy and also an operation for "frozen" right shoulder. medications on admission: outpatient medication regimen includes premarin 1.25 mg p.o. q. day, aspirin 325 mg p.o. q. day, toprol xl 25 mg p.o. q. day, ativan .5 mg p.o. q. am, buspar 20 mg p.o. b.i.d., wellbutrin 100 mg p.o. q. am, vioxx 25 mg p.o. q. day, lipitor 20 mg p.o. q. am, celexa 20 mg p.o. q.h.s. allergies: no known drug allergies. social history: he is married and has one son and has had a tobacco history as well as recovering alcoholic. risk factors: coronary artery disease risk factors include hypercholesterolemia and smoker greater than 53 pack years. he has no diabetes, no family history, no hypertension. laboratory data: laboratory studies on admission include a hematocrit of 47.0, bun/creatinine 16/1.1 and inr of 0.9. his preoperative chest x-ray shows no acute cardiopulmonary disease. physical examination: admission examination reveals temperature 97.8, 58 sinus bradycardia, 118/66 blood pressure, breathing rate of 18, 97% room air saturation, he is 5 foot 11, 214 lb. he is a white male, appearing his stated age. head, eyes, ears, nose and throat was normocephalic, atraumatic. pupils equally round and reactive to light and accommodation. extraocular movements intact. no evidence of jugulovenous distension, no carotid bruit. oropharynx was negative. cardiac examination, regular rate and rhythm, normal s1 and s2, no murmur, rub or gallop. pulmonary examination was clear to auscultation bilaterally. abdomen was soft, nontender, nondistended. there was no hepatosplenomegaly, no bruits, no pulsatile mass noted. extremities, no cyanosis, clubbing or edema, calf tenderness, no nonhealing ulcers. no evidence of varicosities. he has palpable dorsalis pedis and posterior tibialis pulses bilaterally. neurologically he was grossly intact with 30/30, folstein examination by minimental status. hospital course: after his catheterization was performed on and cardiac surgery had evaluated the patient he was preopped on that night. he was sent to the operating room on where he underwent a coronary artery bypass graft times four for the diagnosis of left main disease with unstable angina. he received a left internal mammary artery to the left anterior descending and saphenous vein graft to the diagonal as well as the obtuse marginal as well as to posterior descending artery. he left the operating room with his pericardium left open. he had a right radial artery line and right internal jugular swan-ganz catheter, two ventricular and two atrial pacing wires. he had two mediastinal chest tubes and one left pleural tube. his cardiopulmonary bypass time was 95 minutes with a crossclamp time of 72 minutes. his mean arterial pressure leaving the operating room was 81 with a central venous pressure of 12, pad of 19 and mean pa pressure of 24. he was atrially paced, was on propofol drip at 10 mcg/kg/min. dr. was satisfied with his targets and the patient did well. by postoperative day #1 he had already been extubated on the night of surgery and on the morning of postoperative day #1 he was noted to have an 11 beat run of ventricular tachycardia. this was self-terminating, however. his temperature was afebrile. he was otherwise in sinus with frequent premature ventricular contractions. he was no longer being atrially paced. his central venous pressure was 11. he was making adequate urine output. his chest tubes had put out more than 400 over the shift and an additional 150 that morning. his examination was unremarkable. his white count was 15.3 postoperatively with a hematocrit of 37.1. bun and creatinine were 18 and 0.8. at this point he was doing well. his swan was removed. his11 beat run of ventricular tachycardia was treated with electrolyte repletion as well as starting low dose beta blocker. he was out of bed, ambulating. his diet was advanced and he was ultimately transferred to the floor. his chest tubes were removed on postoperative day #2. chest x-ray did show small bilateral pleural effusions, no evidence of pneumothorax. cardiac silhouette was otherwise stable. the patient was doing well. he had brought attention to the fact that he had just had the breast mass on his right chest. an evaluation was completed by the breast care service with dr. . at that time they thought that the patient should not undergo mammogram, he could follow up as an outpatient once he has recovered from his cardiac surgery at which time his breast mass can be evaluated. this was not felt to be a suspicious breast mass, however, dr. will further workup this issue once he has completed his cardiac rehabilitation. by postoperative day #4 the patient was afebrile, vital signs stable and he was ambulating at level 5. he completed stairs with the physical therapist and had been cleared by their services. he no longer had any pacing wires, no chest tubes and no foley catheter. his last hematocrit was 32.2 on with a bun/creatinine of 13 and 0.7. his discharge examination was notable for a temperature of 99.3 with 76 sinus rhythm. he had not had ectopy for greater than 72 hours. blood pressure was 100/59. he was breathing at a rate of 18 and sating at 94% on room air. his lungs were clear, slightly decreased at the bases. his heart was regular with normal s1 and s2. his chest was stable. he had no evidence of drainage and no erythema. he additionally had no extremity edema. his abdominal examination was otherwise benign. the right chest mass was somewhat firm but mobile. there was no skin dimpling, no skin changes and no areolar discharge. he had no axillary adenopathy nor was there any supraclavicular adenopathy and he was nontender. given these findings and his recovery from surgery he ultimately was discharged to home without services. discharge medications: 1. lopressor 25 mg p.o. b.i.d. 2. he can return to toprol xl 25 mg p.o. q. day after his follow up with his primary care physician in seven to 14 days. 3. percocet 5/325 one to two tablets p.o. q 4-6 hours prn 4. colace 100 mg p.o. b.i.d. 5. aspirin 325 mg p.o. q. day 6. premarin 1.25 mg p.o. q. day 7. buspar 20 mg p.o. b.i.d. 8. ativan .5 mg p.o. q. am 9. wellbutrin 100 mg p.o. q. am 10. vioxx 25 mg p.o. q. day 11. lipitor 20 mg p.o. q. am 12. celexa 20 mg p.o. q.h.s. 13. lasix 20 mg p.o. b.i.d. times seven days 14. k-dur 20 meq p.o. b.i.d. times seven days to be taken in concordance with his lasix and his postoperative diuresis discharge disposition: to home without services. discharge diagnosis: 1. left main disease 2. unstable angina 3. status post coronary artery bypass graft with left internal mammary artery to left anterior descending, saphenous vein graft to the diagonal, saphenous vein graft to the obtuse marginal and also saphenous vein graft to his right posterior descending artery , m.d. dictated by: medquist36 procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery angiocardiography of left heart structures left heart cardiac catheterization other and unspecified coronary arteriography diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome pure hypercholesterolemia personal history of tobacco use lump or mass in breast 

Answer: The patient is high likely exposed to