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: cardiac cath history of present illness: 63 year-old m with cad s/p cabg ( - lima to lad, svg to om2, svg to d1, svg to pda), s/p ptca ( - stents placed to svg to d1 graft and svg to pda graft) who presented with chest pain to osh, transferred here for cardiac cath, now s/p cath. he awoke from sleep at home with 8/10 chest pain, l arm discomfort, and diaphoresis. no sob or nausea. he arose and felt lightheaded and proceeded to have a syncopal event. no trauma. he went to the osh ed at 2 am for evaluation; he received heparin bolus and gtt, plavix, and morphine. nitro gtt was started and patient worsened. labs showed ck 136, mb 3.5, trop 0.16, ecg showed nsr, with 1 mm ste inf and reciprocal changes in v1/v2. he was transferred to for cath. . cardiac cath showed right dominant circulation with 100% ostial lad lesion and 100% proximal rca lesion with collaterals. distal lcx 60%. svg-rca occlusion, svg-om occluded. svg-diag iwth 60% proximal lesion and patent graft. 60% mid lima-lad with collaterals. co 5.64, ci 2.92, ra 9, pcwp 19, pa 29/13, rv 23/13. no interventions were performed; pt was transferred to ccu for medical therapy and hemodynamically stable. . ros: he reports stable doe after 1 block. pt denies pnd, orthopnea, or le edema. no history of claudication, cva/tia. no fever or chills. no recent weight loss or gain. has sinus congestion. denied cough or palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no melena or brbpr. no dysuria. denied arthralgias or myalgias. no rash. past medical history: 1. cad s/p cabg: , lima to lad graft, svg to om2, svg to d1 and svg to pda. presented with unstable angina. ef 74%, anterolateral hk, 90prca, 90% lad, 70% mlad, 90% d2, 80% dcx, two 80% sequential om1 lesions. s/p ptca and stenting of the proximal, mid, and distal svg-r-pda and svg to d1 in . 2. hypercholesterolemia. 3. hypertension. 4. history of tobacco use - quit > 40 yrs ago 5. brachial plexus injury social history: the patient works in home room modeling and construction; he is a former firefighter. he is married with grown children. occasional social alcohol use. quit smoking >40 yrs ago. family history: brothers, mother and father with premature cad. brother with cva bone ca in father melanoma in sister ca in sister physical exam: admission pe: vitals: t: 97 p: 83 bp: 136/76 rr: 15 sao2: 93% on 3l nc general: awake, alert, nad. exam limited since patient required to lay flat heent: perrl/eomi, sclera anicteric. mmm, op without lesions neck: supple, no carotid bruits appreciated, 2+ carotid pulses. unable to assess jvp. pulm: lungs clear anteriorly cardiac: rrr, nl. s1s2, no m/r/g appreciated abdomen: soft, nt/nd, + bs, no organomegaly noted. ext: no edema b/t, 2+ femoral, dp and pt pulses b/l. r groin with pressure dressing in place. skin: no rashes or lesions noted. neurologic: alert & oriented x 3. able to relate history without difficulty. pertinent results: admission labs s/p cath: . 06:03am blood wbc-12.2*# rbc-4.51* hgb-13.4* hct-38.1* mcv-85 mch-29.8 mchc-35.2* rdw-12.8 plt ct-203 06:03am blood pt-13.1 ptt-56.1* inr(pt)-1.1 06:03am blood glucose-137* urean-13 creat-0.9 na-140 k-4.0 cl-109* hco3-21* angap-14 06:03am blood ck(cpk)-352* 06:03am blood ck-mb-30* mb indx-8.5* 06:03am blood calcium-7.6* phos-2.9 mg-1.8 . other labs: 06:03am blood ck(cpk)-352* 02:32pm blood ck(cpk)-3001* 10:08pm blood ck(cpk)-3179* 05:36am blood ck(cpk)-2416* 06:03am blood ck-mb-30* mb indx-8.5* 10:08pm blood ck-mb-362* mb indx-11.4* 05:36am blood ck-mb-209* mb indx-8.7* 02:44pm blood %hba1c-5.8 -done -done 10:08pm blood triglyc-106 hdl-43 chol/hd-2.7 ldlcalc-51 . cardiac cath (): cardiac cath showed right dominant circulation with 100% ostial lad lesion and 100% proximal rca lesion with collaterals. distal lcx 60%. svg-rca occlusion, svg-om occluded. svg-diag iwth 60% proximal lesion and patent graft. 60% mid lima-lad with collaterals. co 5.64, ci 2.92, ra 9, pcwp 19, pa 29/13, rv 23/13. no interventions were performed. . cxr (): the patient has had median sternotomy and coronary bypass grafting. borderline cardiomegaly stable. lungs clear. no pulmonary edema or pleural effusion. . echo (): the left atrium is mildly dilated. the left ventricular cavity size is normal. there is moderate regional left ventricular systolic dysfunction. overall left ventricular systolic function is moderately depressed (estimated lv ejection fraction ?40%). resting regional wall motion abnormalities include inferior and inferolateral akinesis/hypokinesis. no definite thrombus seen (cannot definitively exclude). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. . compared with the report of the prior study (images unavailable for review) of , left ventricular systolic function is now significantly impaired. . discharge labs: . 05:45am blood wbc-11.1* rbc-4.07* hgb-12.9* hct-34.9* mcv-86 mch-31.6 mchc-36.9* rdw-12.9 plt ct-187 05:45am blood plt ct-187 05:45am blood glucose-103 urean-15 creat-1.0 na-139 k-3.9 cl-104 hco3-27 angap-12 05:45am blood calcium-8.6 phos-3.1 mg-2.2 brief hospital course: 63 yo m with htn, hyperlipidemia, cad s/p cabg and ptca, who presented with acs s/p cath, transferred to ccu for medical managment. his hospital course for this admission is as follows: . 1 ischemia: acs likely from inferolateral mi from vein graft occlusion to om or to rca, s/p cardiac cath, no interventions, currently pain-free. we stopped intergrillin and heparin since no acute thrombosis found s/p cath. we continued asa 325', plavix 75', and lipitor 80' initially, and plavix was discontinued on given the pt didn't have any stents placed. we started low dose bblock and acei initially with metoprolol 12.5mg'' and lisinopril 5mg', and titrated up to 25mg'' and 10mg', respectively, as bp and hr tolerated. he was discharged home on toprol xl 50mg po qday. echo on showed moderately depressed lv systolic function (estimated lv ejection fraction ~40%), with resting regional wall motion abnormalities include inferior and inferolateral akinesis/hypokinesis, we followed his hct closely and with goal to keep hct >30. given patient became hypotensive on ntg, we avoided ntg and symptomatically control pain with mso4 (pt didn't have much pain s/p cath and didn't take any pain meds in the hospital, and pain free since day 2 of his hospital stay). . 2 pump: echo on s/p cath showed estimated lvef approximately 40% with resting regional wall motion abnormalities include inferior and inferolateral akinesis/hypokinesis. he was continued on acei and bblocks. . 3 rhythm: continued monitor on tele; remained nsr . 4 htn: we started low dose bblock and acei initially with metoprolol 12.5mg'' and lisinopril 5mg', and titrated up as bp and hr tolerated to 25mg'' and 10mg', respectively. he was discharged home on lisinopril 10mg po qday and toprol xl 50mg po qday. . 5 hyperlipidemia: checked lipid panels which showed total cholesterol 115, tg 106, hdl 43, ldl 51; and continued lipitor 80mg'. . 6 prophylaxis: sc heparin (discontinued once patient started ambulating), bowel regimen, . 7 fen: cardiac diet . 8 code status: full medications on admission: home meds: lipitor 25 qd atenolol 12.5 qd lisinopril 10 qd asa 325 . medications on transfer: heparin gtt integrillin gtt plavix 600 po load asa 325 atenolol lipitor discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day). 4. lisinopril 5 mg tablet sig: two (2) tablet po daily (daily): hold for sbp<90. 5. toprol xl 50 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po once a day. disp:*30 tablet sustained release 24hr(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis acute coronary syndrome, s/p catheterization without interventions secondary diagnoses: 1. cad s/p cabg: , lima to lad graft, svg to om2, svg to d1 and svg to pda. presented with unstable angina. ef 74%, anterolateral hk, 90prca, 90% lad, 70% mlad, 90% d2, 80% dcx, two 80% sequential om1 lesions. s/p ptca and stenting of the proximal, mid, and distal svg-r-pda in . 2. hypercholesterolemia. 3. hypertension. 4. history of tobacco use - quit > 40 yrs ago 5. brachial plexus injury discharge condition: the patient was discharged hemodynamically stable, afebrile with appropriate follow up. discharge instructions: 1. please follow up with your pcp as described below. . 2. please take all your medications exactly as prescribed and described in this discharge paperwork. we replace your atenolol with toprol xl 50mg po qday for your blood pressure and your heart. increased your statins to 80mg po qday for your lipids and heart. if you experience any dizziness, sob, or any other symptoms, please contact your pcp directly for any adjustment of medications. . 3. please call your doctor if you are experiencing chest pain, shortness of breath, fever, chills, or with any other concerning symptoms. followup instructions: please follow up with your pcp, . on at 12:45pm for an appoitment. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of right heart structures diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension other complications due to other cardiac device, implant, and graft acute myocardial infarction of inferolateral wall, initial episode of care 

Answer: The patient is high likely exposed to