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: sent for catheterization after found to have dilated cm on echo major surgical or invasive procedure: - left heart catheterization, coronary angiogram - coronary artery bypass grafting times 5 with the left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to the right acute marginal, first and second obtuse marginal artery and first diagonal artery. history of present illness: mr. is a 48 y/o m with diabetes (diagnosed in ), hyperlipidemia, htn, and newly diagnosed dilated cardiomyopathy who is s/p catheterization. the patient was initially supposed to have shoulder surgery done this past , but was found to have elevated sugars and diagnosed with dm. the surgery was rescheduled for earlier this month, and pre-operative echo was done showing biventricular dilation and severe hypokinesis, with mild mitral and moderate tricuspid regurgiation. there was also evidence of moderate pulmonary artery systolic htn. an ef of % was reported. despite this ef, the patient denies any shortness of breath, dyspnea on exertion, chest pain, or decreased exercise tolerance due to fatigue. he does have some decreased exercise tolerance, but attributes it to r hip pain not fatigue. the patient also denies any history of pnd or sleep orthopnea. the only symptoms that the patient does report is leg swelling since . on cath, lmca had distal 50% disease, diffuse lad disease with 80-90% occlusions in small vessel at mid and distal segments, total occlusion of l cx after large om1 and diffuse disease in rca marginal branches. wedge pressure was 32, pa pressues in 70s, pt was given 40 mg iv lasix. . on arrival to the floor, patient was stable and cp free. past medical history: dm type 2, recently diagnosed high cholesterol hypertension social history: -tobacco history: denies -etoh: used to drink heavily on weekends in 20-30s, beers/day -illicit drugs: denies the patient lives with his second wife and two children. he has three children from previous marriage. he used to play soccer a lot when he as younger, but stopped playing regularly six years ago. he still reports playing soccer now on occassion. originally from . family history: grandmother had throat cancer (was a smoker) aunt had dm no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission pe: vs 114/80 pulse 94 100 on ra general: well appearing, pleasant gentleman, nad, alert and appropriate heent: ncat. sclera anicteric neck: supple cardiac: rrr, s1, s2 lungs: clear to auscultation b/l, no wheezes/crackles abdomen: soft, non-tender, non-distended extremities: warm, well perfused, 1+ dp/pt pulses, confirmed with doppler, 2+ pitting edema b/l 3/4 up the shin pertinent results: 07:05am blood glucose-133* urean-22* creat-0.8 na-138 k-4.8 cl-99 hco3-27 angap-17 07:45am blood %hba1c-8.7* eag-203* 10:00am blood triglyc-87 hdl-45 chol/hd-3.8 ldlcalc-108 2d-echocardiogram: the left atrium is dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. overall left ventricular systolic function is severely depressed (lvef= 15-20%). there is no ventricular septal defect. the right ventricular cavity is mildly dilated with moderate global free wall hypokinesis. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: biventricular dilatation and severe hypokinesis. mild mitral and moderate tricuspid regurgitation. moderate pulmonary artery systolic hypertension. . . cardiac cath: coronary angiography: left dominant lmca: distal 50% lad: diffuse disease with serial 80-90% occlusions in a small vessel (2.0 mm) at the mid and distal segments. small diagonal branches have diffuse disease. lcx: total occlusion mid cx after large om1. om2 fills via collaterals. rca: likely nondominant with diffuse diseas in marginal branches and serial 80% lesions. assessment & recommendations 1. csurg consult 2. admit for management of decompensated chf and titration of medical therapy. 3. secondary prevention cad and chf. . brief hospital course: mr. was admitted to the on for a cardiac catheterization. this revealed severe dilated cardiomyopathy with three vessel disease. the cardiac surgery service was consulted for surgical evaluation. he was worked-up in the usual preoperative manner including and viability study and carotid ultrasound. the carotid ultrasound showed a 60-69% right internal carotid artery stenosis and a 40% left internal carotid artery stenosis. the viability study revealed a fixed defect in the distal anterior and apical region. given his high risk for surgery, a tranplant consutation was obtained. workup revealed that he appeared to be an acceptable transplant/vad candidate should the need arise. on , mr. was taken to the operating room where he underwent coronary bypass grafting to five vessels. please see operative note for details. postoperative he was taken to the intensive care unit for monitoring. he was transfused with red blood cells for postoperative anemia. he required several days of pressors prior to extubation for blood pressure and cardiac output support. he was also noted to aggitated as sedation was weaned and was thus switched to precedex. he was ultimately extubated on . he developed a fever however work-up was negative. as his atelectasis improved, his fever went away. coreg and lisniopril were started given his heart failure. on he was transferred to the step down unit for further recovery. he continued to be gently disuresed towards his preoperative weight. he was noted to be fatigued, nauseated and jaundiced and a liver ultrasound showed no evidence of acute cholecystitis, some ascites and a poorly visualized pancreas. his total bilirubin was elevated at 5 however trended down and was 3.9 on discharge. his lipase was elevated at 85. his nausea improved. he continued to wrok daily with the physical therapy service. mr. continued to make steady progress and was discharged home on . he will follow-up with dr. , dr. and dr. as an outpatient. medications on admission: glimepiride 4 mg lisinopril 5 mg daily metformin 850 mg simvastatin 20 mg daily discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*90 tablet, delayed release (e.c.)(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*1* 3. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 4. glimepiride 4 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 6. metformin 850 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. simvastatin 10 mg tablet sig: two (2) tablet po qhs. disp:*30 tablet(s)* refills:*2* 9. lasix 20 mg tablet sig: one (1) tablet po once a day for 5 days. disp:*5 tablet(s)* refills:*0* 10. potassium chloride 10 meq capsule, extended release sig: one (1) capsule, extended release po once a day for 5 days. disp:*5 capsule, extended release(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: coronary artery disease dilated cardiomyopathy noninsulin dependent diabetes mellitus s/p coronary artery bypass graft x 5 hypertension hypercholesterolemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: 1) 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 2) please no lotions, cream, powder, or ointments to incisions 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart 4) 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 5) no lifting more than 10 pounds for 10 weeks 6) please call with any questions or concerns 7) take lasix and potassium once daily for 5 days then stop. **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 surgeon: dr. date/time: 1:15 cardiologist: dr. phone: date/time: 1:20 wound care nurse phone: date/time: 11:00 medical building 2a 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: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters (aorto)coronary bypass of four or more coronary arteries diagnoses: other primary cardiomyopathies nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere anemia, unspecified coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension pulmonary collapse other specified forms of chronic ischemic heart disease 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 acute on chronic systolic heart failure diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy jaundice, unspecified, not of newborn 

Answer: The patient is high likely exposed to