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: hydrochlorothiazide / iodine; iodine containing / shellfish attending: chief complaint: sscp after vomiting, new orthopnea major surgical or invasive procedure: cabg x 3 (lima>lad, svg>om, svg>pda) history of present illness: the patient is a 71m with h/o cad with 2 bms to lad and cx, dm, htn, gastroparesis who was referred to the ed by his pcp ( ) with 3 weeks of worsening sob, non-exertional cp radiating to the left arm after vomiting, and 4 pillow orthopnea. he has had episodes of vomiting after eating often, but associated sscp is new. no lle but pulmonary edema on exam with crackles of the way up. ekg showed st depressions in lateral leads v2 - v6 with flipped deep ts. cp free in ed. trop positive. cards was called and cath recommended. in ed got 600 plavix, heparin gtt, integrillin gtt. no o2 in ed. . cardiac cath showed left main disease (90% distal) that was not intervened upon and poor lv function (ef 20%) and cardiac surgery was consulted for cabg. past medical history: past medical history: diabetes, dyslipidemia, hypertension percutaneous coronary intervention, in showing left main 30% stenosis, patent lad stents, 30% restenotic circumflex lesion in the distal aspect of the stent, jailed om1 ostium with 60% stenosis, rca ostially occluded. -- transient ischemic attack in , status post recurrent event, status post cardiac endarterectomy under the care of dr. in complicated by slow flow and involving stroke, urgent angiography by dr. revealing brachiocephalic stenosis 90%, status post angioplasty stenting at that time -- status post stenting of the brachiocephalic artery into the subclavian artery for rescue of the right upper extremity for upper extremity claudication, now with resolution -- history of posterior circulation syndrome, this resolved following subclavian stenting -- peripheral disease status post lower extremity revascularizations by way of atherectomy in and of , rutherford- scale is zero -- pseudogout -- gallbladder surgery social history: social history is significant for the current tobacco use (~ ppd), he has smoked for about 60 years as much as 3ppd in the past. there is no history of alcohol abuse and he denies illicit substance use. he is retired and previously worked selling men's clothing. he is divorced and lives alone. family history: his brother had cabg 2 years ago and also smoked. mother and sister with breast cancer. he has 3 children, no history of breast cancer in them. his son had gynecomastia with onset at age 12, which required surgical excision physical exam: physical examination: . bp 169/75 hr (reg) 85 rr 20 temp 97.9 o2sat 94% 2l 194 lbs . gen: well developed, well nourished and well groomed. the patient was oriented to person, place and time. the patient's mood and affect were not inappropriate. . heen: no xanthalesma, conjunctiva were pink, no pallor or cyanosis of the oral mucosa. . neck: supple, jvp of 10 cm. the carotid waveform was normal. there was no thyromegaly. . chest: no chest wall deformities, scoliosis or kyphosis. . pulm: respirations were not labored and there were no use of accessory muscles. ctab, normal bs and no adventitial sounds or rubs. . cor: pmi located in the 5th intercostal space, mid clavicular line. no thrills, lifts or palpable s3 or s4. normal s1s2, no rubs, murmurs, clicks or gallops. . abd: abdominal aorta was not enlarged by palpation, no hepatosplenomegaly, nt, soft, nd . ext: no pallor, cyanosis, clubbing or edema. . skin: no stasis dermatitis, ulcers, scars, or xanthomas. . pulses: no abdominal, femoral bruits. carotid bruits b/l . right: carotid 2+ femoral 1+ popliteal 1+ dp 1+ pt 1+ . left: carotid 2+ femoral 1+ popliteal 1+ dp 1+ pt 1+ pertinent results: admit labs 01:30pm blood wbc-11.0 rbc-4.20* hgb-14.2 hct-39.7* mcv-95 mch-33.8* mchc-35.8* rdw-14.0 plt ct-254 neuts-72.0* lymphs-22.2 monos-4.5 eos-1.0 baso-0.3 pt-13.0 ptt-57.2* inr(pt)-1.1 glucose-62* urean-29* creat-1.3* na-140 k-3.8 cl-102 hco3-27 angap-15 . ecg- nsr@74, nl axis, ivcd, lvh, st depressions and deep inverted t waves in v3-v6 . cardiac cath final diagnosis: 1. three vessel coronary artery disease. 2. severe systolic and diastolic ventricular dysfunction. 3. severe pulmonary hypertension. 4. moderate aortoiliac arterial disease. . echo conclusions: the left atrium is moderately dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is top normal/borderline dilated. resting regional wall motion abnormalities include basal inferior akinesis and lateral hypokinesis. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . ct chest 1. heavy calcified aorta and its major branches including the aneurysmatic dilatation of the brachiocephalic trunk. 2. centrilobular emphysema, mild. 3. subpleural areas of honeycombing suggesting long-standing lung fibrosis such as ipf. 4. bilateral pleural effusions right more than left, small. 5. heavy coronary calcifications with insertion of the stent in the lad. 6. status post cholecystectomy and gastroesophageal junction surgery. . abd dopplers 1. patent celiac and sma arteries with slightly increased systolic peak in the celiac axis. if there is clinical suspicion for celiac axis stenosis, this could be better evaluated by mra or cta. 2. left-sided pleural effusion. . 05:10am blood wbc-8.4 rbc-2.93* hgb-9.4* hct-27.2* mcv-93 mch-32.2* mchc-34.7 rdw-16.7* plt ct-305 04:15am blood pt-18.1* ptt-30.3 inr(pt)-1.7* 05:10am blood pt-18.3* ptt-83.0* inr(pt)-1.7* 05:10am blood glucose-149* urean-22* creat-1.1 na-139 k-4.2 cl-104 hco3-26 angap-13 brief hospital course: 71m w/ cad, dm, htn, hypercholesterolemia, pvd p/w stuttering cp, sent for cath and found to have left main disease. carotid u/s showed < 40% , 50-60% . he underwent celiac and l subclavian stenting on . on he went to the operating room where he underwent a cabg x 3. he was transferred to the sicu in critical but stable condition. he awoke and was extubated by pod #1. he was weaned from his nitroglycerine and tansferred to the floor on pod #2. he did well post operatively. he was seen by physical therapy. he was started on heparin and coumadin for paroxysmal afib. he continued to have a sternal click with no fevers, white count, drainage or erythema. he was seen in consultation by cardiology for his continued bursts of afib, they recommended continuing with lopressor, anticoagulation, and increasing his ace-i. he was ready for discharge on . medications on admission: aspirin 325mg qd nifedipine 30mg qhs enalapril 20mg qhs chlorthalidone 25mg qam lipitor 40mg qam metoprolol 25mg metformin 850mg centrum qhs folic acid 400mcg qhs novolin n 36u qam, 18u qpm novlin r 18u qam, 6u qpm loperimide 2mg prn indomethacin 25mg tid prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 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:*0* 3. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 7. enalapril maleate 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain for 3 weeks. disp:*30 tablet(s)* refills:*0* 9. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 10. warfarin 5 mg tablet sig: one (1) tablet po once (once) for 1 months. disp:*30 tablet(s)* refills:*2* 11. outpatient lab work check protime, inr monday () and thurs () and then as needed afterwards. please call results to dr. at discharge disposition: home with service facility: homecare discharge diagnosis: cad pmh: s/p mesenteric/celiac stents (), pci (), multiple peripheral stents, tia, htn, dm-2, gout, pvd, rhd, chronic diarrhea, ? gastroparesis discharge condition: good. discharge instructions: call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. shower, no baths, no lotions, creams or powders to incisions. no heavy lifting or driving until follow up with surgeon. followup instructions: please call to schedule these appointments: dr. 4 weeks dr. 2 weeks dr. 2 weeks already scheduled appointments: provider: study phone: date/time: 3:00 provider: , m.d. phone: date/time: 4:00 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 two coronary arteries angiocardiography of left heart structures diagnostic ultrasound of heart angioplasty of other non-coronary vessel(s) insertion of drug-eluting stent(s) of other peripheral vessel(s) transposition of cranial and peripheral nerves insertion of two vascular stents procedure on two vessels diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified cardiac complications, not elsewhere classified gout, unspecified atrial fibrillation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified personal history of other diseases of circulatory system old myocardial infarction other emphysema stricture of artery gastroparesis hypertensive chronic kidney disease, malignant, with chronic kidney disease stage i through stage iv, or unspecified 

Answer: The patient is high likely exposed to