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: codeine attending: chief complaint: chest pain major surgical or invasive procedure: four vessel coronary artery bypass grafting(lima to lad, svg to diagonal, svg to om2, svg to rca) history of present illness: mr. is a 60 year old male with known coronary artery disease. recent stress test was positive for ischemia. cardiac catheterization on at hospital revealed severe three vessel coronary artery disease, including 60% left main lesion. lvef was estimated at 60%. given his critical coronary anatomy, he was transferred to the for cardia surgical intervention. on admission, patient denied history of chest pain. there was no prior history of mi or chf. past medical history: coronary artery disease, prior pci/stenting in iron deficiency anemia hypertension dyslipidemia hypothyroidism history of polyps, s/p polypectomy history of hemorrhoids, bright red blood per rectum prior hemorrhoid banding tonsillectomy ankle surgery social history: retired fbi , currently special education teacher. denies tobacco history. admits to social alcohol, no history of alcohol abuse. married. family history: uncle died at age 55 of mi. mother had cabg in her 50's. physical exam: discharge exam: vitals -99.4, 125/77, 84sr, 20, 93%ra heent -ncat, eomi lungs -diminished at bases heart - rrr, no murmur or rub abdomen -nabs, soft, non-tender, non-distended ext - 2+edema b/l neuro - non-focal wounds - sternotomy- c/d/i, no erythema or drainage, sternum stable evh- c/d/i, no erythema or drainage pertinent results: blood wbc-8.3 rbc-4.52* hgb-10.6* hct-34.6* mcv-77* mch-23.4* mchc-30.6* rdw-15.5 plt ct-228 blood pt-13.1 ptt-29.2 inr(pt)-1.1 blood glucose-89 urean-18 creat-1.2 na-140 k-4.1 cl-103 hco3-27 angap-14 blood alt-32 ast-31 ck(cpk)-359* alkphos-78 amylase-57 totbili-1.0 blood ck-mb-5 ctropnt-<0.01 blood albumin-4.4 mg-2.2 blood %hba1c-7.1* echo: the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. 06:00am blood wbc-10.6 rbc-3.40* hgb-8.2* hct-25.7* mcv-76* mch-24.1* mchc-31.9 rdw-17.1* plt ct-195 06:00am blood glucose-59* urean-17 creat-1.2 na-138 k-3.7 cl-102 hco3-25 angap-15 tee echocardiography report , (complete) done at 1:03:38 pm final referring physician information , c. , status: inpatient dob: age (years): 60 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: intraoperative tee for cabg icd-9 codes: 440.0 test information date/time: at 13:03 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: suboptimal tape #: 2008aw3-: machine: aw3 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.5 cm <= 4.0 cm left atrium - four chamber length: *7.3 cm <= 5.2 cm left ventricle - ejection fraction: 60% >= 55% aorta - arch: 2.6 cm <= 3.0 cm aorta - descending thoracic: 2.2 cm <= 2.5 cm aortic valve - lvot diam: 2.4 cm findings left atrium: moderate la enlargement. elongated la. no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. all four pulmonary veins identified and enter the left atrium. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: focal calcifications in aortic root. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. physiologic mr (within normal limits). tricuspid valve: normal tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. physiologic (normal) pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. suboptimal image quality. the patient appears to be in sinus rhythm. results were conclusions pre bypass the left atrium is moderately dilated. the left atrium is elongated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. physiologic mitral regurgitation is seen (within normal limits). dr. was notified in person of the results in the operating room at the time of the study. post bypass normal biventricular systolic function. no significant changes from pre bypass study. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 13:16 ?????? caregroup is. all rights reserved. brief hospital course: mr. was admitted to the cardiac surgical service and underwent routine preoperative evaluation. this included preoperative echocardiogram(see result section) and gi consult for history of intermittent brbpr over the last 4-5 months. there was no evidence of active gi bleeding and colonoscopy was deferred secondary to critical left main lesion and severe three vessel coronary artery disease. preoperative course was otherwise uneventful and he was cleared for surgery. on , dr. performed coronary artery bypass grafting surgery. for surgical details, please see separate dictated operative note. following surgery, he was brought to the cvicu for invasive monitoring. he received vancomycin 1gram iv every 12 hours for four doses due to being in the hospital greater than 24 hours prior to surgery. within 24 hours, he awoke neurologically intact and was extubated without incident. on post-op day one he was transferred to the telemetry floor for further care. on post operative day 2 his chest tubes were discontinued. he was gently diuresed towards his pre-op weight and beta blockers were titrated for maximum hemodynamics. epicardial pacing wires were removed on post-op day three. he worked with physical therapy during his post-op course for strength and mobility. pre-op blood work revealed a hemoglobin a1c of 7.1. he was started on sliding scale insulin and glyburide with good control of his blood sugars. he did not tolerate the glyburide as he became symptomatic with blood sugars in the 70's. on post-op day 5 he appeared to be doing well and was discharged home with vna services and the appropriate follow-up appointments. medications on admission: transfer meds: aspirin 81 qd, diazepam 5 qd, diltiazem 180 qd, synthroid 125 qd, lipitor 20 qd, mvi, niacin cr qd, bendaryl 25 qd, nitro prn discharge medications: 1. 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* 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. niacin 500 mg capsule, sustained release sig: two (2) capsule, sustained release po bid (2 times a day). disp:*120 capsule, sustained release(s)* refills:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. disp:*40 tablet(s)* refills:*0* 8. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed. disp:*60 tablet(s)* refills:*0* 9. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). disp:*qs * refills:*0* 10. multivitamin capsule sig: one (1) capsule po once a day. disp:*30 capsule(s)* refills:*0* 11. vitamin c 1,000 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 12. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed. disp:*60 tablet(s)* refills:*0* 13. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. disp:*14 tablet(s)* refills:*0* 14. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 2 weeks. disp:*28 tab sust.rel. particle/crystal(s)* refills:*0* 15. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: care discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 elevated hemoglobin a1c pmh: s/p coronary stent , hypertension, dyslipidemia, hypothyroidism, iron deficiency anemia, history of hemorrhoids and colon polyps, s/p tonsillectomy, s/p left ankle surgery discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month or while taking narcotics for pain. 7) call with any questions or concerns. followup instructions: dr. in weeks, call for appt dr. in weeks, call for appt dr. in weeks, call for appt dr (gastroenterology, ) tuesday @1pm. procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension unspecified acquired hypothyroidism percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia insulins and antidiabetic agents causing adverse effects in therapeutic use iron deficiency anemia, unspecified internal hemorrhoids with other complication other specified hypoglycemia hemorrhage of rectum and anus other specified disorders of intestine impaired fasting glucose 

Answer: The patient is high likely exposed to