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: left sided weakness major surgical or invasive procedure: cerebral angiogram with intervention history of present illness: mr. is a 72 year-old right-handed man with pmh significant for cabg who presents with acute onset left sided weakness. his wife was present with him and noted that around 1 pm, he suddenly started sweating, slumping over and slurring his words. he was immediately brought to the ed within 25 minutes of symptom onset. prior to the onset of these symptoms, he was in good health. he has no prior history of strokes. his vascular risk factors include cad s/p cabg, brief history of htn for which he was on a medication (believed to be b-blocker, though not currently on any meds) and about 50 pack year smoking history. past medical history: -cad s/p 3 vessel cabg in -htn (treated for 1 year in the past, but apparently improved and not currently on any meds) -duodenal ulcer s/p cauterization about 2 years ago (this occurred in the setting of being on asa, which has seen been d/c) social history: he lives in and is currently in visiting family; he arrived . he is retired. he smokes 8 cigarettes per day, prior to cabg smoked cigarettes per day, he has smoked for about 50 years. family history: there is significant vascular history (cad and strokes) in his father and brothers. physical exam: at admission: vitals: p: 77 r: 26 bp: 151/91 sao2: 98% on 2l o2 general: awake, cooperative heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: supple pulmonary: lcta b/l cardiac: rrr, s1s2, no murmurs appreciated abdomen: soft, nt/nd, +bs extremities: warm, well perfused neurologic: nih stroke scale score was: 18 1a. level of consciousness: 0 1b. loc question: 0 1c. loc commands: 0 2. best gaze: 1 (right gaze preference) 3. visual fields: 2 4. facial palsy: 2 5a. motor arm, left: 4 5b. motor arm, right: 0 6a. motor leg, left: 4 6b. motor leg, right: 0 7. limb ataxia: 0 8. sensory: 2 9. language: 0 10. dysarthria: 1 11. extinction and neglect: 2 mental status: awake, alert, oriented to person, city, month and year (said date was ). he has a dense left sided neglect (says his hand is examiner's). speech is dysarthric but fluent. he has anomia for low frequency objects but able to name high frequency objects. he is able to repeat. comprehension is intact. cranial nerves: perrl 3 to 2mm. left hemianopia vs. left hemineglect. right gaze preference at rest. he is able to track finger across midline with full eoms. left facial droop. motor: normal bulk. left ue flaccid tone and diminished tone in lle. lue plegic. lle initially plegic but subsequently able to hold lle against gravity briefly. right sided strength is all at least antigravity. sensory: no grimmace to noxious stimuli on left and says he does not feel pinprick on left. he has extensor posturing with noxious stimulation of left upper extremity and during time in ed, did have withdrawal of left lower extremity to noxious. dtrs: patellar reflex slightly brisker on right compared to left, though brisk b/l. there was a flexor plantar response b/l. coordination: no dysmetria on right finger-nose. plegic on left so not assessed. gait: deferred physical exam on discharge: pertinent results: 01:45pm blood wbc-7.7 rbc-5.29 hgb-15.7 hct-45.7 mcv-87 mch-29.8 mchc-34.4 rdw-13.8 plt ct-345 01:45pm blood pt-9.9 ptt-21.5* inr(pt)-0.9 01:40pm blood creat-0.8 03:16am blood glucose-114* urean-10 creat-0.7 na-137 k-4.0 cl-107 hco3-19* angap-15 03:16am blood alt-19 ast-21 alkphos-62 totbili-1.1 08:20pm blood ctropnt-<0.01 03:16am blood ctropnt-<0.01 03:16am blood albumin-3.4* calcium-8.0* phos-3.0 mg-1.8 cholest-164 03:16am blood %hba1c-5.7 eag-117 03:16am blood triglyc-80 hdl-51 chol/hd-3.2 ldlcalc-97 01:50pm blood glucose-98 na-138 k-4.2 cl-102 calhco3-24 08:20pm urine color-yellow appear-clear sp -1.005 08:20pm urine blood-mod nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-0.2 ph-5.0 leuks-neg 08:20pm urine rbc-30* wbc-<1 bacteri-none yeast-none epi-0 08:20pm urine bnzodzp-pos barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg mr head without contrast: impression: bilateral areas of restricted diffusion, more significant on the right, involving the frontal, occipital, and caudate nucleus on the right and also the left frontal lobe, left centrum semiovale, likely consistent with an acute/subacute thromboembolic ischemic event, previously demonstrated by head ct. nchct: impression: right frontal and parieto-occipital hypodensities compatible with acute on subacute evolving watershed infarcts. no signs of hemorrhage. correlation with mri is recommended. cerebral angiogram: findings: left common carotid artery arteriogram shows filling of the left internal carotid artery along the cervical, petrous, cavernous, and supraclinoid portion. the anterior and middle cerebral arteries are seen well. the anterior cerebral artery is seen to be dominant on the left side. there is no stenosis at the carotid bifurcation in the neck though there is significant calcification. right common carotid artery arteriogram again shows high-grade stenosis of the right common carotid bifurcation at the origin of the external carotid. the stenosis at this segment is about 80%. there is also distal disease involving the first 20 mm of the internal carotid artery. the left middle cerebral artery fills well with no branch occlusion. right common carotid artery arteriogram status post stenting and angioplasty shows widely patent right common and internal carotid artery. there is no residual stenosis. right common femoral artery arteriogram shows widely patent right common femoral artery. impression: underwent carotid stenting and angioplasty after he presented with a high-grade stenosis and a right hemispheric syndrome. there were no complications. cta head and neck: impression: 1. evidence of extensive acute ischemia throughout the right middle cerebral arterial territory, with focal abnormalities of rcbv/cbf, within, as well as in the contralateral hemisphere, suspicious for "core" infarcts. 2. extensive steno-occlusive disease involving the right internal carotid artery from its origin and throughout its cervical portion. there is only minimal evidence of recanalization, with flow to the carotid terminus and ipsilateral mca via cross-filling from a patent circle of , as detailed above. 3. markedly anomalous posterior circulation, as detailed above, including a very large-caliber and tortuous left persistent trigeminal artery (a patent fetal carotico-basilar anastomosis), as well as a robust fetal-type right pca. this likely accounts for the markedly small caliber of the distal v4 segments of both vertebral arteries, which demonstrate effective pica-termination, as well as the very diminutive basilar artery. 4. no evidence of significant steno-occlusive disease or aneurysm larger than 2 mm involving the intracranial circulation. 5. severe bullous pan-acinar emphysema involving the included lung apices. cxr: impression: an endotracheal tube is seen with its tip approximately 5 to 5.5 cm above the carina. a nasogastric tube is seen coursing below the diaphragm with its tip within the stomach. the patient is status post median sternotomy. heart is upper limits of normal in size. the mediastinal contours are within normal limits. calcification of the aorta is consistent with sclerosis. there is some perihilar fullness and vascular redistribution suggestive of pulmonary venous hypertension, no overt pulmonary edema. no focal airspace consolidation is seen to suggest pneumonia. no pleural effusions or pneumothoraces transthoracic echo: mild pulmonary artery systolic hypertension. normal biventricular cavity sizes with preserved global and regional biventricular systolic function. no definite structural cardiac source of embolism identified. transesophageal echo: no pfo, asd or intracardiac thrombus. complex artheroma in the descending aorta. normal biventricular size and global systolic function. labs on discharge: none brief hospital course: mr. is a 72 year-old right-handed man with pmh significant for cad s/p cabg (in ) who presents with left sided weakness. neuro: he was a code stroke, with deficits notable for right gaze preference, left neglect, left facial droop and initially left sided plegia and sensory loss; initial nihss 18. on imaging, he was found to have an acute r mca stroke and found to have right ica occlusion with distal recanalization, but then also with apparent r superior divivision mca occlusion. he received iv tpa- bolus at 1350 (symptom onset at 1300). there were no clear initial improvement in deficits aside from some improvement in movement of left lower extremity and pupils more in midline at rest. given lack of significant improvement and clot noted on cta, he was sent for interventional angiogram. a stent was placed in the right proximal ica for high-grade stenosis with good perfusion afterwards. mri post intervention showed infarcts involving the frontal, occipital, and caudate nucleus on the right and the left frontal lobe and left centrum semiovale. the patient was seen by physical and occupational therapy and his strength gradually improved in his left leg, though not left arm, over the ensuing days. the right mca and pca infarcts are most probably due to emboli/hypoperfusion from the right ica occlusion (the right pca infarct can be explained by emboli through the right fetal pca to the occipital lobe). the small left frontal and left centrum semiovale infarcts are possibly due to emboli that were generated by the catheter during the conventional angiogram procedure. despite extensive evaluation, no cardioembolic source was found. the patient was recommended to undergo holter monitoring as an outpatient to evaluate again for possible atrial fibrillation. cardiac: the patient was monitored on telemetry with no signs of atrial fibrillation. tte revealed no intracardiac thrombus and no pfo. tee showed complex atheroma in the descending aorta. clopidogrel 75mg po daily started for secondary stroke prevention and to prevent stent rethrombosis. simvastatin 20mg po daily was started for goal ldl < 100. diet: after being seen by speech and swallow the patient had pureed solids and thin liquids. patient was full code 1. dysphagia screening before any po intake? y 2. dvt prophylaxis administered? y 3. antithrombotic therapy administered by end of hospital day 2? y 4. ldl documented? y ldl 97 5. intensive statin therapy administered? no, ldl <100 6. smoking cessation counseling given? y 7. stroke education given? y 8. assessment for rehabilitation? y 9. discharged on statin therapy? y 10. discharged on antithrombotic therapy? y plavix 11. discharged on oral anticoagulation for patients with atrial fibrillation/flutter? n/a pending results platelet aggregation assay medications on admission: none discharge medications: 1. clopidogrel 75 mg po daily please start morning of rx *clopidogrel 75 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*2 2. lisinopril 10 mg po daily rx *lisinopril 10 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*0 3. simvastatin 20 mg po daily rx *simvastatin 20 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*0 discharge disposition: home discharge diagnosis: right ischemic stroke with right ica occlusion discharge condition: general: awake, cooperative, nad. oriented x3 right gaze preference and (largely resolved) partial left-sided visual neglect and mild sensory neglect. motor: 4+ left hip flexor, 5 left ham. flaccid left arm. toes upgoing on the left. joint position sense impaired on left toe and left arm up to elbow. discharge instructions: dear mr. , you were admitted to the hospital with a stroke due to a clot in a blood vessel in your brain. we treated you with a medication that breaks up the clot and also went into the blood vessel in your brain and placed a stent to keep the artery open. you had an ultrasound of your heart which did not show a clot, which was reassuring. you should have a holter monitor arranged by your primary doctor to evaluate you further for any abnormal heart rhythms. we have started you on medications for cholesterol and blood pressure, it is very important that you continue these. we have made the following changes to your medications: start clopidogrel 75mg daily (a blood thinner) lisinopril 10mg daily (for blood pressure) simvastatin 20mg daily (for cholesterol control) on discharge, please follow up with your primary care doctor and ask him to refer you to a neurologist. also, you would benefit from physical therapy. please discuss this with your doctor . it was a pleasure taking care of you, we wish you all the best! followup instructions: you should see your primary doctor when you return home and ask him to arrange for you to see a neurologist near you. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours injection or infusion of platelet inhibitor diagnostic ultrasound of heart insertion of endotracheal tube injection or infusion of thrombolytic agent arteriography of cerebral arteries percutaneous angioplasty of extracranial vessel(s) percutaneous insertion of carotid artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent procedure on single vessel diagnoses: tobacco use disorder unspecified essential hypertension coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status occlusion and stenosis of carotid artery with cerebral infarction facial weakness hemiplegia, unspecified, affecting nondominant side 

Answer: The patient is high likely exposed to