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: lipitor / gemfibrozil attending: chief complaint: chest pain major surgical or invasive procedure: coronary artery bypass graft x3 coronary artery bypass grafting x3 with the left internal mammary artery to left anterior descending artery, and reverse saphenous vein graft to the obtuse marginal artery, and the diagonal artery. 2. left atrial appendage resection. for chronic afib history of present illness: mr. is a 74 yo m with cad s/p mi, anxiety, htn, hyperlipidemia and chronic afib, who presented to osh on with nstemi, and was transferred to on for cardiac cath. cath demonstrated complex lad and diagonal disease, and was evaluated by cardiac surgery for revasularization after plavix washout. . mr. presented initially on after developing substernal chest pain. the pain was associated with mild sob and radiated to his left shoulder. in the osh ed, he was given sl nitro and aspirin and the pain subsided. he was loaded with plavix. .at osh, his troponin peaked at 0.40 on @ . . past medical history: - cad, h/o mi - hypertension - hyperlipidemia - gout - atrial fibrillation, chronic - anxiety - bilateral tkr. -right hip replacement social history: the patient lives with his wife and a son. quit smoking in , after smoking 3 ppd for 15 years. he drinks 4-5 beers per day. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: physical examination: vs - 96.9 157/82 79 16 99%2l gen: wdwn male in nad. oriented x3. mood, affect appropriate. heent: perrl, eomi. mmm. neck: supple with no elevation of jvp. cv: irregular, normal s1, s2. no m/r/g. no s3 or s4. chest: nasal cannula in place. resp were unlabored, no accessory muscle use. lung exam limited by patient's inability to move post-procedure. abd: soft, ntnd. no hsm or tenderness. ext: no c/c/e. no femoral bruits. no hematoma. c/d/i. . pulses: right: carotid 2+ femoral 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ dp 2+ pt 2+ pertinent results: echo prebypass the left atrium is moderately dilated. the left atrium is elongated. mild spontaneous echo contrast is seen in the body of the left atrium. mild spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). a left atrial appendage thrombus cannot be excluded due to presence of spontaneous echo contrast and difficulty visualizing tip of appendage. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is mildly dilated with normal free wall contractility. there are simple atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. postbypass the patient is a-v paced and is not on any inotropes. the left atrial appendage has been ligated. we are unable to identify any remnants of the appendage and there is no flow in the area of the appendage on color doppler. left ventricular systolic function continues to be normal (lvef>55%). trace aortic regurgitation and trivial mitral regurgitation remain. the thoracic aorta is intact. pre-op 11:25am pt-18.4* ptt-33.8 inr(pt)-1.7* 11:25am plt count-118* 11:25am wbc-4.0 rbc-4.21* hgb-13.8* hct-39.7* mcv-94 mch-32.8* mchc-34.8 rdw-13.6 11:25am triglycer-74 hdl chol-58 chol/hdl-2.9 ldl(calc)-93 11:25am %hba1c-5.3 eag-105 11:25am albumin-3.8 cholest-166 11:25am alt(sgpt)-22 ast(sgot)-24 alk phos-67 tot bili-0.7 11:25am glucose-219* urea n-9 creat-0.6 sodium-129* potassium-3.9 chloride-97 total co2-24 anion gap-12 discharge 05:55am blood wbc-6.9 rbc-3.01* hgb-10.1* hct-27.7* mcv-92 mch-33.6* mchc-36.5* rdw-14.2 plt ct-118* 05:55am blood plt ct-118* 05:55am blood glucose-108* urean-15 creat-0.6 na-132* k-3.5 cl-97 hco3-31 angap-8 radiology report chest (portable ap) study date of 10:06 am medical condition: 74 year old man with removal of chest tubes reason for this examination: eval for ptx final report in comparison with the study of , all of the monitoring and support devices other than the right ij catheter have been removed. no definite evidence of pneumothorax. bibasilar changes of atelectasis persist, more prominent on the left, where there is some associated pleural effusion. dr. brief hospital course: the patient was admitted to the hospital and after a plavix washout was brought to the operating room on for a coronary artery bypass graft x 3 and left atrial appendage ligation. see operative report for details, in summary he had: coronary artery bypass grafting x3 with the left internal mammary artery to left anterior descending artery, and reverse saphenous vein graft to the obtuse marginal artery, and the diagonal artery, left atrial appendage resection. his cross-clamp time was 70 minutes with a bypass pump time of 83 minutes. overall he tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. vancomycin was used for surgical antibiotic prophylaxis. on the day of surgery he woke neurologically intact, was weaned from the ventilator and extubated. beta blocker, statin and diuresis was initiated and he was gently diuresed toward his preoperative weight. initially mr. was sensitive to lopressor and became bradycardic to the 40's after receiving one dose of 25mg lopressor. lopressor was held temporarily and resumed at a lower dose and gently increased. coumadin therapy was resumed for atrial fibrillation. the patient was transferred to the telemetry floor for further recovery on pod1. all tubes lines drains and pacing wires were discontinued per cardiac surgery protocol without complication. mr. has chronic hyponatremia and was placed on a fluid restriction, serum sodium levels were monitored. he was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod #4 mr. was ambulating freely, the wound was healing and pain was controlled with oral analgesics. he was discharged in good condition with appropriate follow up instructions. dr was contact to follow his coumadin dosing. medications on admission: home medications: - aspirin 325 mg - allopurinol 300 mg daily - imdur 60 mg daily - zestril 40 mg daily - amlodipine 5 mg daily - xanax 0.125mg - coumadin 2.5 mg daily - tamsulosin 0.4 mg daily - docusate 100 mg added at osh: - plavix 75 mg daily (plavix 300 mg load on ) - solumedrol 40 mg ivp and a.m. - heparin 1000 units/hr discharge medications: 1. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 2. alprazolam 0.25 mg sig: one (1) po bid (2 times a day) as needed for anxiety. 3. ezetimibe 10 mg sig: one (1) po daily (daily). 4. allopurinol 300 mg sig: one (1) po daily (daily). 5. aspirin 81 mg , delayed release (e.c.) sig: one (1) , delayed release (e.c.) po daily (daily). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. acetaminophen 325 mg sig: two (2) po q4h (every 4 hours) as needed for pain. 8. ranitidine hcl 150 mg capsule sig: one (1) capsule po once a day. disp:*30 capsule(s)* refills:*2* 9. metoprolol tartrate 25 mg sig: 0.5 po bid (2 times a day). disp:*30 (s)* refills:*2* 10. warfarin 1 mg sig: md daily (daily) as needed for afib: inr goal >2.0 for afib. disp:*60 (s)* refills:*0* 11. furosemide 20 mg sig: one (1) po bid (2 times a day) for 3 days. disp:*6 (s)* refills:*0* 12. potassium chloride 10 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 3 days. disp:*6 tab sust.rel. particle/crystal(s)* refills:*0* 13. warfarin 5 mg sig: one (1) po once (once) for 1 doses. disp:*1 (s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease s/p cabg x3 pmh: gout, myocardial infarction, hypertension, anxiety - takes xanax every night and wakes at times in panic, hyperlipidemia, atrial fibrillation (on coumadin), s/p total hip arthroplasty right - , s/p bilateral knee replacement - both in discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with tylenol incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema: trace bilat discharge instructions: 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 please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart 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 no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **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. on @2:30 cardiologist:dr on @3:15p please call to schedule appointments with your 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** labs: pt/inr for coumadin ?????? indication atrial fibrillation goal inr 2-2.5 first draw results to dr fax procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension hyposmolality and/or hyponatremia gout, unspecified atrial fibrillation other and unspecified hyperlipidemia anxiety state, unspecified old myocardial infarction long-term (current) use of anticoagulants knee joint replacement hip joint replacement long-term (current) use of antiplatelet/antithrombotic 

Answer: The patient is high likely exposed to