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: simvastatin attending: chief complaint: chest discomfort with exertion referred for cardiac catheterization. major surgical or invasive procedure: cabgx3(lima-lad,svg-om,svg-pda)asd closure/ligation of history of present illness: 68 y.o male with chest discomfort on exertion, was referred for cardiac catheterization. catheterization report on showed an ef of 60%, no mr lad:40-50%, lcx: 90%, rca 100%. he was then referred to for cardiac surgery. past medical history: pmh: dm type 2, af, djd, anxiety, arthritis. psh:l tkr, cervical fusion c2-4, tonsillectomy, rt hernia repairx2, lipoma removal rt chest : zetia 10', celexa 20', digoxin 0.25', avodart 0.5', metformin 500", gluburide 2.5", verapamil 240 qa & 120 qp, lipitor 40', doxasosin 4', coumadin 10(3x/wk)15(4x/wk), asa 81', social history: occupation: financial tobacco: quit ppdx33yrs etoh: drinks/week family history: family history: race: caucasian brother died from mi at age 65 father had an mi in his early 60s sister had a stroke at age 59. physical exam: admission physical exam pulse:64, resp: 18, bp r: 143/77 l:132/91 height: 5'9", wgt: 240lbs general: nad skin: unremarkable well healed scar r chest heent: unremarkable, glasses chest: lungs cta bilat heart: rrr abdomen: obese, benign extremities: well-perfused, no edema varicosities: none neuro: none focal pulses: femoral, bp, pt radial equal bilaterally +2 carotid bruit: none bilaterally discharge physical exam neuro: none-focal pulmonary: decreased air l base sternal incision: no drainage, no erythema abdomen: soft, non-tender, bowel sound present extremities: warm, no edema, 1+ pedal pulses leg incision: lle, evh dry and intact pertinent results: 01:30pm urine color-straw appear-clear sp -1.037* 01:30pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 11:30am glucose-115* urea n-19 creat-0.7 sodium-133 potassium-4.1 chloride-99 total co2-27 anion gap-11 11:30am alt(sgpt)-18 ast(sgot)-15 alk phos-47 tot bili-0.5 11:30am albumin-3.7 11:30am %hba1c-6.6* 11:30am wbc-8.5 rbc-4.66 hgb-13.8* hct-41.3 mcv-89 mch-29.7 mchc-33.5 rdw-14.2 11:30am plt count-285 11:30am pt-13.1 ptt-26.4 inr(pt)-1.1 07:35am blood wbc-13.1* rbc-2.94* hgb-8.9* hct-25.8* mcv-88 mch-30.2 mchc-34.3 rdw-14.4 plt ct-308# 07:15am blood pt-15.3* inr(pt)-1.3* 07:35am blood plt ct-308# 07:35am blood glucose-107* urean-36* creat-0.9 na-136 k-4.1 cl-96 hco3-32 angap-12 radiology final report chest (portable ap) 2:50 pm chest (portable ap) reason: evaluate for effusion medical condition: 68 year old man with reason for this examination: evaluate for effusion portable chest, at 15:02 comparison study: . clinical information: effusion. findings: since the prior study, there is mild interval increase in the left-sided pleural effusion, which is now moderate. there is continued left lower lobe consolidation. the right lung is relatively clear. cardiomediastinal silhouette is within normal limits. there is a median sternotomy. impression: interval increase in left pleural effusion. left lower lobe atelectasis. dr. approved: sun 8:11 am echocardiography report , (complete) done at 9:30:40 am preliminary referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 68 m hgt (in): 70 bp (mm hg): 140/80 wgt (lb): 240 hr (bpm): 65 bsa (m2): 2.26 m2 indication: intraoperative tee for cabg, asd closure, laa ligation icd-9 codes: 745.5, 410.91, 427.31, 786.51, 440.0 test information date/time: at 09:30 interpret md: , md test type: tee (complete) 3d imaging. son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2007aw4-: machine: 4 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.4 cm <= 5.6 cm left ventricle - ejection fraction: 50% to 55% >= 55% aorta - annulus: 2.5 cm <= 3.0 cm aorta - sinotubular ridge: 2.7 cm <= 3.0 cm aorta - ascending: *3.7 cm <= 3.4 cm aorta - descending thoracic: *2.9 cm <= 2.5 cm findings multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: moderate to severe spontaneous echo contrast in the body of the la. depressed laa emptying velocity (<0.2m/s) cannot exclude laa thrombus. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left-to-right shunt across the interatrial septum at rest. secundum asd. left ventricle: normal lv wall thickness. normal lv cavity size. low normal lvef. right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated aortic sinus. mildly dilated ascending aorta. normal aortic arch diameter. simple atheroma in aortic arch. mildly dilated descending aorta. simple atheroma in descending aorta. aortic valve: mildly thickened aortic valve leaflets (3). no ar. mitral valve: mildly thickened mitral valve leaflets. torn mitral chordae. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic 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. the rhythm appears to be atrial fibrillation. results were personally reviewed with the md caring for the patient. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-bypass: 1. moderate spontaneous echo contrast is seen in the body of the left atrium. the left atrial appendage emptying velocity is depressed (<0.2m/s). a left atrial appendage thrombus cannot be excluded. there is prominence of the pectinate muscles. 2. a left-to-right shunt across the interatrial septum is seen at rest. a secundum type atrial septal defect is present. 3. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is low normal (lvef 50-55%). there is hypokinesis of the inferior and inferior lateral walls from the mid=papillary to apical levels. 4. right ventricular chamber size and free wall motion are normal. 5. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. there are simple atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. 6. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. 7. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. a2 scallop is notable for a torn chordae. post-bypass: pt removed from cardiopulmonary bypass on phenylephrine infusion and av paced. 1. biventricular function is maintained, regional wall abnormalites as noted pre-bypass. 2. asd is closed; there is no flow across the intra-atrial septum. 3. the left atrial appendage has been obliterated. 4. aortic contours are intact post-decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician brief hospital course: mr was admitted on for cardiac catheterization which revealed 3vds and was then referred to for cardiac surgery. he was brought to the operating room on and underwent a cabgx3 lima-lad, svg-om, svg-pda, asd closure and ligation of l atrial appendage without any immediate complication. he was then transferred to the intensive care in stable condition. he received vancomycin in during his perioperative period because he was inpatient prior to his surgery. he did well in the immediate period, he anesthesia was reversed and he was weaned off the ventilator and extubated. on pod1 he was weaned off of his vasoactive infusions and his cts were removed followed by a cxr that showed no pneumothorax. on pod2, he had and episode of rapid af and was treated with beta-blockers and anticoagulation. on pod3 he was transferred to f6 for further post-operative care management. over the last couple of days, he has advance his activity level with the help of physical therapy. on pod6 it was decided that he was stable and ready to transfer out to a rehabilitation center for further management of his physical activity. his inr will be followed by tcu at discharge and then by dr when discharge from the rehabilitation center. medications on admission: zetia 10mg daily celexa 20mg daily digoxin 0.25mg daily metformin 500mg avodart 0.5mg daily glyburide 2.5mg verapamil 120mg qpm lipitor 40mg bedtime doxazosin 4mg daily coumadin 10mg 3x/wk coumadin 15mg 4x/wk asa 81mg daily sl nitro prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. hydromorphone 2 mg tablet sig: one (1) tablet po every hours as needed. 4. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 5. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po twice a day for 2 weeks. disp:*qs tab sust.rel. particle/crystal(s)* refills:*0* 6. warfarin 10 mg tablet sig: 10mg alt w/15mg tablets po once a day: target inr 2-2.5 previously 10mg alt with 15mg pt to receive 10mg on . disp:*qs tablet(s)* refills:*0* 7. glyburide 2.5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*qs tablet(s)* refills:*2* 8. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*2* 9. doxazosin 4 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*qs tablet(s)* refills:*2* 10. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*qs tablet(s)* refills:*2* 11. avodart 0.5 mg capsule sig: one (1) capsule po once a day. disp:*qs capsule(s)* refills:*2* 12. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*0* 13. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). disp:*qs tablet(s)* refills:*0* 14. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). disp:*qs tablet(s)* refills:*2* 15. verapamil 240 mg tablet sustained release sig: one (1) tablet sustained release po qam (once a day (in the morning)). disp:*qs tablet sustained release(s)* refills:*2* 16. verapamil 120 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). disp:*qs tablet(s)* refills:*2* 17. furosemide 20 mg tablet sig: one (1) tablet po twice a day for 2 weeks. disp:*qs tablet(s)* refills:*0* discharge disposition: extended care facility: rehab unit at - discharge diagnosis: cad now s/p cabg dm2, afib, djd, anxiety, arthritis, l tkr, cervical fusion c2-4, tonsillectomy, rt hernia repairx2, lipoma removal rt chest 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 lifting more than 10 pounds or driving until follow up with surgeon. followup instructions: dr. 2 weeks dr. 2 weeks dr. 4 weeks md procedure: single internal mammary-coronary artery bypass coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization diagnostic ultrasound of heart excision or destruction of other lesion or tissue of heart, open approach other and unspecified repair of atrial septal defect diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation other and unspecified hyperlipidemia anxiety state, unspecified other and unspecified angina pectoris ostium secundum type atrial septal defect long-term (current) use of insulin long-term (current) use of anticoagulants long-term (current) use of aspirin 

Answer: The patient is high likely exposed to