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: patient recorded as having no known allergies to drugs attending: chief complaint: chest pain major surgical or invasive procedure: off pump coronary artery bypass grafting times four (left internal mammary artery to left anterior descending artery, saphenous vein graft to ramus, saphenous vein graft to obtuse marginal, saphenous vein graft to right coronary artery) history of present illness: mr. is a 61 year old male experiencing left sided chest discomfort which radiates toward left shoulder for about two months, occuring with activity and rest, lasting about 2 minutes. he was referred to cardiac surgery after a cardiac catheterization revealed severe coronary artery disease. past medical history: coronary artery disease, multiple pci unstable angina aortic aneurysm carotid stenosis (left occlusion, 99% right stenosis) hypertension pericarditis dyslipidemia (intolerant to lipitor) pancreatitis colon polyps diverticulosis peripheral artery disease permanent pacemaker (syncopal episode) - guidant pacr s/p pancreatectomy s/p splenectomy surgical repair of abdominal aortic aneurysm social history: mr. works in production at ice cream factory. he lives with his spouse. has a 50 pack year history, and his last cigarette was on . he imbibes 5 drinks each day on saturday and sunday. family history: his mother had carotid disease and died at age 66. physical exam: pulse: 50 av paced resp: 14 o2 sat: 96 % b/p right: 145/83 left: 122/70 height: 5'8" weight: 172 # general: skin: dry intact multiple areas of red discoloration circular non raised have been occuring for last year heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 100% av paced abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: none varicosities: none neuro: grossly intact, nonfocal alert and oriented x3 pulses: femoral right: +2 left: cath site dp right: +1 left: +1 pt : +1 left: +1 radial right: +2 left: +2 pertinent results: carotid u/s: 1. occluded left ica. 2. 70 to 79% right ica stenosis. echo: pre-bypass: 1.the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. 2. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is mildly depressed (lvef= 45 %). 3. right ventricular chamber size and free wall motion are normal. 4. there are complex (mobile) atheroma in the aortic arch. there are complex (mobile) atheroma in the descending aorta. 5. there are three aortic valve leaflets. there is no aortic valve stenosis. trace aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. 7. there is no pericardial effusion. post off pump cabg: pt is on phenylephrine and intermittently paced. 1. biventricular function is unchanged. 2. aorta is intact. visualized mobile atheromas appear to be still present. 3. other fingings are unchanged dr. notified in person of the results. cxr: there is new pleural effusion seen on the lateral view, most likely right, corresponding to the clinical findings. the cardiomediastinal silhouette is stable. the pacemaker leads are in the right atrium and right ventricle. the patient is after median sternotomy and cabg. there is no pneumothorax. 03:59pm blood wbc-10.4 rbc-4.66 hgb-15.1# hct-44.2 mcv-95 mch-32.5* mchc-34.3 rdw-13.6 plt ct-305 10:25am blood wbc-13.3* rbc-2.94* hgb-9.4* hct-28.6* mcv-98 mch-32.1* mchc-32.9 rdw-14.0 plt ct-330 03:59pm blood pt-14.2* ptt-31.9 inr(pt)-1.2* 06:45am blood pt-12.6 inr(pt)-1.1 03:59pm blood glucose-100 urean-20 creat-0.9 na-140 k-4.6 cl-102 hco3-28 angap-15 10:25am blood glucose-160* urean-17 creat-0.8 na-135 k-4.4 cl-102 hco3-24 angap-13 07:25pm blood alt-18 ast-50* ld(ldh)-439* alkphos-71 amylase-23 totbili-0.4 brief hospital course: mr. was admitted on from to cardiac surgery for a pre-operative work-up. on he underwent an off pump coronary artery bypass grafting times four. please see the operative note for details. he was transferred in critical but stable condition to the cardiac surgery intensive care unit. by post-op day one the patient was extubated, alert and oriented, neurologically intact and hemodynamically stable on no inotropic or vasopressor support. he was found suitable for transfer to telemetry at this time. he continued to make good progress. chest tubes and pacing wires were discontinued without complication. the patient's permanent pacemaker was interrogated by the electrophysiology service. beta blocker was started and the patient was gently diuresed toward his preoperative weight. he did have a brief burst of post-operative atrial fibrillation and was started on amiodarone. the remainder of his post-op course remained uneventful and he was discharged to home in good condition with vna services on post-op day five. medications on admission: lopressor 100 mg daily norvasc 10 mg daily asa 325 mg daily mmultivitamin omeprazole 20 mg daily simvastatin 20 mg daily started 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). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 6 days: then 400mg daily for 7 days then 200mg daily ongoing. disp:*75 tablet(s)* refills:*1* 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. multivitamin tablet sig: one (1) tablet po daily (daily). 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 10. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*75 tablet(s)* refills:*1* 11. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 12. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily): check leiver function test in one month. disp:*30 tablet(s)* refills:*2* 13. furosemide 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 14. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 7 days. disp:*7 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: coronary artery disease s/p coronary artery bypass x 4 discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr for dr. (cardiac surgery) at in 3 weeks (), please call for appointment. dr (pcp) in weeks (), please call for appointment. dr (cardiologist) in 4 weeks (), please call for appointment. see dr. (mw vascular) in 1 month. wound check appointment 2 as instructed by nurse () md procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass pericardiotomy diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome tobacco use disorder atherosclerosis of native arteries of the extremities with intermittent claudication atherosclerosis of aorta atrial fibrillation occlusion and stenosis of carotid artery without mention of cerebral infarction cardiac pacemaker in situ abdominal aneurysm without mention of rupture occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction diverticulosis of colon (without mention of hemorrhage) adhesive pericarditis 

Answer: The patient is high likely exposed to