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: history of present illness: the patient is a 76-year-old gentleman with a history of coronary artery disease (with a history of an inferior wall myocardial infarction in ; status post coronary artery bypass graft in and a redo coronary artery bypass graft in ) who was admitted on for three days of persistent epigastric discomfort. at this point, the patient denied any chest pain, shortness of breath, headaches, visual changes, nausea, vomiting, diarrhea, constipation, fevers, chills, or sweats. the patient complained of increased bloating and belching which was not similar to anginal pain he had experienced in the past. he denied having chest pain for the past 12 years. on , the patient was awoken from sleep when he had anginal chest pain. electrocardiogram was without evidence of st segment elevations. initial cardiac enzymes were negative on admission; however, now are significant for a troponin t elevation from 0.54 to 0.85. however, his creatine phosphokinase of 129 was trending down. an echocardiogram was performed, and the patient was found to have an ejection fraction of 25%, paced at 58 (which was elevated) and a new 4+ mitral regurgitation. the patient was then referred for a cardiac catheterization. in the catheterization laboratory, angiography revealed a 90% stenosis of the proximal saphenous vein graft to the right coronary artery and 80% stenosis of the distal ramus. a stent was placed in the proximal region of the saphenous vein graft with no evidence of residual stenosis and resultant timi-iii flow. the patient was started on integrilin and milrinone and transferred to the coronary care unit. past medical history: 1. coronary artery disease. (a) the patient had an inferior myocardial infarction in . (b) status post coronary artery bypass graft with left internal mammary artery to first diagonal, saphenous vein graft to left anterior descending artery, saphenous vein graft to right coronary artery. (c) status post redo coronary artery bypass graft in . (d) the patient also had a catheterization on showing patent grafts with 50% touchdown of left internal mammary artery occlusion. noted to have a pressure gradient across his left subclavian artery. 2. peripheral vascular disease; status post coronary artery bypass graft on with left renal stent placed for renal artery stenosis; bilateral iliac stents placed. 3. hypercholesterolemia. 4. hypertension. 5. chronic obstructive pulmonary disease. 6. gastroesophageal reflux disease. 7. congestive heart failure; echocardiogram from showed an ejection fraction of 25%, 4+ mitral regurgitation, 3+ tricuspid regurgitation, akinetic left ventricular wall motion, and dilated right ventricle. 8. bilateral carotid endarterectomies. medications on admission: 1. aspirin 81 mg by mouth once per day. 2. lipitor 10 mg by mouth once per day. 3. cardura 4 mg by mouth once per day. 4. cardizem 240 mg by mouth once per day. 5. toprol 200 mg by mouth once per day. 6. diovan 160 mg by mouth once per day. 7. lasix 40 mg by mouth once per day. 8. potassium chloride 10 meq by mouth once per day. 9. niacin 1000 mg by mouth once per day. 10. prilosec 20 mg by mouth every day. 11. fish oil 4000 units by mouth every day. allergies: social history: the patient quit smoking approximately 20 years ago. occasional alcohol use. no drug use. family history: mother deceased from a cerebrovascular accident at 50 years of age. father deceased from congestive heart failure at the age of 80. physical examination on presentation: physical examination on admission to the coronary care unit revealed vital signs with a temperature of 97 degrees fahrenheit, blood pressure was 95/39, heart rate was 68, respiratory rate was 20, and oxygen saturation was 100% on 2 liters nasal cannula. pulmonary artery diastolic pressure was 10. generally, the patient was lying in bed and calm. in no acute distress. head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light and accommodation. positive bilateral carotid bruits. elevated jugular venous pulsation. cardiovascular examination revealed a regular rate. normal first heart sounds and second heart sounds. a holosystolic murmur at the apex and left sternal border. lung examination revealed decreased breath sounds bilaterally. crackles noted at the anterior bases bilaterally. abdominal examination revealed positive bowel sounds. soft, nontender, and nondistended. extremity examination revealed pulses were 2+. no edema. right femoral line in place. assessment and plan: the patient is a 76-year-old male with coronary artery disease now with elevated troponin levels and occlusion of the saphenous vein graft to the right coronary artery, status post stent placement, with no evidence of residual stenosis. the patient was started on a milrinone drip for afterload reduction, and fluid status was monitored. hospital course by issue/system: the patient was continued on the milrinone drip for afterload reduction understanding that the mitral regurgitation may decrease. 1. ischemia issues: in terms of his ischemia, the patient denied any further chest pain. no electrocardiogram changes were noted. the patient was continued on his aspirin and plavix. the patient was noted to have ectopic beats on the milrinone drip. therefore, the drip was titrated down, and the patient was started on captopril 6.25 mg three times per day. the patient also received one unit of packed red blood cells for a drop in his hematocrit from 25.8 which corrected to 31.6. on admission to the coronary care unit, the patient's chest x-ray showed pulmonary vasculature congestion. he received 100 mg of intravenous lasix for diuresis as well as being continued on captopril for afterload reduction. the patient was initially on a high oxygen requirement, requiring a nonrebreather face mask; however, after the patient was diuresed and afterload reduced, the patient's oxygen requirement decreased until the patient was 100% on room air. 2. rhythm issues: in terms of his rhythm, the patient converted between atrial fibrillation and a normal sinus rhythm and demonstrated evidence of paroxysmal atrial flutter as well as premature atrial contractions. however, the patient's rhythm corrected on its own. the patient is currently in a normal sinus rhythm. however, due to his current ischemia, and dilated left atrium, the patient was started on coumadin to prevent thrombus formation. 3. renal issues: in terms of the patient's renal function, his creatinine was elevated to 2.2 on admission to the coronary care unit with afterload reduction, increased perfusion of the kidneys, and appropriate diuresis the patient's creatinine trended down to 1.6 and is currently improving. the patient also complained dysuria; however, a urinalysis was negative for leukocyte esterase and nitrites. the patient was not started on antibiotics but was given a trial of pyridium for symptomatic relief. the patient will not be started on antibiotics unless urine cultures are positive. urine cultures currently pending. a repeat echocardiogram showed a dilated left atrium with a diameter of 5.7 cm. the left ventricular wall showed basal and mid inferior akinesis, dilated left ventricular and right ventricular (which was larger than previous examination), 4+ mitral regurgitation, 2+ tricuspid regurgitation, and without significant change. ejection fraction was 20% to 25%. plans for this patient: 1. cardiovascular: (a) coronary artery disease; status post percutaneous coronary intervention of his saphenous vein graft to the right coronary artery. the patient was to be continued on aspirin, plavix, and lipitor. (b) pump: ejection fraction of 25%, 4+ mitral regurgitation, dilated left ventricle and right ventricle, and dilated left atrium. the patient was at increased risk for atrial fibrillation given left atrial size and ischemia. the patient was to be continued on warfarin and continued on an ace inhibitor for afterload reduction. (c) rhythm: as stated before, the patient was to be continued on his coumadin for the risk for atrial fibrillation and atrial flutter and was to be sent home with of hearts monitor on discharge. 2. gout: the patient had an episode of pain consistent with gout in his left big toe which was relieved with colchicine 0.6 mg by mouth as needed. currently, the patient with no complaints of pain. the patient has had a diagnosis of gout in the past and has been successfully treated with indocin; however, at the time of treatment the patient's kidney function was not at baseline. therefore, nonsteroidal antiinflammatory drugs could not be initiated. the patient has been treated successfully with colchicine treatment. 3. renal: urinalysis was negative for leukocyte esterase or nitrites. dysuria was likely secondary to inflammation or trauma from the foley catheter. the patient was given a prescription for pyridium for his dysuria, and symptomatic relief was noted. the patient's creatinine decreased from 2.2 to 1.6 (currently) and was trending down. the patient was started on lasix 40 mg once per day and may be sent home with this medication as the patient is likely to have dietary indiscretion as an outpatient. discharge disposition: the patient was to be sent home with of hearts monitor. the patient was not likely to require home services. the patient was to be followed in the for frequent inr checks. the patient was to follow up with dr. in approximately one month. the patient was to be scheduled for an echocardiogram prior to his cardiology follow-up appointment. current condition at discharge: condition on discharge was stable. current medications on discharge: 1. atorvastatin 10 mg by mouth once per day. 2. coumadin 5 mg by mouth once per day. 3. plavix 75 mg by mouth every day. 4. lisinopril 10 mg by mouth twice per day. 5. toprol-xl 100 mg by mouth once per day. 6. colchicine 0.6 mg one tablet by mouth q.1-2h. as needed (for gouty pain). 7. aspirin 81 mg by mouth once per day. 8. prilosec 20 mg by mouth every day. 9. fish oil capsules. 10. niacin 1000 mg by mouth once per day. 11. lasix 40 mg by mouth once per day. 12. potassium chloride 10 meq by mouth once per day. , m.d. dictated by: medquist36 procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor angiocardiography of right heart structures diagnoses: subendocardial infarction, initial episode of care mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified coronary atherosclerosis of autologous vein bypass graft atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease chronic systolic heart failure 

Answer: The patient is high likely exposed to