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: ankle swelling major surgical or invasive procedure: coronary artery bypass grafting x 3 (left internal mammary artery grafted to left anterior descending artery/saphenous vein grated to obtuse marginal/posterior left ventricular artery)- history of present illness: this is an 83 year old male admitted to with congestive heart failure (acute systolic hf) and nstemi. new echocardiogram showed lvef of 43% with mild mr . he was stabilized on medical therapy and transferred to the for further evaluation and treatment. cardiac catheterization here revealed severe three vessel disease. given the severity of his disease, he has been referred for surgical revascularization. past medical history: past medical history - cad, ischemic cardiomyopathy - hypertension - dyslipidemia - history of complete heart block - chronic renal insufficiency - anemia - spinal stenosis - lumbar scoliosis - varicose veins past surgical history - biventricular pacemaker - hand surgerycardiac: social history: quit smoking at age 21, does not currently use alcohol or illicit drugs family history: no history of early cardiac death. otherwise non-contributory. physical exam: physical exam pulse: 70 sr resp: 20 o2 sat: 98% ra temp: 98.7 b/p right: 123/63 left: 118/66 height: 68" weight: 155lbs general: wdwn elderly male in nad skin: dry, warm, intact, no jvd. multiple nevi/keratosis noted, particularly along sternal tract. heent: ncat, perrla, eomi, sclera anicteric, op benign neck: supple full rom , no jvd chest: mildly diminished at basis r>l heart: rrr, nls1-s2, no m/r/g abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused trace edema varicosities: right gsv with gross varicosities likley branches from maingsv. left appears suitable on standing. neuro: grossly intact, no focal deficits, mae, gait steady. pulses: femoral right:2 left:2 dp right:2 left:2 pt :2 left:2 radial right:2 left:2 carotid bruit right: faint bruit left: none pertinent results: 05:07am blood wbc-16.3* rbc-3.87* hgb-11.8* hct-35.8* mcv-93 mch-30.4 mchc-32.9 rdw-16.3* plt ct-414 11:28am blood wbc-32.9*# rbc-2.41*# hgb-7.4*# hct-22.6*# mcv-94 mch-30.6 mchc-32.7 rdw-13.0 plt ct-445* 08:10am blood pt-17.5* ptt-32.8 inr(pt)-1.6* 11:28am blood pt-21.1* ptt-37.4* inr(pt)-2.0* 05:07am blood glucose-114* urean-46* creat-1.1 na-136 k-4.2 cl-101 hco3-26 angap-13 12:32pm blood urean-51* creat-1.3* cl-107 hco3-23 echocardiography report , j (complete) done at 9:09:32 am final referring physician information , c. , status: inpatient dob: age (years): 83 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: abnormal ecg. aortic valve disease. congestive heart failure. coronary artery disease. left ventricular function. mitral valve disease. right ventricular function. icd-9 codes: 427.60, 424.1, 424.0 test information date/time: at 09:09 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 #: 2009aw05-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.7 cm <= 4.0 cm left atrium - four chamber length: *5.7 cm <= 5.2 cm left ventricle - septal wall thickness: 0.7 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 0.7 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *7.0 cm <= 5.6 cm left ventricle - systolic dimension: 6.2 cm left ventricle - fractional shortening: *0.11 >= 0.29 left ventricle - ejection fraction: 20% to 25% >= 55% aorta - annulus: 2.0 cm <= 3.0 cm aorta - sinus level: 3.2 cm <= 3.6 cm aorta - sinotubular ridge: 2.7 cm <= 3.0 cm aorta - ascending: 2.7 cm <= 3.4 cm aorta - descending thoracic: 2.5 cm <= 2.5 cm aortic valve - valve area: *1.5 cm2 >= 3.0 cm2 findings due to severe global lv dysfunction and poor svo2 (50%), epinephrine infusion was started immediatey after inductioon with significant improvement inlv function. the reoprted wma's are being reported with the epinephrine infusion multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: moderate la enlargement. moderate to severe spontaneous echo contrast in the body of the la. depressed laa emptying velocity (<0.2m/s) no thrombus in the laa. all four pulmonary veins identified and enter the left atrium. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. no asd by 2d or color doppler. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness. severely dilated lv cavity. severe regional lv systolic dysfunction. severe global lv hypokinesis. severely depressed lvef. right ventricle: mildly dilated rv cavity. mild global rv free wall hypokinesis. aorta: normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. moderately thickened aortic valve leaflets. mild as (area 1.2-1.9cm2). no ar. mitral valve: moderately thickened mitral valve leaflets. mild mitral annular calcification. moderate thickening of mitral valve chordae. tricuspid valve: normal tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. 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. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. suboptimal image quality - poor echo windows. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-bypass: the left atrium is moderately dilated. moderate to severe spontaneous echo contrast is seen in the body of the left atrium. the left atrial appendage emptying velocity is depressed (<0.2m/s). no thrombus is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity is severely dilated. there is severe regional left ventricular systolic dysfunction with akinetic apex, iferior wall and lateral wall. there is moderate hypokinesis of the remaining segments (lvef =20-25 %). . the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate thickening of the mitral valve chordae. post cpb: 1. marginally improved lv global and focal systolic function with backgeound inotropic support. ef= 30%. 2. mildly improved rv globa;l rv systolci function. 3. intact aorta and unchanges valvular structure and function electronically signed by , md, interpreting physician 12:15 ?????? caregroup is. all rights reserved. brief hospital course: mr. was taken to the operating room and underwent coronary artery bypass grafting x 3 (left internal mammary artery grafted to left anterior descending artery/saphenous vein grated to obtuse marginal/posterior left ventricular artery). cross clamp time=63 minutes. cardiopulmonary bypass time=85 minutes. please refer to dr operative report for further details. he tolerated the procedure well and was transferred to the cvicu in critical but stable condition intubated, sedated, and on pressors and inotropes to optimize cardiac hemodynamics. postoperatively, ep interrogated his dual chamber ppm. mr. neurologically intact and was extubated without difficulty. all lines and drains were discontinued in a timely fashion. aspiirin, beta-blocker, statin and diuresis was initiated. pod#3 he was transferred to the step down unit for further monitoring. physical therapy was consulted for evaluation of strength and mobility. he continued to progress and on pod#10 he was cleared by dr. for discharge to rehab. all follow up appointments were advised. medications on admission: medications(transfer): metoprolol 25 , lasix 20 qd, lisinopril 20 qd, aspirin 325 qd, sq heparin, lipitor 10 qd active meds: 1. 2. acetaminophen 3. aspirin ec 4. atropine sulfate 5. azithromycin 6. furosemide 7. heparin 8. lisinopril 9. metoprolol tartrate 10. pneumococcal vac polyvalent 11. potassium chloride 12. simvastatin 13. sodium chloride 0.9% flush discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever/pain. 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 4. atorvastatin 40 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 5. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 6. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 8. metolazone 2.5 mg tablet sig: two (2) tablet po bid (2 times a day) for 2 weeks. 9. furosemide 40 mg tablet sig: one (1) tablet po twice a day for 2 weeks. 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po bid (2 times a day) for 2 weeks: hold for k>4.5. tab sust.rel. particle/crystal(s) discharge disposition: extended care facility: & rehab center - discharge diagnosis: 1. severe 3-vessel coronary artery disease. 2. ischemic cardiomyopathy. 3. complete heart block status post pacemaker/defibrillator. 4. poor left ventricular function with an ejection fraction of 30%. 5. previous inferior wall myocardial infarction. discharge condition: alert and oriented x3 nonfocal ambulating with assistance sternal pain managed with percocet prn discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: please call to schedule appointments surgeon dr. in 4 weeks primary care dr., r. in weeks cardiologist dr , in weeks wound check appointment - 6 () - your nurse will schedule procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnoses: coronary atherosclerosis of native coronary artery unspecified pleural effusion congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified other specified forms of chronic ischemic heart disease chronic systolic heart failure fitting and adjustment of cardiac pacemaker pseudomonas infection in conditions classified elsewhere and of unspecified site spinal stenosis, lumbar region, without neurogenic claudication acute myocardial infarction of inferolateral wall, subsequent episode of care 

Answer: The patient is high likely exposed to