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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: cystoscopy, urethral dilation, foley catheter placement coronary artery bypass graft x4 (lima-lad, svg-lad,svg-dg,svg-om1,svg-om2) history of present illness: this 56 year old gentleman has a history of coronary artery disease and is status post myocardial infarction in and . he has been experiencing chest pressure for the past 2 months, intermittent, occurring at rest and associated with shortness of breath, resolving without intervention. he developed chest tightness and shortness of breath on which did not resolve and he called 911. he was admitted to for further work-up. a cardiac catheterization was obtained which revealed severe three vessel coronary artery disease. given the severity of his disease, he was transferred to the for surgical management. past medical history: coronary artery disease - 5 total stents stemi with pci with stents x 3 to circ at lgh mi with hypertension hyperlipidemia chronic renal insufficiency creat 1.5 bph pancreatitis from gall bladder stones copd past hx urinary tract infection blind in left eye ? right nephrectomy - ? wilms tumor as child cholecystectomy lysis of adhesions for small bowel obstruction - dr. inguinal hernia repair abdominal hernia repair social history: lives with: wife and adult child in , 2 kids, 3 step kids occupation: maintenance mechanic, currently working tobacco: active smoker. - 1ppd x 42 years etoh: none family history: noncontributory physical exam: pulse: 54 resp: 18 o2 sat: 93% ra b/p right:92/59 left: height: 63" weight: 200 general: aaox 3 in nad skin: dry intact heent: perrla eomi left lid lag, left eye blindness neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + well healed midline abdominal scar extremities: warm , well-perfused no edema varicosities: none neuro: grossly intact pulses: femoral right: slight oozing at cath sit left: 2+ dp right:1+ left:1+ pt :1+ left:1+ radial right:2+ left:2+ carotid bruit right:none left:none pertinent results: 05:00am blood wbc-10.0 rbc-3.36* hgb-10.3* hct-29.9* mcv-89 mch-30.8 mchc-34.6 rdw-13.2 plt ct-163 06:52pm blood wbc-7.8 rbc-5.01 hgb-15.6 hct-44.7 mcv-89 mch-31.1 mchc-34.8 rdw-13.3 plt ct-158 05:00am blood plt ct-163 01:35am blood pt-14.9* ptt-25.9 inr(pt)-1.3* 06:52pm blood pt-13.5* ptt-28.1 inr(pt)-1.2* 06:52pm blood plt ct-158 01:35pm blood fibrino-259 05:30am blood glucose-130* urean-22* creat-1.1 na-140 k-3.8 cl-106 hco3-26 angap-12 06:52pm blood glucose-127* urean-13 creat-1.0 na-138 k-4.1 cl-101 hco3-30 angap-11 06:52pm blood alt-41* ast-24 ld(ldh)-173 alkphos-57 amylase-35 totbili-0.6 06:52pm blood lipase-42 06:52pm blood ck-mb-3 ctropnt-<0.01 05:30am blood mg-2.4 01:35am blood calcium-8.4 phos-3.6 mg-2.0 06:52pm blood %hba1c-6.5* eag-140* cxr findings: in comparison with study of , there has been placement of a right ij catheter that extends to the mid-to-lower portion of the svc. improved lung volumes with small bilateral pleural effusions. mild indistinctness of pulmonary vessels suggests some increased pulmonary venous pressure and there are continued mild atelectatic changes. gastric dilatation is not appreciated on the current study. echo findings left atrium: normal la size. right atrium/interatrial septum: pfo is present. left ventricle: moderate symmetric lvh. normal lv cavity size. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending, transverse and descending thoracic aorta with no atherosclerotic plaque. normal diameter of aorta at the sinus, ascending and arch levels. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets with trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. regional left ventricular wall motion: conclusions prebypass: the left atrium is normal in size. a patent foramen ovale is present. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque to 30 cm from the incisors. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. normal diastolic funcition with e' = 8cm/sec. no clot in laa. normal coronary sinus. essentially normal exam with moderate lvh. postbypass: unchanged, normal systolic funciton with lvef > 55%, no swma, no valvular abnormalities. no dissection seen after aortic cannula removed. good hemodynamics with no swma following chest closure. pft spirometry 7:50 am pre drug post drug actual pred %pred actual %pred %chg fvc 2.78 3.84 72 fev1 1.74 2.83 61 mmf 0.64 3.00 21 fev1/fvc 63 74 85 lung volumes 7:50 am pre drug post drug actual pred %pred actual %pred tlc 4.71 5.73 82 frc 2.25 3.17 71 rv 1.83 1.90 97 vc 2.88 3.84 75 ic 2.46 2.57 96 erv 0.41 1.27 33 rv/tlc 39 33 118 he mix time 2.00 dlco 7:50 am actual pred %pred dsb 21.36 26.02 82 va(sb) 4.42 5.73 77 hb 15.60 dsb(hb) 20.80 26.02 80 dl/va 4.70 4.54 104 brief hospital course: following transfer from an outside hospital for surgical evaluation he underwent preoperative workup. on he was brought to the operating room and underwent coronary artery bypass graft surgery. please see the operative report for further details. of note there was difficulty with catheter placement and urology was consulted. he underwent cystoscopy with urethral dilation with foley catheter placement by urology in operating room. he received vancomycin and cefazolin for perioperative antibiotics and gentamycin due to urethral dilation. he was transferred to the intensive care unit for post operative management. post operatively he was noted for collapse of the right upper lobe on postoperstive radiogram and with increased peep levels this reexpanded. his oxygen saturation level were adequate, despite pao2 of 60s. preoperative pfts demonstarted severly reduced fev1 and dlco. his lungs were stiff in the operating room, consistent with his 100+ pack year smoking. he was weaned from the ventilator on pod 1 after diuresis. pulmonary toilet was aggressively persued with diuresis. he remained in the intensive care unit for respiratory monitoring. he was started on betablockers for heart rate management. physical therapy worked with him on strength and mobility. he was transferred to the floor on post operative day three for the remainder of his care. he continued to do well and was ready for discharge to rehab at health and rehab center on post operative day five. plan for foley catheter foley catheter placed in operating room - please maintain catheter with leg strap and catheter care routinely until monday on monday please remove at 6 am - if fails to void in 8 hours please attempt once to place foley catheter using 14 or 16 french regular catheter (per urology) if unable to place please send to emergency room at for evaluation by urology - please call with any questions or concerns urology # ( medications on admission: aspirin 325mg daily plavix 75mg daily lisinopril 5 mg daily zocor 40 mg daily lopressor 25 mg discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. 5. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours). 6. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: three (3) ml inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 7. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 8. acetaminophen 500 mg tablet sig: two (2) tablet po every six (6) hours as needed for fever or pain. 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 10. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 11. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 7 days. 12. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po daily (daily) for 7 days. discharge disposition: extended care facility: health and rehab center discharge diagnosis: coronary artery disease s/p coronary artery bypass graft surgery urethral stricture requiring dilitation hypertension hyperlipidemia myocardial infarction chronic renal insufficiency benign prostatic hypertrophy pancreatitis from gall bladder stones chronic obstructive pulmonary disease blind in left eye discharge condition: alert and oriented x3, nonfocal ambulating with one assist incisional pain managed with dilaudid as needed incisions: sternal - healing well, no erythema or drainage leg right evh - healing well, no erythema or drainage. edema + bilateral lower extremities 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** foley catheter placed in operating room - please maintain catheter with leg strap and catheter care routinely until monday on monday please remove at 6 am - if fails to void in 8 hours please attempt once to place foley catheter using 14 or 16 french regular catheter (per urology) if unable to place please send to emergency room at for evaluation by urology - please call with any questions or concerns urology # ( followup instructions: you are scheduled for the following appointments surgeon: dr () thrusday 1:00 pm cardiologist: dr () thrusday 9:30 am please call to schedule appointments with: 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** procedure: venous catheterization, not elsewhere classified (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery other cystoscopy dilation of urethra diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified pulmonary collapse other and unspecified hyperlipidemia surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation old myocardial infarction urethral false passage other specified causes of urethral stricture 

Answer: The patient is high likely exposed to