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: angina major surgical or invasive procedure: - coronary artery bypass grafting to four vessels. (left internal mammary->left anterior descedning artery, saphenous vein graft(svg)->diagonal artery. svg->obtuse marginal artery, svg->posterior descending artery.) - cardiac catheterization history of present illness: 68 y.o with history of wegners disease resulting in acute renal failure and a 3 month hospitalization, who continues with chronic renal failure. he has had several years of angina symptoms. he had a stress test in showing a mid apical and inferior wall perfusion defect. due to his renal function it was decided to treat him medically. he now is reporting a significant increase of sublingual nitroglycerin use up to 3 a day. his symptoms are not predictable and occur both with exertion and rest. he underwent a stress test earlier this month, during which he exercised for 3.9 minutes and developed chest pressure and dyspnea. he had 1-2mm of inferolateral st depression and a moderate to large sized severe intensity inferolateral and posterolateral defect which was primarly fixed. this is not much different from a stress test in . dr increased his imdur from 30mg to 60mg during his last visit. pt now reports less sublingual use, down to one a day. his creatinine is presently at 3.6 and pt is being admitted for prehydration prior to cardiac catheteriztion. past medical history: htn hyperdipidemia coronary artery disease gastroesophageal reflux disease chronic kidney diseas - wegener's granulomatosis depression, currently working with counselor bimonthly appendectomy hernia repair in his 20??????s. leg cramps anemia social history: pt smoked for over 25 years up to 4 packs a day. he quit about 10 years ago. lives in by himself. he is retired, but states he still works part time. daughter is his health care proxy, she is available to pick him up at time of discharge. her home number is , cell 1-, or her husband cell 1-. pt has been sober for over 10 years. denies illicit drug use. family history: none physical exam: 98.6 126/62 72 20 97% ra 103.2kg general: pleasant, answers questions appropriately chest: lungs clear to auscultation bilaterally. cor: rrr. nl s1s2. no murmurs, rubs, gallops appreciated. sternum: stable. incision clean and dry abdomen: decreased bowel sounds, soft and nontender without rebound or guarding extremities: warm with 2+ pitting edema to mid shins pertinent results: - echo pre-bypass: 1. no atrial septal defect is seen by 2d or color doppler. 2. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). there is mild regional left ventricular systolic dysfunction with mild apical hypokinesis. overall left ventricular systolic function is normal (lvef>55%). 3. right ventricular chamber size and free wall motion are normal. 4. there are simple atheroma in the aortic root. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. there is no aortic valve stenosis. no aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. mr and increased to moderate to severe when bp increased to 150/90. during opcab, mr was severe. dr. was notified in person of the results. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine and is in sinus rhythm. 1. biventricular function is normal. 2. mr is mild 3. aorta is intact post decannulation cardiac catheterization 1. selective coronary angiography of this co-dominant system demonstrated severe three vessel coronary artery disease. the lmca had mild diffuse disease. the lad had diffuse proximal 50% and mid 60% disease. the lcx had proximal 80% stenosis with a large om2 vessel with a 60% mid and 90% distal stenosis. the rca had diffuse proximal 90% and mid 60-70% stenosis. 2. limited resting hemodynamic measurement demonstrated normal left sided filling pressure with an lvedp of 10mmhg. pullback of the catheter from the left ventricle across the aortic valve did not demonstrate a pressure gradient. brief hospital course: mr. was admitted to the on for a cardiac catheterization.this revealed severe three vessel disease. given the severity of his disease, the cardiac surgical service was consulted for surgical revascularization. mr. was worked-up in the usual preoperative manner. on , mr. was taken to the operating room where he underwent coronary artery bypass grafting to four vessels. please see operative note for details. part of the operation was performed off pump in effort to protect his kidneys. postoperatively he was taken to the intensive care unit for monitoring. on postoperative day one, mr. neurologically intact and was extubated. beta blokcade, aspirin and a statin were resumed. he was transferred to the step down floor where he was gently diuresed given his renal issues. physical therapy was consulted to work on strength and balance. by post-operative day 4 he ws ready to be discharged to rehab. medications on admission: atenolol 10', calcitriol 0.25', imdur 60', lisinopril 2.5', lovastatin 40', ntg sl-prn, quinine sulfate 324 hs sucralfate 1"", asa 81', omeprazole 20" discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 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:*0* 3. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. disp:*qs tablet(s)* refills:*0* 4. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. disp:*5 suppository(s)* refills:*0* 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. disp:*qs ml(s)* refills:*0* 6. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. quinine sulfate 324 mg capsule sig: one (1) capsule po hs (at bedtime). disp:*30 capsule(s)* refills:*0* 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). disp:*60 capsule, delayed release(e.c.)(s)* refills:*0* 10. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*0* 11. epoetin alfa 4,000 unit/ml solution sig: as directed injection qmowefr (monday -wednesday-friday). disp:*qs qs* refills:*0* 12. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*0* 13. furosemide 20 mg iv q12h discharge disposition: extended care facility: center - discharge diagnosis: cad hypertension hyperlipidemia chronic kidney disease due to wegener's granulomatosis depression anemia obesity discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks from date of surgery. 6) no driving for 1 month or while taking narcotics for pain. 7) call with any questions or concerns. followup instructions: please follow-up with dr. in 1 month. ( please follow-up with dr. in 2 weeks. please follow-up with dr. in weeks. scheduled appointemnts: provider: , md phone: date/time: 10:00 md procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization coronary arteriography using a single catheter angiocardiography of right heart structures diagnoses: acidosis anemia in chronic kidney disease coronary atherosclerosis of native coronary artery esophageal reflux chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified depressive disorder, not elsewhere classified other and unspecified hyperlipidemia other and unspecified angina pectoris other sedatives and hypnotics causing adverse effects in therapeutic use psychophysical visual disturbances wegener's granulomatosis 

Answer: The patient is high likely exposed to