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: mr. is a 66-year-old male known to dr. and our service. he had been inpatient at the end of with cardiac catheterization showing vvd and he was referred for coronary artery bypass graft at that time. carotid ultrasound showed 80 to 99 percent right sided plaque and 60 to 69 percent left sided plaque. he underwent stenting of the right carotid on , he experienced has post intervention with question of sah and was unclear as to why his surgery was delayed at that time. it was considered that he would wait 4 to 6 weeks for coronary artery bypass graft after his carotid stenting. he is also experiencing worsening of his right lower extremity and claudication and on he had a thrombectomy at the right aorta bifemoral graft. at this time prior to admission on he reported one episode of nonspecific gas verses chest pain on , it was unrelieved by sublingual nitroglycerin which sent him to the emergency room. he was negative for myocardial infarction by enzymes and electrocardiogram. denied any shortness of breath, nausea, vomiting, diaphoresis, dizziness, syncope or edema. aortobifemoral bypass grafting with peripheral vascular disease and chronic renal insufficiency. he had no chest pain since his admit. when he was seen on the 28th his meds at home were as follows: 1. atenolol 12 mg once daily 2. ticlid 250 mg p.o. twice a day 3. lipitor 80 mg p.o. daily. 4. lisinopril 20 mg p.o. twice a day. 5. tricor 160 mg p.o. once daily 6. aspirin 81 mg daily. allergies: iodine, plavix and norvasc. when he was seen on the 20th his pressure was 117/61 with a heart rate of 65, respiratory rate 24, sating 99 percent on room air. he was alert and oriented neurologically and appropriate, had expiratory wheezes on the right side. his lungs were clear otherwise. his heart was regular rate and rhythm with an s1 and s2 and no murmur, rub or gallop heard. his abdomen was soft, nontender, with positive bowel sounds. his extremities were warm, well perfused with no edema or varicosities. his right groin incision site was well healed. he had bilateral dorsalis pedis and posterior tibial 1 plus pulses and bilateral 2 plus radial pulses. he was also seen by dr. and dr. on the 21st prior to admission. preoperative labs were hematocrit of 35.1, pt 14.2, ptt 68.1, inr 1.3, bun 38, creatinine 2.2, and a k of 4.6. discussion was held as to whether or not a neuro consultation will be held at that time prior to the patient coming back at some point for his surgery. dr. also advised the patient to stop smoking for a week to ten days prior to him coming back and have a repeat creatinine and platelet counts prior to his discharge. he also recommended to repeat creatinine and platelets before surgery and tentatively scheduled the patient for . the patient was actually re-admitted on and was seen by cardiology at that time. on the patient underwent coronary artery bypass graft times three by dr. with a left internal mammary artery to the left anterior descending coronary artery, a vein graft to the posterior descending coronary artery, and a vein graft to the om. he was transferred stable to the cardiothoracic intensive care unit on a propofol titrated drip. the patient was also seen and evaluated by case management and on postop day one he was transfused one unit of packed red blood cells for low hematocrit which then rose to 30. he was not able to tolerate cpap because of some agitation. he was hemodynamically stable in sinus rhythm at 80, he had a blood pressure of 108/61, his index was 2.99. he remained intubated. at that time his heart was regular rate and rhythm, his lungs were clear bilaterally, his examination was otherwise unremarkable and his creatinine rose to 3.0. his swann was discontinued, he started intravenous lasix with plan to try and extubate him. the patient was also on insulin drip at two units an hour and neo-synephrine drip at 1.2 mcg per kg per minute. dopamine drip was also started. the patient remained in the intensive care unit. later that evening the patient was cardioverted for rapid atrial fibrillation in 180's to with blood pressure 80's despite neo- synephrine at 6 mcg per kg per minute. the patient converted to normal sinus rhythm after a single cardioversion at 100 joules. he remained n a procainamide drip as an anti- arrhythmic at that time. at 7:30 in the morning the patient went into atrial flutter, atrial fibrillation, at 8 o'clock he converted to normal sinus rhythm with frequent premature atrial contractions. he remained on procainamide drip at 2 mg a minute, he was transfused two units of packed red blood cells for a hematocrit of 24, repeat crit was 28.4. he was also given several doses of intravenous lasix between units of blood. the patient remained in sinus rhythm at that time. on postop day two, his examination was unremarkable other than decreased breath sounds bilaterally. his chest tubes were discontinued. on postop day three he received 3 mg of coumadin the night prior for his history of atrial fibrillation. his incisions were clean, dry and intact grossly with decreased breath sounds bilaterally. he had 1 plus peripheral edema, his hematocrit stayed at 28.2 with a creatinine that dropped slightly from 2.9 to 2.5. a hip panel was sent off, the pacing wires were discontinued. he was seen and evaluated by physical therapy. after his extubation the patient was stable, he complained of some itching and he had a little bit of a rash on his abdomen and back with raised areas that were hive like, non-bleached sheets were ordered and applied. the patient was also given 25 mg benadryl dose for his itching and rash and percocet for pain. he was transferred out to the floor on the 28th. foley was discontinued. on postop day four the patient had another episode of atrial fibrillation the evening prior which converted to normal sinus rhythm with intravenous lopressor. he remained on procainamide orally, had been restarted on his ticlid for his carotid stent and continued beta-blockade with lopressor 50 mg p.o. twice a day. procaine nap levels were pending. creatinine dropped from 2.5 to 2.3. hematocrit was stable at 33.8, inr was 3.2, hip panel was pending. the patient had coarse rhonchorus breath sounds at the lower basis bilaterally. he had trace peripheral edema. incision was clean, dry and intact. coumadin was held that evening for his inr already at 3.2. he continued to work with physical therapy, following that had no complaints. on postop day five he remained in sinus rhythm with a pressure of 140/64, he had decreased breath sounds at the basis, he was alert with a nonfocal examination. procainamide was discontinued. he remained hemodynamically stable. his inr dropped to 2.9 the following day, hematocrit remained stable at 30.7, creatinine dropped to 2.1. the patient was encouraged to take more p.o.'s, he worked with an incentive spirometer, he continued to ambulate with the nurses and physical therapy. he was seen by the ep service on , the day of discharge and they recommended discontinuing his procainamide, increasing his lopressor, continue his coumadin and to follow-up with his primary cardiologist and ep in the future. the patient was discharged on with the following diagnosis: 1. status post coronary artery bypass graft times three. 2. peripheral vascular disease, status post right carotid stenting and bilateral carotid stenosis. 3. myocardial infarction with percutaneous transluminal coronary angioplasty 10 years ago. 4. hypertension. 5. hypercholesterolemia. 6. positive smoking history. 7. status post aortobifemoral bypass graft. 8. meniere's disease. 9. left kidney atrophy. discharge medications: 1. lasix 40 mg p.o. daily times seven day. 2. potassium chloride 20 meq p.o. twice a day times seven days. 3. colace 100 mg p.o. twice a day. 4. percocet 5/325 mg one tab p.o. q 4 hours p.r.n. for pain. 5. protonix 40 mg entericoated one tablet p.o. every 24 hours. 6. ticlid 250 mg p.o. twice a day. 7. lopressor 75 mg p.o. twice a day. 8. coumadin 2.5 mg p.o. just on the day of discharge with instructions to follow-up for an inr check on and to call the results to dr. the primary care physician for further dosing. the patient was also instructed to follow-up with dr. in one to two weeks in the office as he would be responsible for his coumadin inr management. the patient was also instructed to follow-up with dr. his cardiologist in one to two weeks and make an appointment with dr. his surgeon for postop surgical check in the office at four weeks. the patient was discharged on . , m.d. procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome pure hypercholesterolemia unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation peripheral vascular disease, unspecified personal history of tobacco use percutaneous transluminal coronary angioplasty status old myocardial infarction unspecified disorder of kidney and ureter 

Answer: The patient is high likely exposed to