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: penicillins / belladonna attending: chief complaint: unstable angina major surgical or invasive procedure: - cabg x3 (free lima to lad, svg to om, svg to pda) history of present illness: this 86 year old man with known 3 vessel coronary artery disease s/p cath . he has a history of hypertension, dyslipidemia and non insulin dependent diabetes. he was diagnosed with a right thalamic stroke in with a left carotid stenosis. echo at the time revealed an lvef of 45% with mild global hypokinesis. subsequent ett revealed evidence of an inferior mi with mild ischemia, lvef 30-35%. he was referred previously to for left heart catheterization which revealed 3 vessel disease. it was decided at that time that he would be treated with medical management. he reports that he has had intermittent chest pain over the past three weeks. he was recathed at osh and transferred to for evaluation of revascularization. past medical history: hypertension hyperlipidemia non insulin dependent diabetes prior silent mi by ett : right thalamic stroke with left hemiparesis, treated at . plavix initiated. frequency ventricular ectopy hypothyroidism skin cancer possible sleep apnea chronic gout with admit to with acute episode involving right knee, s/p tap anemia glaucoma hard of hearing (has hearing aids but has not used since his stroke) ocular migraines hx of frequent falls short term memory loss bilateral cataract surgery social history: patient is divorced and lives alone. he recently moved into . he has two children. his daughter is highly involved in his care, but she lives one hour away in nh. the other daughter lives in . smoked during world war ii. he does not drink family history: non-contributory physical exam: pulse: 86 resp: 20- o2 sat: 95% ra b/p 127/87 height: " weight:140lb five meter walk test #1_______ #2 _________ #3_________ general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right: left: dp right: left: pt : left: radial right: left: carotid bruit none appreciated, pulses right:2+ left:2+ pertinent results: carotid ultrasound 1. there is 40% stenosis in the right ica and 40-59% stenosis in the left ica. 2. mild heterogeneous plaque in the left ica and minimal amount of plaque in the right carotid bulb. echo conclusions pre-bypass: no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the interatrial septum is aneurysmal. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is moderately depressed (lvef=35%). doppler parameters are most consistent with grade i (mild) left ventricular diastolic dysfunction. the right ventricular cavity is dilated with normal free wall contractility. there are simple atheroma in the ascending aorta. the aortic arch is mildly dilated. there are complex (>4mm) atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results in the operating room at the time of the study. post-bypass: the patient is receiving epinephrine by infusion. the right ventricle displays normal systolic function. the left ventricle displays some improvement in global systolic function with an ejection fraction of about 45%. valvular function is unchanged. the thoracic aorta is inatct after decannulation. ct scan 1. no appreciable supra-annular calcification in minimally dilated, ascending thoracic aorta. 2. severe coronary arterial calcifications. 3. 4mm pulmonary nodule in the right lower lobe warrants ct reevaluation in 12 months, a reasonable adaption of the guidelines 12:25am blood wbc-7.4 rbc-3.50* hgb-10.7* hct-31.5* mcv-90 mch-30.6 mchc-34.0 rdw-15.2 plt ct-227 05:30am blood wbc-8.1 rbc-3.68* hgb-11.1* hct-32.2* mcv-88 mch-30.3 mchc-34.5 rdw-15.2 plt ct-216# 12:25am blood glucose-243* urean-28* creat-1.3* na-141 k-4.7 cl-107 hco3-25 angap-14 05:30am blood glucose-94 urean-16 creat-0.9 na-142 k-3.6 cl-105 hco3-25 angap-16 06:55am blood glucose-183* urean-19 creat-1.0 na-140 k-3.7 cl-103 hco3-27 angap-14 brief hospital course: mr. was admitted to the on via transfer from an outside hospital for further management of his coronary artery disease. he was worked up in the usual preoperative manner. a carotid duplex ultrasound was obtained which revealed a 40-59% stenosis in the left internal carotid artery and mild disease in the right. a ct scan showed no significant intracranial process, no appreciable supra-annular calcification in minimally dilated, ascending thoracic aorta and 4mm pulmonary nodule in the right lower lobe warrants ct reevaluation in 12 months. on , mr. was taken to the operating room where he underwent coronary artery bypass grafting. please see operative note for details. postoperatively he was taken to the intensive care unit for monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was hemodynamically stable, weaned from inotropic and vasopressor support. he was confused initially and treated with haldol. confusion cleared and he was alert and oriented x 3 by pod 4. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. mr. was not started on an ace inhibitor, as his blood pressure would not tolerate it. this should be considered as an outpatient. by the time of discharge on pod #6 the patient was ambulating with assistance, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to rehab of in good condition with appropriate follow up instructions. medications on admission: allopurinol- 300 mg tablet - 1 tablet(s) by mouth daily amitriptyline - 25 mg tablet - 1 tablet(s) by mouth daily,clopidogrel 75 mg tablet - 1 tablet(s) by mouth daily glipizide- 10 mg tablet - 1 tablet(s) by mouth twice a day indomethacin 25 mg capsule -1 capsule(s) by mouth three times a day isosorbide mononitrate 30 mg tablet extended release 24 hr - 1 tablet(s) by mouth once a day levothyroxine 25 mcg tablet -1 tablet(s) by mouth daily losartan - 25 mg tablet - 1 tablet(s) by mouth daily metformin 500 mg tablet - 1 tablet(s) by mouth twice a day omeprazole - dosage uncertain simvastatin - 40 mg tablet - 1tablet(s) by mouth daily medications - otc docusate sodium - (prescribed by other provider) - 100 mg capsule - 1 capsule(s) by mouth twice a day multivitamin - (prescribed by other provider discharge medications: 1. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 2. glipizide 5 mg tablet sig: two (2) tablet po bid (2 times a day). 3. pilocarpine hcl 4 % drops sig: one (1) drop ophthalmic q6h (every 6 hours). 4. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. multivitamin tablet sig: one (1) tablet po daily (daily). 8. indomethacin 25 mg capsule sig: one (1) capsule po tid (3 times a day). 9. amitriptyline 25 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*0* 10. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 11. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 14. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 16. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain, fever. 17. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 18. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed): per attached sliding scale. 19. levothyroxine 25 mcg tablet sig: one (1) tablet po once a day. 20. metoprolol tartrate 25 mg tablet sig: two (2) tablet po bid (2 times a day): hold for hr<60,sbp<90. discharge disposition: extended care facility: - discharge diagnosis: coronary artery disease s/p cabg x3 hyperlipidemia non insulin dependent diabetes prior silent mi by ett : right thalamic stroke with left hemiparesis, treated at . plavix initiated. frequency ventricular ectopy hypothyroidism skin cancer possible sleep apnea chronic gout with admit to with acute episode involving right knee, s/p tap anemia glaucoma hard of hearing (has hearing aids but has not used since his stroke) ocular migraines hx of frequent falls short term memory loss bilateral cataract surgery discharge condition: alert and oriented x3 nonfocal ambulating with assistance, deconditioned incisional pain managed with ultram, tylenol incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema - trace discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) 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** followup instructions: you are scheduled for the following appointments surgeon: dr. , thursday, 1:00 cardiologist: -te , at 2:00pm please call to schedule appointments with your 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: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism gout, unspecified personal history of tobacco use other and unspecified hyperlipidemia personal history of other malignant neoplasm of skin loss of weight other late effects of cerebrovascular disease unspecified hearing loss old myocardial infarction late effects of cerebrovascular disease, hemiplegia affecting unspecified side unspecified psychosis history of fall long-term (current) use of antiplatelet/antithrombotic 

Answer: The patient is high likely exposed to