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 / lipitor attending: chief complaint: shortness of breath major surgical or invasive procedure: s/p ivc filter placement s/p coronary artery bypass graft x3 (left internal mammary > left anterior descending artery, saphenous vein graft > obtuse marginal, saphenous vein graft > right coronary artery), pa thrombectomy under circulatory arrest s/p cardiac catherization history of present illness: 81 year old male with productive cough for past 2 months with increasing dyspnea on exertion. workup revealed three vessel coronary artery disease and a pulmonary embolism. past medical history: diverticulitis hypertension back pain elevated cholesterol left foot drop cataracts copd with acute bronchitis vertebral fusion social history: retired electrical contractor lives with nephew etoh occasional tobacco quit smoked for 50 years family history: nc physical exam: admission vitals 144/74, 84, 22, wt 69kg neck supple, full rom chest cta bilat heart rrr abd soft, nt, nd +bs ext warm, well perfused, no varicosities pulses +2 pt, dp, fem, no carotid bruits discharge vitals 99, 106/52, sr 68, 18, 93% ra neuro a/ox3 nonfocal pulm cta cardiac rrr sternal inc no drainage, no erythema sternum stable abd soft, nt, nd bm ext warm, no edema left leg inc no erythema no drainage pertinent results: 06:45am blood wbc-10.1 rbc-2.98* hgb-9.1* hct-27.5* mcv-92 mch-30.7 mchc-33.2 rdw-13.4 plt ct-207 07:00pm blood wbc-11.2* rbc-4.77 hgb-14.3 hct-41.7 mcv-87 mch-29.9 mchc-34.2 rdw-12.9 plt ct-212 09:25am blood pt-25.2* ptt-49.0* inr(pt)-2.5* 07:00pm blood pt-13.4* ptt-28.8 inr(pt)-1.2* 07:00pm blood plt ct-212 06:45am blood glucose-88 urean-23* creat-1.3* na-139 k-4.2 cl-101 hco3-29 angap-13 03:35pm blood glucose-115* urean-25* creat-1.8* k-4.6 07:00pm blood glucose-129* urean-15 creat-1.1 na-137 k-4.3 cl-101 hco3-24 angap-16 07:00pm blood alt-17 ast-23 ld(ldh)-205 alkphos-64 totbili-0.8 03:02am blood calcium-8.2* phos-4.5 mg-2.5 chest (pa & lat) 3:05 pm findings: compared with , multiple tubes and catheters have been removed. a left chest tube remains in unchanged position at the base. no pneumothorax is seen. the lungs are clear. no chf. small bilateral effusions appear. impression: no pneumothorax. echocardiogram date/time: at 11:51 test: tee (complete) measurements: right atrium - four chamber length: *5.2 cm (nl <= 5.0 cm) left ventricle - inferolateral thickness: 0.9 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 3.7 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 2.8 cm left ventricle - fractional shortening: *0.24 (nl >= 0.29) left ventricle - ejection fraction: 55% to 65% (nl >=55%) aorta - valve level: 3.1 cm (nl <= 3.6 cm) aorta - ascending: 2.8 cm (nl <= 3.4 cm) aortic valve - valve area: *2.3 cm2 (nl >= 3.0 cm2) pulmonary artery - main diameter: 2.8 cm interpretation: findings: left atrium: normal la size. right atrium/interatrial septum: mildly dilated ra. normal interatrial septum. no asd by 2d or color doppler. left ventricle: normal lv wall thicknesses and cavity size. right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets with trivial mr. s. tricuspid valve: normal tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. no pr. dilated main pa. dilated branch pa. pericardium: small pericardial effusion. conclusions: pre bypass: left ventricular wall thicknesses and cavity size are normal. lvef >60%. right ventricular is mildly enlarged with normal function. the right atrium is mildly enlarged.. there are simple atheroma in the aortic arch and descending thoracic aorta. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. the main pulmonary artery is dilated. the branch pulmonary arteries are dilated. there is a large echogenic mass seen in the right main pulmonary artery about 2-3 cm distal to the branchpoint. it is visible both on tee and epicardial echo. there is a small amount of flow around the mass. there is a small pericardial effusion. epiaortic scan was completed at sites of crossclamp, cannulation, and proximal grafts. there was a small flat plaque on the posterior wall near the proposed site of cannulation, but otherwise the sites were clear of plaques. post bypass: preserved biventricular function. lvef >60%. there is no longer a mass in the right main pulmonary artery, although the borders appear somewhat irregular at the site of the previous mass. flow is nonturbulent in the main and branch pulmnary arteries. aortic contours are intact. remaining exam is unchanged. all findings discussed with surgeons at the time of the exam. venous ultrasound acute, partially occlusive thrombus involving left common femoral vein, possibly extending proximally, no thrombus identified in the superficial femoral or popliteal veins in the left. hematology service addendum by , md, phd on : attending: asked to see this patient for a possible hypercoagulable state. patient interviewed, examined, past hx and labs reviewed. this is an 81 yo man with a recent history of a cabg procedure during which time he was found to have a large pulmonary embolus, removed by embolectomy. he also had a left common femoral vein clot. patient had taken coumadin in the past. physical exam shows only rhonchi lower lung fields bilaterally, no adenopathy or organomegaly. labs: wbc 10.8, hgb 9, plat 154,000, aptt 60, inr 1.3-1.4, creast 1.4 impression: cardiovascular disease with recent pe and dvt, now on coumadin. given that he will likely need continual anticoagulation for his severe pe, i do not see the purpose of a workup for a hypercoag state at this time, as this will not change his future treatment, which is likely to be lifelong anticoagulation. brief hospital course: ms. was transferred from hospital on for surgical management of his coronary artery disease. he was worked-up in the usual preoperative manner. on , he was taken to the operating room where he underwent coronary artery bypass grafting to three vessels as well as a pulmonary embolism thrombectomy given that the intraoperative echo revealed a pulmonary embolus. please see operative report for further details. he tolerated the procedure well and was transferred to the csru for invasive monitoring in stable condition. a lower extremity ultrasound was performed which showed a left common femoral deep vein thrombosis. the vascular surgery service was consulted and ivc filter was inserted. on postoperative day one, he was weaned from sedation, awoke neurologically intact and was extubated. a beta blocker, aspirin and a statin were resumed. the hematology service was consulted given his hypercoagulable state. it was recommended as he had already received heparin in the setting of an acute thrombus, that a hypercoagulable work-up be performed as an outpatient as results would be unreliable at this time. likely, lifelong anticoagulation would be recommended. heparin as a bridge to coumadin was continued for anticoagulation. on postoperative day two, he was transferred to the step down unit for further recovery. he was gently diuresed towards his pre-op weight. physical therapy followed patient during entire post-op course for assistance with his strength and mobility. he continued to make steady process without any post-op complications and was discharged to rehab on post op day five. he will follow-up with dr. , his cardiologist and his primary care physician as an outpatient. dr. will manage his coumadin dosing once he is discharged from rehabilitation. his goal inr is 2.0-3.0 for pulmonary embolism and deep vein thrombosis. he will also need a hypercoagulable work-up with his primary care provider as an outpatient. medications on admission: asa 81mg daily atenolol 25mg daily mvi albuterol lasix 20mg daily discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 1 months. 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 5. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 6. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. 7. furosemide 40 mg tablet sig: one (1) tablet po once a day for 5 days: take for 5 days then stop. 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 5 days: take for five days with lasix then stop. 9. coumadin 1 mg tablet sig: take as directed for goal inr 2.0-3.0 tablets po once a day: start . goal inr is 2.0-3.0 for pulmonary embolism and deep vein thrombosis. dose accordingly. discharge disposition: extended care facility: life care center of discharge diagnosis: coronary artery disease s/p cabg x3 pulmonary embolus s/p pa thrombectomy under circulatory arrest hypertension elevated cholesterol copd left foot drop vertebral fusion cataracts deep vein thrombosis discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. 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. 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. 6)no driving for 1 month. 7)coumadin for pulmonary embolism and deep vein thrombosis. goal inr is 2.0-3.0. dr. will follow coumadin on discharge from rehab. please call to arrange appointment for blood draw (pt/inr) for day after discharge from rehab. 8)will need outpatient hypercoaguable workup and routine age specific cancer screening by primary care physician. followup instructions: dr (surgeon) in 1 month. () please call for appointment. dr (pcp) in weeks for routine postoperative visit and immediately following discharge from rehab for coumadin management(). please call for appointment. dr (cardiologist) in 2 weeks. please call for appointment pt/inr goal 2.0-3.0 for pulmonary embolism - first check to be day after discharge from rehab. dr. will monitor pt/inr once discharged from rehab. please call office to notify planned discharge date from rehab. *will need an outpatient hypercoaguable workup and routine age specific cancer screening with primary care physician. procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries interruption of the vena cava incision of vessel, other thoracic vessels diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified essential hypertension chronic airway obstruction, not elsewhere classified acute venous embolism and thrombosis of deep vessels of proximal lower extremity other pulmonary embolism and infarction 

Answer: The patient is high likely exposed to