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: this is a 60 year-old male with a past medical history of coronary artery disease status post coronary artery bypass graft in with severe three vessel disease, congestive heart failure with recent catheterization showing moderately to severely elevated right and left sided filling pressures with 90% occlusion of his left anterior descending coronary artery and subtotally occluded left circumflex and diffusely diseased left internal mammary coronary artery to the left anterior descending coronary artery with 90% stenosis at the touch down of the left anterior descending coronary artery. the patient also has hypertension, hypercholesteremia and type 2 diabetes. he was transferred from hospital where he presented with 10 out of 10 chest pain. the patient reported taking two nitroglycerins sublingual yesterday without significant relief of his chest pain. the patient states he has been having chest pain since his cardiac catheterization on , but was particularly worse on the day prior to admission. at hospital the patient was experiencing 10 out of 10 chest pain and received nitropaste two inches, three sublingual nitroglycerins, morphine 4 mg intravenously, lopressor 5 mg intravenously. the patient's pain was subsequently decreased to 1 out of 10 after the sublingual nitroglycerins. his vital signs remained stable throughout his stay at the outside hospital. the patient was transferred on a nitroglycerin drip and aggrastat drip as well as given lovenox and aspirin. past medical history: 1. significant coronary artery disease status post coronary artery bypass graft in , status post q wave inferior myocardial infarction. at that time left internal mammary coronary artery was grafted to the left anterior descending coronary artery, saphenous vein graft to the obtuse marginal and saphenous vein graft to the posterior descending coronary artery. on he had another catheterization showing occluded grafts with 80% stenosis of his left internal mammary coronary artery. in a catheterization showed severe three vessel disease with 30% left main disease, 60% proximal left anterior descending coronary artery disease, diffusely diseased left anterior descending coronary artery, proximal right coronary artery occlusion, atretic left internal mammary coronary artery to left anterior descending coronary artery and severe left ventricular dysfunction with an ef of 30%. on the patient had another catheterization that showed again three vessel disease with the left main severely and diffusely diseased with proximal left anterior descending coronary artery 90% and proximal left circumflex subtotally occluded, diffusely diseased left internal mammary coronary artery to left anterior descending coronary artery with 90% stenosis at touch down site of the left anterior descending coronary artery. increased right sided filling pressures with lvedp of 25, wedge of 25 and at that time he had a failed intervention to his left internal mammary coronary artery graft. 2. hypertension. 3. hypercholesterolemia. 4. type 2 diabetes. 5. congestive heart failure. medications on admission: 1. atenolol 50 q day. 2. lipitor 40 q day. 3. multivitamin. 4. aspirin. 5. zestril 40 q day. 6. isordil 60 b.i.d. 7. protonix 40 q day. 8. lasix 40 q day. 9. plavix 75 q day. allergies: no known drug allergies. social history: the patient lives with wife and children. not currently smoking or drinking. the patient has a brother in his 40s with coronary artery disease. physical examination on admission: the patient was afebrile with a blood pressure of 90/50, heart rate 76, breathing at 18, 90% on 2 liters. in general, the patient is in no acute distress. heent pupils are equal, round and reactive to light. anicteric sclera. oropharynx is clear. mucous membranes are moist. neck showed no evidence of jvd. cardiovascular examination positive s1 and positive s2. no murmurs, rubs or gallops. occasional skipped beats. lungs faint bibasilar crackles. abdomen is soft, obese, nontender, nondistended with positive bowel sounds. extremities minimal lower extremity edema with 1+ dorsalis pedis pulses bilaterally. neurological examination awake, alert and oriented times three. cranial nerves ii through xii are intact. pertinent laboratories and studies on admission: the patient's white blood cell count is 6.7, hematocrit 35, platelet count 251. chem 7 129, sodium 5.3, potassium 97, chloride 19, bicarb 37, bun 1.5, creatinine 460, glucose calcium 8.8, inr 1.6. ck 111, mb 2.3, mb index 2.1. troponin i 2.7, which is elevated. electrocardiogram shows normal sinus rhythm at 60 beats per minute, normal axis, normal intervals, q wave inversions in 2, 3 and avf and in v4 through v6. chest x-ray showed cardiomegaly, but no evidence of acute congestive heart failure. hospital course: 1. coronary artery disease: the patient was taken to the catheterization laboratory on where similar findings were noted on his prior catheterization and had a stent placed in his proximal left anterior descending coronary artery as well as his left main. he had failed intervention for his vein graft to his right coronary artery and no intervention done to his left internal mammary coronary artery. the patient was also noted to have a wedge pressure of 31. the patient was sent to the coronary care unit with an intraaortic balloon pump given his poor cardiac output and continued chest pain. in the coronary care unit he was continued on his plavix, aspirin, beta-blocker, statin, ace inhibitor and on heparin drip and aggrastat drip status post catheterization. however, on his platelet count was noted to drop from 251 to 5 on and his aggrastat drip and heparin drip were discontinued. he was monitored closely for signs of bleeding and had mild amount of epistaxis. see additional information in heme section of the hospital course. the patient was transferred to the floor having intermittent chest pain and was transitioned to po nitrates for his chest pain. he briefly required nitroglycerin drip for relief of chest pain in the coronary care unit and he was transitioned to po nitrates. he was slowly titrated off his drip. the patient was initially placed on long acting nitrate of imdur, however, due to hypotension issues was transitioned to shorter acting isosorbide dinitrate and titrated up as his blood pressure tolerated. when the patient left the hospital he was chest pain free for greater then 24 hours. during his episodes of chest pain in the clubbing, cyanosis or edema and on the floor he had no st or t wave changes that were changed from normal. it was felt the patient was likely not a candidate for further intervention given his limited remaining blood supply to his myocardium. dr. was considering a possible intervention to his left internal mammary coronary artery graft, however, will hold off on any plan until the patient more urgently requires intervention given the complicated nature of the procedure. in the interim the patient will be maximally medically treated with aspirin, plavix, beta blocker, statin and ace inhibitor. he will be given po nitrates for pain relief. pump: the patient was diuresed once he came into the intensive care unit with intravenous lasix. he was responding to 40 mg intravenously. his pa diastolic pressures, which were used as an estimate of his wedge pressures decreased significantly during his stay in the coronary care unit and were approximately in the low 20s when he was transferred to the floor. rhythm: the patient had frequent premature atrial contractions noted on telemetry and was thought to be in atrial fibrillation, however, he was mostly in normal sinus rhythm with frequent premature atrial beats. his heart rate was well controlled with beta-blocker. 2. renal: the patient had slight renal insufficiency on admission with a baseline creatinine of .8 to .13 and received a large dye load due to his complicated catheterization and was given mucomyst post procedure as well as some slight intravenous hydration. his creatinine returned to baseline of 1.3 prior to discharge. 3. hematology/infectious disease: the patient was noted to have a significant drop in his platelet count down to 5000 from 250,000 on admission. the drop was thought to be due to a reaction from the aggrastat and any future anticoagulation with aggrastat should be avoided in this patient. the patient was given a total of 3 units of platelets during hospital stay with a negative dic laboratories and his platelet count slowly over a three day period returned to baseline. his intraaortic balloon pump removal was delayed due to his thrombocytopenia and after given 3 units of platelets it was removed with a platelet count of greater then 100,000. the patient had occasional epistaxis that did not cause significant blood loss and did once his platelet count returned to . the patient required 1 unit of packed red blood cells due to a hematocrit of less then 30, but was stable prior to discharge. 4. endocrine: the patient was noted to have blood sugars greater then 400 on admission without an anion gap, however, was on no oral hypoglycemics or insulin. he was on insulin prior to the last three months and was apparently controlling his glucose with diet. consult was ordered and they recommended starting low dose glyburide and titrating up as tolerated. the patient was discharged on 10 mg of po glyburide and asked to follow up with his primary care physician in one to two weeks after discharge. at discharge his blood sugars were ranging in the 100 to 200 range. condition on discharge: stable and chest pain free for greater then 24 hours with cardiac enzymes that were trending down. discharge medications: 1. plavix 75 q day. 2. aspirin 325 mg q day. 3. protonix 40 mg q day. 4. lipitor 40 q day. 5. lasix 20 q day. 6. metoprolol 25 b.i.d. 7. lisinopril 5 q.h.s. 8. isosorbide dinitrate 20 t.i.d. 9. glyburide 10 q day. discharge diagnoses: 1. unstable angina. 2. severe three vessel coronary artery disease. 3. reaction to aggrastat causing thrombocytopenia. 4. type 2 diabetes. 5. hypertension. 6. hypercholesterolemia. 7. systolic congestive heart failure with ejection fraction of less then 30%. recommended follow up: the patient should follow up with dr. in approximately one to two weeks and follow up with his primary care physician also in one to two weeks. , m.d. dictated by: medquist36 procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor other and unspecified coronary arteriography implant of pulsation balloon transfusion of packed cells transfusion of platelets insertion of drug-eluting coronary artery stent(s) diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified coronary atherosclerosis of autologous vein bypass graft atrial fibrillation cardiogenic shock chronic systolic heart failure acute myocardial infarction of unspecified site, initial episode of care diabetes with neurological manifestations, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to