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 58-year-old gentleman who presents with a 2-week to 3-week history of substernal chest pain on exertion associated with shortness of breath. the patient has no significant cardiac risk factors except for obesity. he has been in relatively good health. a few weeks prior to admission he began having dyspnea on exertion. this has gotten progressively worse over the last week such that he can only walk approximately one block without becoming short of breath. he is also now experiencing substernal chest pain radiating down his left arm. on , he had exercise tolerance test that was positive but refused admission. on , he had a cardiac catheterization that demonstrated a left ventricular ejection fraction of 60%, a 90% stenosis of his left anterior descending artery, a 90% stenosis of his right coronary artery, a 90% stenosis of his first obtuse marginal, a 90% stenosis of his second obtuse marginal. the patient was subsequently admitted to the for an elective coronary artery bypass graft. past medical history: (past medical history significant for) 1. chronic obstructive pulmonary disease. 2. asthma. 3. cervical disk disease. 4. status post open cholecystectomy. medications on admission: albuterol mdi inhaler 2 puffs q.4h. p.r.n. physical examination on admission: the patient was afebrile with a heart rate of 82, a blood pressure of 140/60, and a respiratory rate of 18. he was in no acute distress. he was alert and oriented times three. his neck was supple. he had no bruits. his lungs were clear. his heart had a regular rate and rhythm, and a 2/6 systolic ejection murmur at the base. he had normal s1 and s2, and no rubs. his belly was soft, nontender, and nondistended. his was obese with normal active bowel sounds. his extremities were warm and well perfused without edema. his posterior tibialis had a 1+ pulse. hospital course: the patient was admitted on , and on , he underwent an uncomplicated coronary artery bypass graft times four with the left internal mammary artery to the left anterior descending artery, a saphenous vein graft to the first obtuse marginal branch, a saphenous vein graft to the second obtuse marginal branch, and a saphenous vein graft to the posterior descending artery. the patient tolerated the procedure well and was transferred to the cardiothoracic intensive care unit in stable and intubated condition. the patient was extubated overnight. his swan-ganz catheter was discontinued, and he was taken off of his cardiac drips. he was started on lopressor and lasix. his diet was advanced as tolerated, and he was transferred to the floor with his foley and chest tubes in place. on postoperative day two, the patient's lopressor was increased to 50 mg b.i.d. his mediastinal chest tubes had minimal output and they were subsequently removed. the patient was requiring respiratory therapy treatment with nebulizers for his chronic obstructive pulmonary disease. on postoperative day three, the patient remained hemodynamically stable, tolerating p.o., and making good urine. his pain was well controlled on p.o. pain medications. his remaining chest tube was removed, as was his foley catheter. he was continued on his lopressor. the patient has a history of dysphagia, and a barium swallow was ordered for the purpose of assessing the etiology of his symptoms. the study revealed a distal esophageal narrowing that was smooth and tapered, suspicious for achalasia. dr. from the gastrointestinal service was contact and told of the patient's history and the results of his barium swallow. dr. had agreed to follow up with the patient in the clinic in two to three weeks after discharge, this was conveyed to the patient along with dr. office phone number. on postoperative day three, the patient was still doing well; however, he was not able to ambulate adequately. physical therapy continued to see the patient and by postoperative day four, he was walking 500 feet and able to climb a flight of stairs without hemodynamic instability. the patient was therefore deemed appropriate for discharge to home without services. physical examination on discharge: he had a temperature of 98.4, heart rate of 88, blood pressure of 126/62, respiratory rate of 20, oxygen saturation of 95% on room air. he was in no acute distress. his neck was supple with no bruits or masses. his lungs were clear to auscultation bilaterally. his sternum was stable, clean, dry, and intact. his heart had a regular rate and rhythm. he had a 2/6 systolic ejection murmur at the base. his belly was soft, nontender, and nondistended. he was obese with normal active bowel sounds. his extremities were warm and well perfused without edema. his incisions were clean, dry, and intact. medications on discharge: 1. lopressor 75 mg p.o. b.i.d. 2. lasix 20 mg p.o. b.i.d. times one week. 3. potassium chloride 20 meq p.o. b.i.d. times one week. 4. motrin 400 mg p.o. q.6h. p.r.n. 5. aspirin 81 mg p.o. q.d. 6. zantac 150 mg p.o. b.i.d. 7. colace 100 mg p.o. b.i.d. 8. percocet one to two tablets p.o. q.3-4h. p.r.n. for pain. discharge diagnoses: 1. coronary artery disease. 2. status post coronary artery bypass graft. 3. chronic obstructive pulmonary disease. condition at discharge: condition on discharge was stable. discharge status: to home. , m.d. dictated by: medquist36 procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome chronic obstructive asthma, unspecified 

Answer: The patient is high likely exposed to