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: crestor attending: chief complaint: exertional chest pain major surgical or invasive procedure: cardiac catheterization twice intra-aortic balloon bump history of present illness: pt is a 62 yo man w/ pmh cri, cad s/p cabg and multiple pcis, who p/w exertional cp, equivalent to his anginal sxs, + stress echo. at osh, pt underwent cardiac catheterization where during injection of dye into native vessels, experienced cp and severe htn, relieved with nitro and iv lopressor. demonstrated svg to om with 80% stenosis. isr and an 80% distal stenosis along with 2 other lesions w/in the graft, patent lima, occluded svg to , patent svg to pda w/ moderate disease. he reports recent increase in his anginal symptoms including doe and chest pressure (mostly with activity, but occasionally at rest). denies sob, orthopnea, edema, palpitations, n/v. he was sent to for pci. cath showed all the grafts occluded except lvg to rca. svg to om had minimal flow. attempted intervention c/b perferation with embolization. a coated stent was placed but the vessel was thrombosed. he was then transferred to the ccu with an acute lateral mi. iabp was placed for support. currently, patient describes 2/10 chest pain, no sob, no palpitations, no n/v or fevers, chills or diaphoresis. past medical history: htn hypercholesterolemia gerd cad- s/p cabg, stents, 3 vessel disease chronic renal insufficiency s/p appy s/p inguinal repair 100% carotid stenosis left (by pt report) s/p cea right carotid social history: +tobacco- has tried numerous times to quit but never successful. whole family smokes. currently ppd (used to be more) for 40years. has tried patches, gum, hypnosis. drinks 3 oz of wine per night. lives with wife and two cats. family history: cad physical exam: physical exam: vitals - t 95.9, bp 156/86, hr 62, rr 17, o2 sat 100% on ra, iabp 1:1 general - a&o x3, pleasant male in nad heent - perrl, mmm, anicteric sclera, non-injected conjunctiva, no cervical lad or supraclavicular lad, no carotid bruits heard cvs - balloon pump heard lungs - ctab without w/r/r abd - +bs, soft, ntnd ext - no e/c/c. r groin c/d/i, no hematoma. l groin small oozing, no hematoma. r foot cool but palpable pulses dp and pt. l foot pulses palpable dp and pt. pertinent results: admission labs 10:03pm: glucose-127* urea n-16 creat-1.4* sodium-136 potassium-4.4 chloride-104 total co2-24 anion gap-12 . wbc-13.8*# rbc-3.57* hgb-12.1* hct-33.9* mcv-95 mch-33.9* mchc-35.7* rdw-12.5 plt count-255# . 10:03pm ck(cpk)-476* ck-mb-36* mb indx-7.6* ctropnt-0.63* . pleural effusion cytology: negative for malignant cells. mesothelial cells, macrophages and neutrophils. . cardiac cath: comments: 1. selective limited vein graft angiography of sapehenous vein graft to an obtuse marginal branch of the left circumflex coronary artery revealed a degenerated, thrombotic lesion of 80% in the mid graft and a proximal 60-70% stenosis partially within a stented segment in the proximal portion of the graft. 2. unsuccessful ptca and stenting in the svg-->om with 3.5 cypher des complicated by no-reflow phenomenon that failed to resolve despite thrombectomy and intracoronary vasodilators, and peforation treated with a 3.5 covered stent in the proximal segment of the graft. final diagnosis: 1. three vessel coronary artery disease. 2. unsuccessful pci of svg to om. 3. unresolved no-reflow phenomenon. 4. vein graft peforation treated with covered stent. 5. intr-aortic balloon pump support. . tte (echo): 1. the left atrium is elongated. 2.there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). 3.right ventricular chamber size is normal. right ventricular systolic function is normal. 4.the aortic valve leaflets are mildly thickened. no aortic regurgitation is seen. 5.the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. 6.there is no pericardial effusion. there is an anterior space which most likely represents a fat pad. . cxr pa/lat: findings: there is no focal consolidation or superimposed edema. the mediastinum again demonstrates evidence of prior median sternotomy and cabg with indwelling coronary stents. the cardiac size is stable in size and morphology. there is a moderate to large sized left pleural effusion. very small right pleural effusion is also evident. there is no pneumothorax. the visualized osseous structures are unremarkable. impression: bilateral pleural effusions, left much greater than right. extensive prior interventions in the heart as noted above left lat decub cxr: new small bilateral pleural effusion, left greater than right, is freely mobile on the left, partially mobile on the right. . cta: no pulmonary embolism, no masses, r hilar lymph node 1.4cm, coronary calcifications, bilateral ground glass opacities likely infection or infiltrate, but could be bronchoalveolar carcinoma. needs f/u in weeks to reevaluate. . brief hospital course: # cardiac: a. cad with ami: pt w/ h/o cad s/p cabg (lima to lad, svg to , , and rca) in and multiple pci who p/w exertional angina, + stress test for cardiac cathetherization. cath showed all the grafts occluded except lvg to rca. svg to om had minimal flow. attempted intervention complicated by perferation with embolization. a coated stent was placed but the vessel was thrombosed. he was then transferred to the ccu with an acute lateral mi. peak ck of 2781, mb of 187, tropt 7.0. iabp was placed for support and d/c'd on and heparin gtt turned off. ef overall preserved with relatively small area of damage. patient had persistant chest pain similar to his anginal pain. he had repeat cardiac catheterization on which was unchanged and no intervention was done. his cad was medically managed with aspirin, plavix (for at least one year), metoprolol, lisinopril, simvastatin. his anginal pain was medically optimized with imdur 120, metoprolol to 100 tid, and lisinopril 2.5mg. . b. pump: had iabp placed during cath (but for coronary art perfusion, not afterload reduction). echo on showed overall improvement of ef at 55% and improved motion. had episodes of hypotension on in setting of incresed medications which were decreased. blood pressure was well controlled on discharge medications. . c. rhythm: pt in nsr throughout and monitored on telemetry . # pleural effusion: initially seen on pa/lat film taken for persistent left sided shoulder pain distinct from his typical angina. it was tapped on and was exudative with pmn predominance. cytology was negative for malignant cells. it is unclear what the eitiology was. cultures pending at discharge. . # anemia: stable throughout. . # cri: pt w/ h/o cri, baseline cr 1.3-1.4. bumped to 1.6 and at discharge it was down to baseline at 1.3-1.4. he was pretreated with mucomyst for all contrast exposures. . # h/o pud: protonix and maalox. . # tobacco abuse: counsel on smoking cessation ----------------- pcp to follow up: 1) pleural effusion cultures 2) repeat ct scan in weeks for resolution of opacities, monitor lymph notde. 3) lytes within 7-10 days medications on admission: asa 325mg daily plavix 75mg daily diovan 80mg daily atenolol 75mg daily simvastatin 40mg daily tricor 145mg daily protonix 40mg daily isosorbide mn 60mg daily avodart 0.5mg daily fish oil 1000mg vitamin c 1000mg discharge medications: fish oil 1000mg vitamin c 1000mg 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 5. isosorbide mononitrate 60 mg tablet sustained release 24hr sig: two (2) tablet sustained release 24hr po daily (daily). disp:*qs tablet sustained release 24hr(s)* refills:*2* 6. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 7. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 9. fenofibrate nanocrystallized 145 mg tablet sig: one (1) tablet po once a day. 10. avodart 0.5 mg capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: primary: cad s/p cath nstemi chronic kidney disease tobacco use pleural effusion discharge condition: stable. vital signs stable. patient still with residual chest pain without obvious gross anatomical cause. discharge instructions: you had a cardiac catheterization. it was complicated by a vein graft thrombosis and subsequent heart damage. you also had a pleural effusion (fluid around your lung. this was tapped and there are results pending. please have your pcp follow up on these. you had a ct which showed some opacities and a lymph node. you should have this followed up by your pcp as well. . we have changed some of your medications. we increased your nitrate (imdur) to try to manage your angina. . please see your cardiologist, dr. and your pcp. . it is very important that you go to cardiac rehab. . followup instructions: follow up with your pcp in the next 7-10 days. please have dr. follow up with the ct scan results and the pleural effusion cultures. . follow up with dr. in the next 2-3 weeks. procedure: coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization implant of pulsation balloon right heart cardiac catheterization nonoperative removal of heart assist system insertion of drug-eluting coronary artery stent(s) transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on two vessels diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome pure hypercholesterolemia unspecified essential hypertension acute kidney failure, unspecified acute myocardial infarction of other anterior wall, initial episode of care coronary atherosclerosis of autologous vein bypass graft cardiac complications, not elsewhere classified surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other complications due to other vascular device, implant, and graft cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft accidents occurring in residential institution urinary complications, not elsewhere classified accidents occurring in unspecified place other drugs and medicinal substances causing adverse effects in therapeutic use mechanical complication due to coronary bypass graft complications affecting other specified body systems, not elsewhere classified, hypertension 

Answer: The patient is high likely exposed to