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: patient recorded as having no known allergies to drugs attending: chief complaint: abnormal stress test major surgical or invasive procedure: cardiac catheterization redo cabg x 3 (lima->lad, svg-> pda, svg->om1) history of present illness: patient is a 68 year old male with known history of coronary artery disease, status post bypass grafting in . (svg-d1, jump lad, svg->om2 and svg to rpda (occluded)). he underwent stenting of ostial vein graft to diagonal and left anterior descending arteries in ', in-stent restenosis in status post ptca and more stenting in graft proximally, stenting of the native left anterior descending artery. he had a relook catheterization one week later due to chest pain which revealed patent stents, a circumflex artery lesion was pressure wired which was negative. the patient was scheduled for a knee replacement next week and had a stress test as part of his workup. he had an ett yesterday which was positive for anterior ischemia, patient also with runs of ventricular tachycardia. patient was going in to dr. office today to be setup with a holter monitor. he reports epigastric/chest discomfort described as a burning ? indigestion pain. he took 2 nitroglycerin tabs without relief. he reported symptoms to dr. and was sent to the emergency . ecg without acute changes. pain free on arrival to emergency . patient reports he has had this epigastric/midsternal burning for several months that occurs after eating. he reports occas lightheadedness and sob but these symptoms are not associated with the discomfort in his chest. past medical history: hyperlipidemia hypertension coronary artery bypass grafting multiple percutaneous coronary interventions sleep apnea restless leg syndrome past bilateral hernia repairs right knee arthritis social history: widowed, lives with 2 sons in , retired but works at golf course during spring/summer season, rare etoh family history: father 1st mi age 51, and died of mi at age 62 physical exam: vs: 49-14 r) 119/91 l) 144/101 02 sat 100% 2l nc general: wdwn , slightly pale sitting up in bed in nad heent: oral mucosa pink, moist neck: 2+ carotids (-)bruit (-)jvd cv: rrr s1, s2 (-)murmurs resp: lungs cta bilat abdomen: soft, ntnd, (+)bowel sounds x 4 pv: femoral 2+ pulses (-)bruit dp 2+ bilat, pt 1+ bilat, (-)edema neuro: alert and oriented x 3, maes pertinent results: 05:30pm wbc-5.2 rbc-3.97* hgb-12.5* hct-35.3* mcv-89 mch-31.5 mchc-35.4* rdw-12.6 05:30pm alt(sgpt)-20 ast(sgot)-20 alk phos-71 amylase-34 dir bili-0.2 11:45pm urine rbc-* wbc-0-2 bacteria-few yeast-none epi-0-2 11:45pm urine blood-mod nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 11:35am blood wbc-9.4 rbc-3.00* hgb-8.6* hct-26.6* mcv-89 mch-28.8 mchc-32.5 rdw-15.0 plt ct-389 05:00am blood pt-14.8* inr(pt)-1.4 11:35am blood glucose-121* urean-16 creat-0.9 na-131* k-3.9 cl-92* hco3-32* angap-11 cardiac catheterization 1. selective coronary angiography demonstrated severe three vessel native coronary artery disease in this right dominant circulation. the lmca had mild disease without flow limitation. the lad was totally occluded after the takeoff of a small diagonal branch. the lcx was without flow limiting disease and became a small vessel about the av groove. the om1 was totally occluded proximally. the om2 was without flow limiting disease. the rca had a 70-80% proximal in-stent restenosis present. there was diffuse disease in the distal vessel from 50-60%. 2. graft angiography demonstrated the svg-om1 with diffuse disease but otherwise patent. the svg-d1-lad showed a patent proximal stent. there was diffuse aneurysmal disease was seen in the d1-lad jump graft with slow flow to the distal lad without a discrete lesion seen. 3. angiography of the in-situ lima showed a normal vessel. 4. left ventriculography demonstrated no mitral regurgitation and preserved left ventricular systolic function with an lvef of 55%. 5. limited resting hemodynamics demonstrated elevated left sided filling pressures with lvedp=15mmhg. ekg baseline artifact. probable prominent sinus bradycardia with prolonged p-r interval at about 0.24 seconds. leads vi-v2 were not recorded. borderline left axis deviation. inferior q waves are not diagnostic but raise consideration of prior inferior myocardial infarction. non-specific st-t wave changes. since the previous tracing of lead reversal has been corrected. the heart rate is slower and the p-r interval is longer. chest x-ray clear lungs. no acute process identified. echo 1. the left atrium is dilated. no mass/thrombus is seen in the left atrium or left atrial appendage. the right atrium is dilated. 2. the left ventricular cavity is mildly dilated. there is moderate global left ventricular hypokinesis. overall left ventricular systolic function is moderately depressed. 3. there is moderate global right ventricular free wall hypokinesis. 4. trace aortic regurgitation is seen. 5. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. 6. there is a large (3-4 cm), posterior, loculated pericardial effusion with fibrin deposits on the surface of the heart. these findings were discussed with dr. . holter monitor the baseline recording was sinus rhythm at rates ranging from 85 to 86 bpm without ectopy. the baseline intervals were as follows: at a rate of 104 bpm, the qt was .35 (prolonged), the pr was .16 (normal), and the qrs was .08 (normal). non-specific st-t changes were noted at baseline. there were 11 daily recordings transmitted which showed sinus rhythm at rates ranging from 68 to 100 bpm (strips #2,8,10,14,16,17,19,23,25,29,32). there were 20 symptomatic recordings with complaints of "burning and pressure at center of chest," "chest pressure," "a.fib/nausea," "chest discomfort level 4," "a.fib, dry mouth," "nausea, stomach discomfort, slight chest discomfort" "shortness of breath," "nausea, tired," and "chest pain." eighteen recordings showed sinus rhythm at rates ranging from 70 to 102 bpm (strips #3-6,11-13,15,18,20-22,24,26,28,30,31). there was 1 isolated vpb (strip #22). one recording on showed atrial fibrillation with average ventricular response rates of 80 to 110 bpm with a maximum rr interval of 1.40 seconds. brief hospital course: mr. was admitted to the medical center on for a cardiac catheterization. this revealed severe native vessel and saphenous vein graft disease. given the severity of his disease, the cardiac surgical service was consulted for surgical revascularization. mr. was worked-up in the usual preoperative manner. on , mr. was taken to the operating room where he underwent a redo sternotomy with coronary artery bypass grafting to three vessels. postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. on postoperative day one, mr. neurologically intact and was extubated. plavix was resumed. the electrophysiology service was consulted for atrial fibrillation which alternated with junctional bradycardia. heparin was started for anticoagulation. low dose beta blockade was used with the plan for cardioversion. on postoperative day two, mr. was transferred to the cardiac surgical step down unit. he was gently diuresed towards his preoperative weight. he developed a ten second asystolic pause which required ventricular back up pacing and his beta blockade was discontinued. he spontaneously converted to a sinus bradycardia for which he continued to be ventricularly paced. it was assumed by the electrophysiology service that a pacemaker would be needed, however they wanted to observe his rhythm a little longer to see if his node would recover. the physical therapy service was consulted for assistance with his postoperative strength and mobility. mr. developed atrial flutter / atrial fibrillation again and amiodarone was started. as mr. did not tolerate his atrial flutter very well, the plan was for a transesophageal echocardiogram, a pacemaker and flutter termination. on , mr. was taken to the electrophysiology lab where he underwent ablation of his atrial flutter. he tolerated the procedure well and felt much improved with being in normal sinus rhythm. he again developed symptomatic periods of atrial fibrillation for which his amiodarone was increased. mr. was transfused with packed red blood cells for a low hematocrit. coumadin was continued for anticoagulation. mr. continued to make steady progress and was discharged home on postoperative day twelve with of hearts holter monitor. he will follow-up with dr. , his cardiologist, the electrophysiology service and his primary care physician as an outpatient. medications on admission: aspirn 325mg daily mirapex 0.125 tablet twice daily atenolol 25mg daily cardizem cd 180mg daily celexa 30mg daily lipitor 40mg daily protonix 40mg daily ativan as needed discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. pramipexole dihydrochloride 0.125 mg tablet sig: one (1) tablet po bid prn (). disp:*60 tablet(s)* refills:*2* 3. citalopram hydrobromide 20 mg tablet sig: 1.5 tablets po daily (daily). disp:*60 tablet(s)* refills:*2* 4. atorvastatin calcium 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. pantoprazole sodium 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* 6. acetaminophen-codeine 300-30 mg tablet sig: 1-2 tablets po q3-4h () as needed. disp:*40 tablet(s)* refills:*0* 7. ferrous gluconate 300 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. amiodarone hcl 200 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 10. warfarin sodium 1 mg tablet sig: two (2) tablet po once a day: on & , then check with dr. office for continued dosing. disp:*120 tablet(s)* refills:*2* 11. lasix 20 mg tablet sig: one (1) tablet po twice a day for 7 days. disp:*14 tablet(s)* refills:*0* 12. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po twice a day for 7 days. disp:*28 capsule, sustained release(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: cad post-op a fib discharge condition: good discharge instructions: no lifting > 10#, or driving for 1 month may shower, no bathing or swimming for 1 month no creams or lotions to incisions followup instructions: with dr. in weeks with dr. in weeks with dr. in 4 weeks procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization diagnostic ultrasound of heart excision or destruction of other lesion or tissue of heart, endovascular approach transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension cardiac complications, not elsewhere classified atrial flutter other and unspecified hyperlipidemia anxiety state, unspecified unspecified disease of pericardium unspecified sleep apnea sinoatrial node dysfunction osteoarthrosis, localized, not specified whether primary or secondary, lower leg 

Answer: The patient is high likely exposed to