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: sulfa (sulfonamide antibiotics) attending: chief complaint: abnormal stress test major surgical or invasive procedure: coronary artery bypass grafting x4 with left internal mammary artery to left anterior descending coronary artery; reverse saphenous vein single graft from aorta to first obtuse marginal coronary artery; reverse saphenous vein single graft from aorta to second obtuse marginal coronary artery; reverse saphenous vein single graft from aorta to posterior left ventricular coronary artery. history of present illness: this 76 year old patient with newly diagnosed diabetes and hyperlipidemia has been followed for a long period of time for chronic stable coronary artery disease. he has never had a cardiac catheterization before; he has presumed cad based on prior abnormal stress test. he was recently referred for a surveillance stress test which was done on . he denies any recent chest pain. he does report some shortness of breath which occurs with exertion such as walking or doing housework. he exercised for 7 minutes and 58 seconds and stopped due to fatigue and leg pain. he was switched to a regadenoson protocol. positive for chest pain during exercise. due to the abnormalites on the stress test, the patient has been referred for outpatient cardiac catheterization. cardiac surgery consulted for coronary revascularization. past medical history: hypercholesterolemia diabetes-recently diagnosed chronic back pain spinal meningitis at age 18 social history: married and lives with his wife. occupation: truck driver for fed ex contact for discharge: wife and daughter : or home services: no tobacco: no etoh: moderate - recreational drug use : no family history: fh: father died of an mi at age 69 physical exam: physical exam pulse: 70 resp:12 o2 sat: 97% b/p right: 143/83 left: 134/64 height: weight:165lbs 74.84kgs general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused no edema varicosities: none neuro: grossly intact pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit right: no left: very soft murmur noted pertinent results: 11:56am blood wbc-11.7*# rbc-3.32* hgb-10.0*# hct-29.4* mcv-88 mch-30.1 mchc-34.1 rdw-13.6 plt ct-114* 01:15pm blood wbc-10.9 rbc-3.91* hgb-11.7* hct-34.1* mcv-87 mch-30.0 mchc-34.4 rdw-13.6 plt ct-118* 06:32pm blood wbc-13.6* rbc-3.85* hgb-11.7* hct-33.8* mcv-88 mch-30.5 mchc-34.7 rdw-13.8 plt ct-128* 02:52am blood wbc-13.4* rbc-3.29* hgb-9.9* hct-28.6* mcv-87 mch-30.2 mchc-34.7 rdw-13.7 plt ct-105* 03:23am blood wbc-12.0* rbc-3.11* hgb-9.5* hct-26.9* mcv-87 mch-30.7 mchc-35.4* rdw-13.7 plt ct-97* 05:28am blood wbc-9.0 rbc-2.83* hgb-8.8* hct-24.9* mcv-88 mch-31.3 mchc-35.5* rdw-13.8 plt ct-103* 05:01am blood wbc-11.6* rbc-3.03* hgb-9.4* hct-26.9* mcv-89 mch-31.1 mchc-35.0 rdw-13.9 plt ct-145* 11:56am blood pt-13.8* ptt-29.3 inr(pt)-1.2* 11:56am blood plt ct-114* 05:01am blood plt ct-145* 01:15pm blood urean-12 creat-0.7 na-138 k-4.1 cl-107 hco3-25 angap-10 06:32pm blood glucose-140* urean-12 creat-0.7 na-137 k-4.5 cl-105 hco3-25 angap-12 02:52am blood glucose-123* urean-13 creat-0.7 na-135 k-4.3 cl-104 hco3-24 angap-11 03:23am blood glucose-117* urean-13 creat-0.6 na-133 k-3.8 cl-99 hco3-29 angap-9 05:28am blood glucose-129* urean-18 creat-0.6 na-134 k-3.7 cl-98 hco3-31 angap-9 05:01am blood glucose-92 urean-19 creat-0.7 na-133 k-4.3 cl-95* hco3-33* angap-9 echocardiography report , (congenital) done at 9:09:33 am final referring physician information , c. , status: inpatient dob: age (years): 76 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: intraoperative tee for cabg icd-9 codes: 746.9, 424.0 test information date/time: at 09:09 interpret md: , md test type: tee (congenital) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2011aw-:1 machine: us2 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.7 cm <= 4.0 cm left atrium - four chamber length: 4.0 cm <= 5.2 cm left ventricle - septal wall thickness: 0.8 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 0.8 cm 0.6 - 1.1 cm left ventricle - ejection fraction: 45% to 50% >= 55% aorta - annulus: 1.7 cm <= 3.0 cm aorta - sinus level: 3.0 cm <= 3.6 cm aorta - sinotubular ridge: 2.4 cm <= 3.0 cm aorta - ascending: 2.8 cm <= 3.4 cm findings left atrium: mild la enlargement. good (>20 cm/s) laa ejection velocity. no thrombus in the laa. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. pfo is present. left-to-right shunt across the interatrial septum at rest. left ventricle: normal lv wall thickness. low normal lvef. right ventricle: dilated rv cavity. normal rv systolic function. aorta: normal ascending aorta diameter. simple atheroma in descending aorta. no thoracic aortic dissection. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets. mild mitral annular calcification. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. physiologic tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. mild pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. results were personally reviewed with the md caring for the patient. conclusions pre-cpb: the left atrium is mildly dilated. no thrombus is seen in the left atrial appendage. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen throughout the cardiac cycle. left ventricular wall thicknesses are normal. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricular cavity is mildly dilated with normal free wall contractility. there are simple atheroma in the descending thoracic aorta. no thoracic aortic dissection is seen. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. no aortic regurgitation is seen. there is focal calcification of the aortic root, most notable in the right coronary cusp. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. post-cpb: lv systolic function appears very mildly depressed, estimated ef=45%. rv function appears normal. there remains a pfo with left to right shunt. there is no evidence of dissection. cxr: 76 year old man s/p cabg reason for this examination: interval change-please obtain after noon final report two view chest, comparison: chest radiographs dating between and . findings: the patient is status post median sternotomy and coronary artery bypass surgery. right internal jugular vascular catheter terminates in superior vena cava. cardiomediastinal contours are stable in the postoperative period. small-to-moderate left pleural effusion has increased in size with associated worsening atelectasis in the left lower lobe. small right pleural effusion is also present, but the degree of right basilar atelectasis has improved. on the lateral view, retrosternal gas and air-fluid collections are likely related to the recent sternotomy. impression: worsening small-to-moderate left pleural effusion with adjacent atelectasis. small right pleural effusion and improving right basilar atelectasis. brief hospital course: on mr. was taken to the operating room and underwent coronary artery bypass grafting x4 (left internal mammary artery to left anterior descending coronary artery; reverse saphenous vein single graft from aorta to first obtuse marginal coronary artery; reverse saphenous vein single graft from aorta to second obtuse marginal coronary artery; reverse saphenous vein single graft from aorta to posterior left ventricular coronary artery) with dr.. please see operative note for further details. cross clamp time=67minutes, cardiopulmonary bypass time=80min. he tolerated the procedure well and transferred to the cvicu intubated and sedated in stable condition. he awoke neurologically intact and was extubated without incident. he was weaned off pressors and beta-blockers/statin/aspirin and diuresis was initiated. all lines and drains were discontinued in a timely fashion. he continued to progress and was transferred to the step down unit for further monitoring. physical therapy was consulted for evaluation and assistance with strength and mobility. the remainder of his hospital course was essentially uneventful. on pod 5 he was cleared for discharge to home in stable condition. all follow up appointments were advised. medications on admission: atenolol - (prescribed by other provider) - 100 mg tablet - 1 tablet(s) by mouth daily diltiazem hcl - (prescribed by other provider) - 120 mg capsule, ext release 24 hr - 1 capsule(s) by mouth daily enalapril maleate - (prescribed by other provider) - 2.5 mg tablet - 1 tablet(s) by mouth daily in the pm ezetimibe - (prescribed by other provider) - 10 mg tablet - 1 tablet(s) by mouth daily finasteride - (prescribed by other provider) - 5 mg tablet - 1 tablet(s) by mouth daily gabapentin - (prescribed by other provider) - 400 mg capsule - 1 capsule(s) by mouth in the am, 1 tablet at 12noon, 2 tablets in the pm metformin - (prescribed by other provider) - 500 mg tablet - 1 tablet(s) by mouth twice a day nitroglycerin - (prescribed by other provider) - dosage uncertain omeprazole - (prescribed by other provider) - 20 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth daily simvastatin - (prescribed by other provider) - 40 mg tablet - 1 tablet(s) by mouth daily tramadol - (prescribed by other provider) - 50 mg tablet - 1 tablet(s) by mouth tid for back pain medications - otc acetaminophen - (prescribed by other provider) - 500 mg tablet - 1 tablet(s) by mouth prn back pain aspirin - (prescribed by other provider) - 81 mg tablet, chewable - 1 tablet(s) by mouth daily discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po once a day for 5 days. disp:*5 tablet(s)* refills:*0* 2. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po once a day for 5 days. disp:*5 tablet, er particles/crystals(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): please take stool softeners while taking narcotic pain medication. hold for loose stools. 4. tramadol 50 mg tablet sig: one (1) tablet po every eight (8) hours as needed for pain: per home regimen. disp:*0 tablet(s)* refills:*0* 5. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 6. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 8. gabapentin 400 mg capsule sig: one (1) capsule po bid (2 times a day): per home regimen. 9. gabapentin 400 mg capsule sig: two (2) capsule po hs (at bedtime): per home regimen. 10. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 11. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 12. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain for 2 weeks: please do not drive or operate machinery while taking this pain medication. take stool softeners to prevent constipation. wean off as tolerated. disp:*40 tablet(s)* refills:*0* 13. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 14. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*1* 15. simvastatin 20 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease secondary: hypercholesterolemia diabetes-recently diagnosed chronic back pain spinal meningitis at age 18 discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema trace edema l>r discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you have an appointment for a wound check on 6 with a midlevel provider on thursday at 10:30am surgeon: dr , md phone: date/time: 1:30 cardiologist:dr office will call to arrange appointment please call to schedule appointments with your primary care dr.: , . in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** 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 pure hypercholesterolemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to