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: mannitol / soy sterol attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization coronary artery bypass graft x4 (left internal mammary artery > left anterior descending, saphenous vein graft > ramus, saphenous vein graft > obtuse marginal, saphenous vein graft > distal right coronary artery) history of present illness: 66 year old male with chest tightness while doing light lifting . this was associated with nausea and diaphoresis. he went to lgh ed where he ruled in for nstemi and was significantly hypertensive requiring ntg to lower bp. he denies any subsequent pain/tightness and was started on asa/heparin and beta blocker. transferred here for intervention after 300mg plavix loaded. past medical history: hypertension social history: mr. is an employee of the . while he quit smoking in , he has a history of smoking two packs per day for 40 years. he drinks alcohol weekly. family history: non-contributory physical exam: vs: t=98.8 bp=178/92 hr= 77 rr=20 o2 sat= 96ra general: wdwn, nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 8 cm. cardiac: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest deformities, scoliosis or kyphosis. resp were unlabored. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominal bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: 05:36am blood wbc-8.7 rbc-3.29* hgb-10.1* hct-30.0* mcv-91 mch-30.8 mchc-33.8 rdw-15.0 plt ct-311 05:06am blood wbc-9.2 rbc-2.94* hgb-9.2* hct-27.2* mcv-93 mch-31.1 mchc-33.6 rdw-13.8 plt ct-371 06:04am blood wbc-12.3* rbc-3.08* hgb-9.9* hct-28.8* mcv-94 mch-32.0 mchc-34.2 rdw-13.9 plt ct-400 05:36am blood pt-26.3* inr(pt)-2.5* 05:06am blood pt-26.6* inr(pt)-2.5* 06:35am blood pt-28.5* inr(pt)-2.8* 06:04am blood pt-29.4* ptt-62.0* inr(pt)-2.9* 06:03am blood pt-23.5* ptt-52.4* inr(pt)-2.2* 05:39am blood pt-18.3* ptt-105.4* inr(pt)-1.6* 04:40am blood pt-15.1* ptt-29.4 inr(pt)-1.3* 12:45pm blood pt-15.7* inr(pt)-1.4* 06:55am blood pt-18.4* ptt-29.9 inr(pt)-1.7* 06:30am blood pt-61.8* ptt-42.5* inr(pt)-6.8* 06:05am blood pt-41.9* inr(pt)-4.3* 08:37am blood pt-75.8* ptt-39.8* inr(pt)-8.6* 05:36am blood glucose-94 urean-29* creat-1.3* na-137 k-4.3 cl-106 hco3-24 angap-11 05:06am blood glucose-93 urean-27* creat-1.3* na-142 k-4.1 cl-110* hco3-23 angap-13 06:35am blood urean-28* creat-1.3* na-140 k-3.9 cl-107 06:04am blood glucose-94 urean-28* creat-1.4* na-141 k-4.0 cl-105 hco3-25 angap-15 06:03am blood glucose-87 urean-28* creat-1.2 na-138 k-4.1 cl-104 hco3-26 angap-12 04:55am blood glucose-103* urean-60* creat-1.9* na-141 k-4.4 cl-105 hco3-24 angap-16 06:35am blood glucose-113* urean-32* creat-2.1* na-136 k-5.1 cl-103 hco3-26 angap-12 echocardiography report , portable tte (complete) done at 4:03:02 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 66 m hgt (in): 65 bp (mm hg): 112/70 wgt (lb): 150 hr (bpm): 74 bsa (m2): 1.75 m2 indication: hypotension. s/p cabgx4 1 week ago. left ventricular function. pericardial effusion. icd-9 codes: 424.0, 424.2 test information date/time: at 16:03 interpret md: , md test type: portable tte (complete) son: doppler: full doppler and color doppler test location: / 6 contrast: none tech quality: adequate tape #: 2011w000-0:00 machine: vivid q-1 echocardiographic measurements results measurements normal range left atrium - long axis dimension: 3.5 cm <= 4.0 cm left atrium - four chamber length: *5.6 cm <= 5.2 cm right atrium - four chamber length: *5.4 cm <= 5.0 cm left ventricle - septal thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.3 cm <= 5.6 cm left ventricle - systolic dimension: 3.0 cm left ventricle - fractional shortening: 0.30 >= 0.29 left ventricle - ejection fraction: >= 60% >= 55% left ventricle - stroke volume: 63 ml/beat left ventricle - cardiac output: 4.65 l/min left ventricle - cardiac index: 2.66 >= 2.0 l/min/m2 left ventricle - lateral peak e': *0.06 m/s > 0.08 m/s left ventricle - septal peak e': *0.07 m/s > 0.08 m/s left ventricle - ratio e/e': 14 < 15 aorta - sinus level: *4.1 cm <= 3.6 cm aorta - ascending: 3.1 cm <= 3.4 cm aorta - arch: 2.2 cm <= 3.0 cm aortic valve - peak velocity: 1.4 m/sec <= 2.0 m/sec aortic valve - lvot vti: 20 aortic valve - lvot diam: 2.0 cm mitral valve - e wave: 0.9 m/sec mitral valve - a wave: 0.8 m/sec mitral valve - e/a ratio: 1.13 mitral valve - e wave deceleration time: 188 ms 140-250 ms tr gradient (+ ra = pasp): *44 mm hg <= 25 mm hg findings this study was compared to the prior study of . left atrium: elongated la. right atrium/interatrial septum: normal ivc diameter (<2.1cm) with >55% decrease during respiration (estimated ra pressure (0-5mmhg). left ventricle: mild symmetric lvh with normal cavity size and global systolic function (lvef>55%). suboptimal technical quality, a focal lv motion abnormality cannot be fully excluded. estimated cardiac index is normal (>=2.5l/min/m2). no resting lvot gradient. right ventricle: normal rv chamber size and free motion. aorta: mildy dilated aortic root. normal ascending aorta diameter. normal aortic arch diameter. aortic valve: normal aortic valve leaflets (?#). no as. no ar. mitral valve: normal mitral valve leaflets with trivial mr. no mvp. tricuspid valve: normal tricuspid valve leaflets with trivial tr. moderate pa systolic hypertension. pulmonic valve/pulmonary artery: pulmonic valve not well seen. pericardium: there is an anterior space which most likely represents a fat pad, though a loculated anterior pericardial effusion cannot be excluded. conclusions the left atrium is elongated. the estimated right atrial pressure is 0-5 mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal motion abnormality cannot be fully excluded. the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free motion are normal. the asscending aorta is dilated at the sinus level. the aortic valve leaflets (?#) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is moderate pulmonary artery systolic hypertension. there is an anterior space which most likely represents a prominent fat pad. impression: suboptimal image quality. mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function. pulmonary artery hypertension. dilated aortic sinus. compared with the prior study (images reviewed) of , global left ventricular systolic function is improved and the estimated pulmonary artery systolic pressure is higher. these findings are suggestive of a primary pulmonary process. brief hospital course: 66 y/o male with hypertension who was transferred from an osh with an nstemi. he was treated with a heparin drip, aspirin, metoprolol, atorvastatin and clopidogrel. cardiac catheterization revealed a right dominant system with left main and three vessel coronary disease involving the lmca, lcx (including the om1 and om2) and rca. based on the catheterization findings, a cabg was recommended. as he had received clopidogrel, he was unable to proceed directly to surgery and required a washout period. he was continue on the heparin drip up to surgery. during the cardiac catherization, there was noted difficulty in passing the catheter into the aorta. an aortic ultrasound revealed a large abdominal aortic aneurysm. ct of the abdomen and pelvis confirmed these findings, revealing a maximal diameter of 8.6 cm. vascular surgery was consulted for the aaa. after discussions between the ct surgery and vascular surgery teams, it was decided that the patient would proceed with the cabg, go home for several weeks and then return for repair of his aaa. on he was brought to the operating room and underwent coronary artery bypass graft surgery, see operative report for further details. he received cefazolin and vancomycin for perioperative antibiotics and was transferred to the intensive care unit for post operative management. that evening he was weaned from sedation, awoke neurologically intact and was extubated without complications. on post operative day one he was started on betablockers and diuretics. he continued to progress and was transferred to the floor. physical therapy worked with him on strength and mobility. on post operative day two his creatinine increased to 2.1 from baseline 1 preoperatively. he was treated with fluids and foley reinserted to monitor urine output. all nephrotoxic medications were stopped and he had bun/cr monitored daily. acute kidney injury with peak cr 2.1 on and bun 60 on . additionally he had post operative atrial fibrillation treated with betablockers and amiodarone which he continued to go in and out of requiring increased betablockers. coumadin was started on , then held due to elevated inr. he did receive ffp for supratherapeutic inr. postoperatively he developed a colonic ileus. transplant surgery and general surgery assisted with management. he was kept npo and narcotics discontinued. a rectal tube was placed and was discontinued when the patient had a bowel movement. a kub was followed and diet was advanced slowly when ileus showed improvement. upon discharge he was not placed on a statin due to his chemical pancreatitis. resuming a statin will need to be reevaluated as an out patient. he was placed on vancomycin and cipro for cellulitus along his left saphenous vein harvest site. per dr., antibiotics should continue through his out patient follow up with dr. in clinic, to be re-evaluated at that time. additionally, he was noted to have a non-occlusive dvt on the lle. coumadin was continued. he continued to progress and was ready for discharge to home with a picc line, antibiotic infusion arranged, and inr/coumadin follow up with his pcp, office, as discussed with rn-, for postoperative atrial fibrillation. on post operative day 18 he was cleared for discharge to home. medications on admission: prazosin 5mg daily transfer med: acetaminophen 325 mg tab q6h prn max 4g alu-mag-simeth 30ml q6h prn aspirin 325 mg daily plavix 75mg daily docusate heparin gtt metoprolol tartrate 25mg morpine 2mg iv q5m prn nitro 0.4 mg sl q5m prn zofran 4mg iv q8h prn n/v prazosin 5mg daily senna simvastatin 40mg qhs discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. outpatient lab work labs: pt/inr for coumadin ?????? indication atrial fibrillation and dvt goal inr 2.0-3.0 first draw results to be called into dr office/ fax # 5. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temp/pain. 6. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). disp:*60 disk with device(s)* refills:*2* 7. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 10 days. disp:*20 tablet(s)* refills:*0* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 9. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 10. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 12. outpatient lab work sunday, : cbc, chem 7, lfts, vancomycin trough results to dr. fax: 13. furosemide 20 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 14. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po once a day for 2 weeks. disp:*14 tablet, er particles/crystals(s)* refills:*0* 15. warfarin 1 mg tablet sig: one (1) tablet po once daily at 4 pm: dose may change daily for goal inr , dx: afib and dvt, dr. to manage. disp:*60 tablet(s)* refills:*2* 16. vancomycin 1,000 mg recon soln sig: one (1) intravenous every twelve (12) hours for 7 days. disp:*14 * refills:*0* discharge disposition: home with service facility: home solutions discharge diagnosis: coronary artery disease s/p cabg non st elevation myocardial infarction (troponin 1.12) acute kidney injury post operative atrial fibrillation abdominal aortic aneurysm - plan for f/u with vascular surgery dyslipidemia hypertension 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 left - healing well, no erythema or drainage. edema +(b)le 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 **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments: cardiac surgeon: dr , 2:00, and 1:30, , vascular surgeon: dr. date/time: 2:00 cardiologist: dr date/time: 1:00 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** labs: pt/inr for coumadin ?????? indication atrial fibrillation and dvt goal inr 2.0-3.0 first draw results to be called into dr office/ fax # md procedure: venous catheterization, not elsewhere classified (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery other postoperative infection unspecified essential hypertension acute kidney failure, unspecified cardiac complications, not elsewhere classified atrial fibrillation personal history of tobacco use other and unspecified hyperlipidemia cellulitis and abscess of leg, except foot paralytic ileus acute venous embolism and thrombosis of deep vessels of proximal lower extremity abdominal aneurysm without mention of rupture vascular complications of other vessels 

Answer: The patient is high likely exposed to