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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: coronary artery bypass graft x 4 (left internal mammary artery to left anterior descending, saphenous vein graft to posterior descending artery, saphenous vein graft to om1 with y-graft to om2) history of present illness: 66yr old with know hx of cad and was being managed medically for several years, hx of diabetes, htn,crd and hyperlipidemia who was scheduled for elective cardiac cath last week due to increased crescendo angina but this was cancelled 2nd to hyperkalemia. today at 4am he developed worsening chest pain and presented to lgh er. troponin and cxr were ok, ekg revealed nsr with non specific lateral wall st scooping. he underwent cardiac cath which was performed by dr. . this revealed 3 vessel cad. he was therefore transferred to for surgical revascularization. past medical history: coronary artery disease s/p coronary artery bypass graft x 4 pmh: chronic renal failure stage 2 gerd hyperlipidemia insulin dependent diabetes hypertension diabetic neuropathy past surgical history: s/p left cea s/p b hand surgery (trigger finger and dupreyens contractures) s/p b fem-fem bypass social history: race:caucasian last dental exam:1 month ago (dr. in mathuen) lives with:wife occupation:retired, worked in manufacturing tobacco:1ppd x 53 years, current smoker etoh:2-3 beers per day family history: father w mi at age 55 physical exam: pulse:72 resp:18 o2 sat:98 b/p 179/98 height:6'1" weight:206 general: skin: dry intact multiple well-healed incisions including left neck, midline abdomen, bilateral groins, medial right knee to shin heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur i/vi diastolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right:1+ left:1+ dp right:1+ left:2+ pt :1+ left:2+ radial right:2+ left:2+ carotid bruit right: - left: - discharge vs: t: 98.5 hr: 88 sr bp: 141/76 sats: 96% ra wt: 96 ra wt: 95.2 general: 66 year-old male doing well heent: normocephalic, mucus membranes card: rrr normal s1,s2 no murmur resp: faint bibasilar crackles gi: benign extr: warm r 2+ edema, l 1+ edema incision: sternal clean, dry, intact neuro: aa&o. ambulating in halls pertinent results: carotid u/s: 1. findings are consistent with less than 40% stenosis on the right. 2. findings are consistent with 40-59% stenosis on the left. echo: prebypass: preserved lv systolic function with lvef >55% with no segmental wall motion abnormalities. the left atrium is normal in size. there is moderate symmetric left ventricular hypertrophy. right ventricular chamber size and free wall motion are normal. the right ventricular free wall thickness is normal. the ascending, transverse and descending thoracic aorta are normal in diameter and there is diffuse mild descending thoracic aortic atherosclerosis.. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. significant diastolic dysfunction with lateral mitral annular tissue doppler e' = 6 cm/sec. postbypass: unchanged; normal wall motion and systolic function. no dissection seen after aortic cannula removed. wbc-10.5 rbc-3.37* hgb-10.8* hct-33.2 plt ct-195 wbc-6.3 rbc-4.18* hgb-13.6* hct-40.9 plt ct-175 glucose-178* urean-31* creat-1.4* na-140 k-4.8 cl-102 hco3-29 glucose-166* urean-24* creat-1.2 na-140 k-4.2 cl-102 hco3-28 glucose-226* urean-27* creat-1.4* na-139 k-4.5 cl-103 hco3-28 mg-2.3 cxr: : specifically, no evidence of pneumothorax. continued enlargement of the cardiac silhouette with mild atelectatic changes. brief hospital course: as mentioned in the hpi, mr. presented to outside hospital with unstable angina. cardiac enzymes were negative and ekg showed sinus rhythm with non specific lateral wall st scooping. he underwent a cardiac cath which found severe three vessel coronary artery disease and was transferred to for surgical management. upon admission he was medically managed while he underwent pre-operative work-up. in addition to usual labs, he underwent carotid u/s and vein mapping. on he was brought to the operating room where he underwent a coronary artery bypass graft x ?. please see operative report for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. later this day he was weaned from sedation, awoke neurologically intact and extubated. he desaturated at night and a sleep consult was called. cpap trial with good results. it is recommended that the patient be discharged with an auto-set cpap pending a formal sleep study. respiratory: aggressive pulmonary toilet, nebs, incentive spirometer, ambulation and good pain control he titrated off oxygen with room saturations of 96% cardiac: hemodynamically stable sinus rhythm 70-90 without ectopy. beta-blockers were titrated to home dose of toprol 100 mg daily. blood pressure 130-140's. cre 1.4 on day of discharge his amlodipine 2.5 mg was restarted and he was instructed to follow-up with his cardiologist regarding restarting lisinopril. fenofibrate 48 mg, simvastatin 40 mg and aspirin 81 mg were continued. gi: ppi and bowel regime. he tolerated a diabetic/cardiac healthy diet. renal: diuresed with lasix iv with good urine output. he was restarted on po lasix 40 mg daily and decrease to 20 mg once his lower extremity edema improved. endocrine: insulin lantus and sliding scale continued with blood sugars < 200. ophthalmologist: on noticed new blurred vision od. he was seen by ophthalmology and found to have a branch-artery occlusion of the inferior/temporal od retina. he has a history of os optic n. dysfunction. he will follow-up with his ophthalmologist as an outpatient. neuropathy: lower extremity gabapentin continued disposition: he was seen by physical therapy who deemed him safe for home. he was discharged with his family on . he will follow-up with his cardiologist, ophthalmologist, sleep study, and dr. as an outpatient. medications on admission: fenofibrate 34mg daily, folic acid 1m daily, lasix 20mg daily, neurontin 100mg , imdur, lantus 50 units pm, lisinopril 20mg daily, toprol 100mg daily, novalog ss, omeprazole 20mg daily, zocor 40mg daily, asa 81mg daily, amlodipine 2.5mg daily, requip 0.25 daily, zyrtec 10mg daily discharge medications: 1. cpap auto-set cpap dx: sleep apnea 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. gabapentin 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*70 tablet(s)* refills:*0* 10. fenofibrate micronized 48 mg tablet sig: one (1) tablet po daily (daily). 11. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 12. furosemide 20 mg tablet sig: one (1) tablet po once a day: take 40 mg daily for 7 days or until lower extremity edema has decreased. 13. insulin glargine 100 unit/ml solution sig: fifty (50) units subcutaneous at bedtime. 14. novolog insulin sliding scale continue your previous insulin sliding scale. 15. amlodipine 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: & hospice discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 past medical history: chronic renal failure stage 2 gerd hyperlipidemia insulin dependent diabetes hypertension diabetic neuropathy past surgical history: s/p left cea s/p b hand surgery (trigger finger and dupreyens contractures) s/p b fem-fem bypass discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema 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 are scheduled for the following appointments provider: care nurse phone: date/time: 10:15 on the building surgeon: dr. date/time: 1:15 building . cardiologist: dr. call for an appointment in weeks. please call to schedule appointments with your sleep clinic, dr. ( to formal arrange sleep study call medical service: 1- for cpap machine settings auto-set. primary care dr. in weeks please call your ophthalmologist dr. for an appointment within 2 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 esophageal reflux intermediate coronary syndrome hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other and unspecified hyperlipidemia long-term (current) use of insulin unspecified sleep apnea chronic kidney disease, stage ii (mild) retinal arterial branch occlusion 

Answer: The patient is high likely exposed to