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: chest pain shortness of breath major surgical or invasive procedure: - coronary artery bypass grafting to four vessels. (left internal mammary->left anterior descending artery, saphenous vein graft(svg)->ramus artery, svg->obtuse marginal artery, svg->posterior descending artery.) history of present illness: 68 year old male admitted to caritas ed with complaint of chest pain and shortness of breath, where he was intubated and underwent diagnostic cardiac catheterization and is transferred here for management of his coronary artery disease. per records, patient complained to his wife chest discomfort at 4:45 am and drove himself to the emergency room. chest pain was described as non-pleuratic substernal discomfort radiating into left shoulder and arm and associated with shortness of breath. he received aspirin and sublingual nitroglycerin po in the ed initially. he was noted to be progressivel dyspneic and then required furosemide 20mg iv, morphine 4mg iv and initiation of nitroglycerin gtt, and metoprolol 5mg iv x 3, and was subsequently intubated due to dyspnea. initial ecg showed sinus tachycardia at 115 with lbbb and no prior for comparison. tni was 1.04 (normal 0.00-0.49) with cpk 182 and mb of 15.2. he initially went to the icu, where he received clopidogrel 500mg x 1, and started on heparin gtt with 4500 unit bolus. he was transferred to cardiac catheterization laboratory and underwent left and right heart catheterization showing rca and lcx occlusion, 50% lmca lesion, and 90% plad stenoses with elevated left-sided filling pressures. he was transferred on heparin gtt to for further management. of note, patient was also ordered for empiric vancomycin and ceftriaxone and had already received ceftriaxone prior to transfer. . on arrival to ccu, patient was intubated, but awake, alert, and in nad. jvp was 10cm and chest x-ray did not demonstrate pulmonary oedema. patient was extubated without event. initial laboratory evaluation showed markedly elevated cpk and patient was started on eptifibatide in addition to heparin. cardiac surgery is now evaluating for surgical resvascularization. past medical history: hypertension hypercholesterolemia type 2 dm, on metformin as outpatient, last a1c 6.2 peripheral vascular disease b12 deficiency chronic bronchitis myocardial infarction acute systolic heart failure social history: - worked in landscaping and steel industry - 4 children, second marriage -tobacco history: smoked 1ppd since age 15, quit 2 weeks ago -etoh: occasional -illicit drugs: none family history: two brothers and one sister alive. on brother with diabetes and one sister with lung disease. mother had cva. father died of mi in 60s. physical exam: general: middle aged male, intubated, nad heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 10 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. 2/6 systolic murmur rusb. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. coarse breath sounds but 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: femoral 1+, no hematoma or bruit at site, dp and pt dopplerable left: femoral 1+ dp and pt dopplerable pertinent results: carotid ultrasound mild atherosclerotic plaque with bilateral 1-39% ica stenosis. antegrade vertebral flow bilaterally echo the left atrium is markedly dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is severely depressed (lvef= 25 %). with mild global free wall hypokinesis. the diameters of aorta at the sinus, ascending and arch levels are normal. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate thickening of the mitral valve chordae. moderate (2+) mitral regurgitation is seen. pft spirometry 1:45 pm pre drug post drug actual pred %pred actual %pred %chg fvc 2.60 3.98 65 fev1 1.85 2.73 68 mmf 1.14 2.60 44 fev1/fvc 71 68 104 lung volumes 1:45 pm pre drug post drug actual pred %pred actual %pred tlc 4.48 6.29 71 frc 2.24 3.55 63 rv 1.68 2.30 73 vc 2.84 3.98 71 ic 2.24 2.73 82 erv 0.56 1.25 45 rv/tlc 37 37 102 he mix time 1.88 dlco 1:45 pm actual pred %pred dsb 13.30 24.64 54 va(sb) 3.98 6.29 63 hb 12.20 dsb(hb) 14.38 24.64 58 dl/va 3.61 3.92 92 06:33am blood wbc-10.2 rbc-3.01* hgb-9.3* hct-26.9* mcv-89 mch-30.8 mchc-34.4 rdw-13.3 plt ct-308 06:33am blood glucose-125* urean-31* creat-1.2 na-138 k-4.0 cl-100 hco3-29 angap-13 brief hospital course: mr. was admitted to the on for further management of his myocardial infarction and coronary artery disease. as his enzymes were trending downward, integrillin was stopped. he was worked up by the cardiac surgical service in preparation for revascularization. a carotid duplex ultrasound was obtained which revealed only mild bilateral internal carotid artery disease. pulmonary function testing was performed given his heavy smoking history. his forced expiratory volume in the first second was diminished at 2.73l or 68% predicted. a dental consult was obtained in anticipation of surgically addressing his mitral regurgitation. after a panorex was obtained, mr. was cleared for surgery from an oral standpoint. on , mr. was taken to the operating where he underwent coronary artery bypass grafting to four vessels. please see operative note for details. postoperatively he was taken to the intensive care unit for monitoring. by pod 1, the patient was extubated, alert and oriented and breathing comfortably. he was neurologically intact and hemodynamically stable, off all vasoactive drips. chest tubes and pacing wires were discontinued without complication. the physical therapy service was consulted for strength and mobility. the patient was transferred to the telemetry floor on pod 3. his blood sugars were well controlled on his home dose of metformin 1000mg two times per day. by post-operative day five he was ready for discharge to home with continued lasix. medications on admission: medications at home: simvastatin 40 mg po qhs metformin 1000 mg amlodipine ? mg po daily aspirin 81 mg po daily b12 vitamin 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:*0* 2. zocor 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 6. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. metformin 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 8. furosemide 20 mg tablet sig: two (2) tablet po once a day: take 2 20mg tablets (40mg daily total) for 5 days, then decrease to 1 20mg tablet (20mg total) daily for 10 more days. please ask pcp to assess for further need for lasix. disp:*30 tablet(s)* refills:*2* 9. potassium chloride 20 meq packet sig: one (1) 20 meq packet po once a day for 15 days. disp:*15 packets* refills:*2* discharge disposition: home with service facility: , discharge diagnosis: st elevation myocardial infarction acute respiratory failure diabetes mellitus type 2 acute systolic dysfunction, ef 25% hypertension acute renal failure hyperlipidemia tobacco abuse discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks from date of surgery. 6) no driving for 1 month or while taking narcotics for pain. 7) no more then 2 grams of sodium (salt) daily 8) call with any questions or concerns. followup instructions: please follow-up with dr. in 1 month. ( please follow-up with dr. (cardiologist) in 2 weeks. please follow-up with dr. (pcp)in weeks.( procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery injection or infusion of platelet inhibitor diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified peripheral vascular disease, unspecified personal history of tobacco use other b-complex deficiencies other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia acute respiratory failure acute systolic heart failure acute myocardial infarction of unspecified site, initial episode of care unspecified chronic bronchitis 

Answer: The patient is high likely exposed to