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: recurrent chest pain major surgical or invasive procedure: coronary artery bypass graft x4: 1. left internal mammary artery to the lateral branch of the left anterior descending artery. 2. bypass from ascending aorta to the medial branch of the left anterior descending artery using reversed autologous saphenous vein graft. 3. bypass from the ascending aorta sequential to the posterior descending artery branch of right coronary artery and then through the ca lateral branch of the right coronary artery. history of present illness: the patient is a 57-year-old male with past medical history significant for coronary artery disease status post inferior stemi and bare metal stent to the right coronary artery in complicated by ventricular fibrillation. the patient received an icd in . the patient now presents for recurrent chest pain. stress test was abnormal in . the patient underwent ultimately left heart cath and coronary angiogram which showed that he had 3-vessel disease. decision was made to take the patient to the operating room for revascularization. the decision with its risks, benefits and alternatives were discussed with the patient and the patient agreed to proceed. a consent was signed and included in the chart. past medical history: 1. cardiac risk factors: dyslipidemia 2. cardiac history: - cad: s/p stemi - on cath table had pulseless vf and was defribrillated x3. cath showed 100% rca stented with bms, 60% diag, 60% om. uneventful post procedure & d/c'd to cardiac rehab - chf: ef 45% - recent tte with posterior wall hypokinesia, inf wall akinesis 3. other past medical history: renal cell carcinoma s/p partial nephrectomy aaa (measured 4.8 cm recently per the pt) social history: works as a police office in . married with 3 children. stopped smoking in . denies alcohol or illicit drug use. family history: both parents were heavy smokers and had copd. father with cad and cabg in his 70s. physical exam: exam pulse: 48sr resp: 20 o2 sat: 96%ra b/p right: left: 114/77 height: 6'0" weight: 195lb general: nad, wgwn, appears stated age skin: dry intact sun-tanned heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally diminished throughout heart: rrr irregular murmur grade ______ well healed left anterior chest icd pocket abdomen: soft non-distended non-tender bowel sounds + , well healed right lateral incision s/p partial nephrectomy extremities: warm , well-perfused edema _none_ varicosities: none neuro: grossly intact pulses: femoral right: 2+ left:2+ dp right: 2+ left:2+ pt : 2+ left:2+ radial right: 2+ left:cath site carotid bruit right: left: no bruits discharge exam: vs: t: 99.9 hr: 60-80 sr bp: 114-130/70 sats: 93% ra weight: 86.5 kg general: 57 year-old man in no apparent distress heent: normocephalic, mucus membranes moist neck: supple no lymphadenopathy cardiac: rrr normal s1,s2 no murmur resp: decreased breath sounds throughout no crackles or wheezes gi: benign extr: warm no edema incision: sternal and left lower extremity clean dry intact no erythema or click neuro: awake, alert oriented pertinent results: tee prebypass: the left atrium is moderately enlarged. no mass/thrombus is seen in the left atrium or left atrial appendage. left ventricular wall thicknesses are normal with thinning of the inferior and inferolateral walls to 0.5 cm. the thinned wall segments are also more brightly echogenic, consistent with scar tissue. the left ventricular cavity is moderately dilated. estimated ef 40-45%. right ventricular chamber size and free wall motion are normal. the ascending, transverse and descending thoracic aorta are mildly dilated in diameter with simple atherosclerotic plaque.. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. postbypass: left ventricular function remains unchanged from prebypass, estimated ef= 40-45%. inferior and inferolateral all hypokinesis appears unchanged. no apparent new wall motion abnormalities. mitral regurgitation remains trace. other valvular function remains unchanged. no evidence of aortic dissection. chest x-ray the lungs are hyperinflated and the diaphragms are flattened, consistent with copd. the patient is status post sternotomy with mediastinal clips. left-sided pacemaker is present, with lead tip over the right ventricle. there is mild cardiomegaly and slight prominence of the cardiomediastinal silhouette, similar to . no chf. there are small bilateral effusions, with underlying atelectasis, slighlty larger. some pleural thickening at the left lung apex laterally is unchanged. the lungs are otherwise grossly clear. wbc-12.1* rbc-3.65* hgb-11.0* hct-33.5 plt ct-133* wbc-9.9 rbc-3.64* hgb-11.2* hct-33.3 plt ct-97* glucose-122* urean-16 creat-1.0 na-136 k-4.5 cl-100 hco3-30 glucose-95 urean-17 creat-0.9 na-139 k-4.0 cl-104 hco3-29 calcium-8.1* phos-2.4* mg-1.9 mrsa screen (final ): no mrsa isolated. brief hospital course: the patient was admitted to the hospital after cardiac cath. she was brought to the operating room on where the patient underwent left internal mammary artery to the lateral branch of the left anterior descending artery. bypass from ascending aorta to the medial branch of the left anterior descending artery using reversed autologous saphenous vein graft. bypass from the ascending aorta sequential to the posterior descending artery branch of right coronary artery and then through the ca lateral branch of the right coronary artery. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. first night post-op he was hypotensive with marginal urine output, he required a-pacing and lopressor and lasix were delayed 24hrs. chest tubes were removed without incident. he was transferred to the floor in pod#1. his icd was interrogated by electrophysiology no arrhythmia were found. his beta-blockers were restarted. he was gently diuresed toward his preop weight. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod4 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged home with vna in good condition with appropriate follow up instructions. medications on admission: lisinopril 40mg daily lorazepam 1mg metoprolol succinate 50mg daily ntg prn protonix 40mg daily prasugrel 10mg daily simvastatin 40mg hs aspirin 81mg daily allergies: nkda discharge medications: 1. aspirin 81 mg po daily 2. lorazepam 1 mg po bid 3. pantoprazole 40 mg po q24h 4. simvastatin 40 mg po daily 5. acetaminophen 650 mg po/pr q4h:prn temperature >38.0 6. docusate sodium 100 mg po bid 7. hydromorphone (dilaudid) 2-4 mg po q3h:prn pain rx *dilaudid 2 mg tablet(s) by mouth every six (6) hours disp #*50 tablet refills:*0 8. ibuprofen 400 mg po q8h:prn pain give with food and water 9. metoprolol succinate xl 50 mg po daily 10. nitroglycerin sl 0.3 mg sl prn chest pain 11. furosemide 20 mg po daily duration: 3 days rx *furosemide 20 mg 1 tablet(s) by mouth once a day disp #*3 tablet refills:*0 discharge disposition: home with service facility: vna assoc. of discharge diagnosis: coronary artery disease. (bms to rca ) stemi, ventricular tachycardia s/p ablation , ischemic cardiomyopathy, lvef 30-35% by echo, s/ sci icd , psvt hyperlipidemia hypertension diabetes mellitus type 2 anxiety gastric ulcer (spring - resolved) hiatal hernia psh: renal cell carcinoma s/p right partial nephrectomy, aaa (patient reports it was noted at 4.1cm by ultrasound at , results of most recent u/s few mos ago not available), followed by dr. discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg, left - healing well, no erythema or drainage. edema: none discharge instructions: 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 no lotions, cream, powder, or ointments to incisions daily weights: keep alog. no driving for approximately one month and while taking narcotics. no lifting more than 10 pounds for 10 weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: please call for a follow-up appointment with dr. and the wound clinic surgeon: dr. cardiologist: please call for a follow-up appointment with dr. within the next 2 weeks. please call to schedule appointments with your primary care dr. , raafati 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 automatic implantable cardioverter/defibrillator (aicd) check diagnoses: other iatrogenic hypotension 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 percutaneous transluminal coronary angioplasty status other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia anxiety state, unspecified old myocardial infarction abdominal aneurysm without mention of rupture personal history of malignant neoplasm of kidney fitting and adjustment of automatic implantable cardiac defibrillator 

Answer: The patient is high likely exposed to