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: cardiac cath coronary artery bypass graft x 5 (left internal mammary artery to left anterior descending, saphenous vein graft to diagonal, saphenous vein graft to obtuse marginal 1, saphenous vein graft to obtuse marginal 2, saphenous vein graft to posterior descending artery) history of present illness: 63 year old male with no known prior cardiac history, presented to his pcp, , on to report progression of symptoms of dyspnea and a lesser sensation of chest discomfort. this was noticed last fall. he initially attributed discomfort to gi upset, but increasingly aware of fatigue and dyspnea on exertion with minor activities such as walking to his mailbox since . while at dr office he experienced chest heaviness, associated with diaphoresis and presyncopal symptoms. he was transported to gsms for evaluation. the office ekg was noted for new t wave inversions v3-v6. he reports being pain free since admission. mi r/o'd by ekg and tni negative x2. he has been referred to cardiac surgery for possible revascularization. past medical history: hypertension hyperlipidemia peripheral artery disease: carotid: r ica 70% stenosis s/p left pontine cva ' (r hemiparesis) chronic constipation depression social history: race:caucasian last dental exam:few months ago lives with: with roommate, sister is close by for support occupation:retired tobacco:denies etoh:pt states "moderate" family history: father died of mi age 62 physical exam: pulse:72 resp:18 o2 sat:99/ra b/p left: 118/66 height: 5'9" weight:228 lbs general: nad, slightly unkempt 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 edema- none varicosities: none neuro: grossly intact x pulses: femoral right: 1+ left: 2+ dp right: 2+ left: 2+ pt : 1+ left: 1+ radial right: cath site, 2+ left: 2+ carotid bruit right: left: no carotid bruits pertinent results: cardiac cath: 1. the patient had a vasovagal reaction with hypotension and bradycardia during attempts to advance the 5 french jl4 catheter into the proximal brachiocephalic artery through a tortuous loop. dopamine 10 mcg/kg/min was required to get the systolic blood pressure back to 120 mm hg, but this was accompanied by tachycardia and chest pain. the dopamine was weaned off, with stable sbp but continued chest pain and tachycardia. metoprolol 2.5 mg iv was given with improvement of heart rate int the 90s and gradual improvement of his chest pain (after a brief period of iv tng infusion). 2. coronary angiography in this codominant system revealed native three vessel coronary artery disease. the lmca had a distal 25% stenosis. the lad was heavily calcified throughout with an ostial 60% stenosis, a calcified mid vessel complex bifurcation lesion involving d1 with 90% in left anterior descending and 80% in first diagonal branch. there was moderate to severe diffuse disease in branching first diagonal with occlusion of a medial distal pole. there were septal and apical collaterals to an am and the rpda. the left circumflex had focal heavy calcification with a tortuous moderate high om1 and a mid av groove circumflex stenosis of 60% after om2. the distal av groove circumflex had a subtotal vs. total occlusion after the tortuous lpl2. the om2 was totally occluded and filled late by left-to-left collaterals. the rca had proximal severe disease with proximal to mid vessel occlusion, seen both while on dopamine and subsequently (arguing against vasopressor induced spasm). 3. post-angiography hemodynamics revealed normal left sided filling pressures with lvedp of 10 mmhg. central aortic pressures were normal 111/56 with a mean of 58 mmhg. carotid u/s: right ica stenosis 40-59%. left ica stenosis <40%. echo: prebypass: no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. regional left ventricular motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results on at 900 am. post bypass: patient is a paced and receiving an infusion of phenylephrine. biventricular systolic function is unchanged. mild mitral regurgitation persists. aorta is intact post decannulation. 06:00am blood wbc-9.4 rbc-4.29* hgb-10.3* hct-33.2* mcv-77* mch-24.0* mchc-31.1 rdw-18.8* plt ct-333 02:15pm blood wbc-7.1 rbc-4.25* hgb-9.1* hct-30.3* mcv-71* mch-21.5* mchc-30.2* rdw-15.8* plt ct-218 02:15pm blood pt-14.6* inr(pt)-1.3* 06:00am blood urean-11 creat-0.9 na-136 k-4.2 cl-103 02:15pm blood glucose-149* urean-12 creat-1.3* na-136 k-3.6 cl-105 hco3-22 angap-13 brief hospital course: mr. presented to on with acute coronary syndrome. he underwent a cardiac cath and was found to have multivessel disease. a pre-op work up was completed and after a plavix washout he was cleared for cardiac surgery. he was taken to the operating room for surgical revascularization on and underwent a coronary artery bypass x5. please see operative note for details. post operatively he was intubated and sedated and admitted to the cvicu for hemodynamic monitoring and management. he awoke neurologically intact and was extubated. he was transferred to the stepdown unit for ongoing post operative management. betablockers/statin/aspirin and diuresis were started and he was diuresed toward his pre-operative weight. chest tubes and temporary pacing wires were removed per protocol. the remainder of this postoperative course was essentially uneventful. he was evaluated by physcial therapy for strength and conditioning and cleared for discharge to his girlfriend's home with home pt on pod#5. all follow up appointments were advised. medications on admission: amlodipine - (prescribed by other provider) - 10 mg tablet - 1 (one) tablet(s) by mouth once a day clopidogrel - (prescribed by other provider) - 75 mg tablet - 1 (one) tablet(s) by mouth once a day metoprolol tartrate - (prescribed by other provider) - 50 mg tablet - 1 (one) tablet(s) by mouth twice a day simvastatin - (prescribed by other provider) - 20 mg tablet - 1 (one) tablet(s) by mouth once a day medications - otc aspirin - (prescribed by other provider) - 325 mg tablet - 1 (one) tablet(s) by mouth once a day discharge medications: 1. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po q12h (every 12 hours) for 10 days. disp:*20 tablet, er particles/crystals(s)* refills:*0* 2. lasix 20 mg tablet sig: one (1) tablet po twice a day for 10 days. disp:*20 tablet(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*45 tablet(s)* refills:*0* 7. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 8. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 9. ferrous gluconate 325 mg (37.5 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 10. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 11. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* discharge disposition: home with service facility: vna care discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 5 past medical history: hypertension hyperlipidemia peripheral artery disease: carotid: r ica 70% stenosis s/p left pontine cva ' (r hemiparesis) chronic constipation depression discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics 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: ??????s office closed, msg left you are scheduled for the following appointments surgeon: dr. on at 1:30pm cardiologist: needs referral 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: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters other endoscopy of small intestine left heart cardiac catheterization (aorto)coronary bypass of four or more coronary arteries colonoscopy diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified pleural effusion unspecified essential hypertension depressive disorder, not elsewhere classified occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure late effects of cerebrovascular disease, hemiplegia affecting unspecified side iron deficiency anemia, unspecified other constipation gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction benign neoplasm of colon barrett's esophagus diverticulosis of colon (without mention of hemorrhage) internal hemorrhoids without mention of complication 

Answer: The patient is high likely exposed to