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: shortness of breath and fatigue major surgical or invasive procedure: diagnostic cardiac catheterization cabg x5(lima->lad,svg->diag,svg->ramus->om2,svg->plv) history of present illness: the patient is a 51-year-old m with pmhx obesity, hld, htn who presented to pmd today () with 2-3 days of malaise, sob, and epigastric bloating. over the past 2 weeks he could not lie flat and occasionally had pnd. he also noted intermittant fever and chills with myalgias with an intermittent dry cough while lying flat. no recent travel or sick contacts. the patient denies having any chest pain, including no cp on exertion. no dizziness or palpitations. on entrance into urgent care today, initial oxygen saturation was 86%. with 6 l nasal cannula, increased to 90% with some improvement in symptoms. the patient reports that he had recently been lost to follow up because he lost his job and also his health insurance. during this time (-) he was very depressed and began drinking heavily. the patient would finish a full bottle of vodka every 2-3 days. he stopped after convincing from his daughter and subsequently found a new job last month. he reports that while he had no health insurance, he was not able to take some of his bp medications. on review of systems, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, hemoptysis, black stools or red stools. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, ankle edema, palpitations, syncope or presyncope. he does have sob on exertion and orthopnea. past medical history: -obesity -dm type ii -hld -htn -depression -dyspepsia -gout *no known hx of cad or chf social history: -tobacco history: non-smoker, never smoked -etoh: 6 months of binge drinking - - see hpi -illicit drugs: marijuana in college patient lives with his daughter. is currently divorced and works as a software programmer. his new job is an overnight shift so he has been more fatigued lately. family history: father had an mi at age 60. brother with dm physical exam: on admission vs: t= 98.3 bp= 102/65 hr= 99 rr= 30 o2 sat= 95% on bipap 50%o2, peep-7 general: 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- jvp difficult to assess central line and bipap mask cardiac: pmi located in 5th intercostal space, midclavicular line. rr, s1, s2, s3 gallop appreciated. no thrills, lifts. no s4. lungs: no chest wall deformities, scoliosis or kyphosis. tachypnic, no accessory muscle use, breath sounds with rales up to mid lung fields, in particular rll. abdomen: obese, soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial 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: admission labs 12:20pm wbc-18.9* rbc-4.99 hgb-15.4 hct-45.3 mcv-91 mch-30.8 mchc-33.9 rdw-13.7 12:20pm neuts-86.6* lymphs-9.4* monos-2.7 eos-0.8 basos-0.5 12:27am blood glucose-182* urean-25* creat-0.9 na-140 k-3.8 cl-100 hco3-25 angap-19 12:20pm blood ctropnt-0.63* 12:27am blood ck-mb-6 ctropnt-0.90* probnp-2829* notable labs 12:27am blood %hba1c-7.9* eag-180* 12:27am blood triglyc-205* hdl-36 chol/hd-6.6 ldlcalc-160* ldlmeas-160* 12:27am blood tsh-0.94 ecg possible atrial ectopic rhythm given unusual axis of p wave. possible old anteroseptal myocardial infarction. possible old inferior myocardial infarction. diffuse non-specific st-t wave abnormalities. tte left ventricular wall thicknesses and cavity size are normal. there is moderate regional left ventricular systolic dysfunction with near akinesis of the distal half of the anterior septum and anterior walls. the apex is mildly aneurysmal and akinetic. the remaining segments contract normally (lvef = 30 %). no masses or thrombi are seen in the left ventricle. there is an anterior space which most likely represents a prominent fat pad. impression: regional left ventricular systolic dysfunction c/w cad (mid lad distribution; cannot exclude takosubo cardiomyopathy if clinically cuggested). compared with the prior study (images reviewed) of , the findings are similar. caridac cath- 1. selective coronary angiography of this right dominant system demonstrated severe three vessel coronary artery disease. the lmca was free of any angiographically-apparent flow-limiting stenoses. the lad had a large 90% lesion proximally. there was a 100% occlusion in the large d1. the lcx also had a 90% stenosis proximally in the large ramus intermedius branch. the large om2 had an 80% stenosis. the rca had a 100% occlusion in the mid-vessel. the distal vessel filled via well-established left-to-right collaterals. 2. limited resting hemodynamics revealed normal systemic systolic arterial pressures, with a central aortic pressure of 124/84, mean 98 mmhg. brief hospital course: 51 year old male presented to from urgent care with 3 days worsening shortness of breath and fatigue. he was found to be in systolic heart failure. cardiac cath revelaed severe 3 vessel disease and patient is scheduled for cabg procedure . systolic chf patient presented with decompensated chf and severe pulmonary edema, requiring intermittent bipap on admission. after several days of aggressive iv diuresis, the patient no longer needed any o2 therapy to maintain normal sats. his medication regimen for heart failure was optimized: now on 40mg lisinopril daily, 12.5 carvedilol , and furosemide 40mg daily. spirionolactone may be started as an outpatient. 3 vessel coronary artery disease cardiac cath revealed: the lad had a large 90% lesion proximally. there was a 100% occlusion in the large d1. the lcx also had a 90% stenosis proximally in the large ramus intermedius branch. the large om2 had an 80% stenosis. the rca had a 100% occlusion in the mid-vessel. the distal vessel filled via well-established left-to-right collaterals. the patient was maintained on asa 81mg. the patient is scheduled for cabg . based on ecg findings and patient's history, he likely had a silent, large anterior mi approximately 4-6 weeks prior to presenting to urgent care center. the patient's cad was medically managed before cabg procedure with aspirin and atorvastatin. he was chest pain free and did not experience shortness of breath leading up to his surgery. the patient was brought to the operating room on where the patient underwent urgent coronary artery bypass graft x5; left internal mammary artery to left anterior descending artery, and saphenous vein graft to diagonal, and saphenous vein sequential graft to ramus and obtuse marginal, and saphenous vein graft to posterior left ventricular branch and endoscopy harvesting of the long saphenous vein. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact. he required milrinone for hemodynamic support until pod#2. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery on pod#3. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod #5 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to home in good condition with appropriate follow up instructions including the need to obtain a cardiologist for follow up. ?pnemonia- on admission, patient had sob, and elevated wbc count (18) with likely rll infiltrate. he completed a 5 day course of po azithromycin and 7 day course of ceftriaxone iv in house. his wbc normalized during hospitalization of rll infiltrate resolved. #htn the patient's blood pressures were well controlled on the carvedilol and lisinopril mentioned above. #hld patient unreliably took is statin at home. this dose was continued in house. measured ldl was 160. #dm measured hga1c was 7.9. the patient was kept on an insulin sliding scale while in house. #depression the patient was maintained on his home fluoxetine dose. he required benzodiazepines intermittently to help him sleep. medications on admission: preadmission medications listed are correct and complete. information was obtained from patientatrius. 1. felodipine 5 mg po daily 2. enalapril maleate 40 mg po daily 3. atenolol 75 mg po daily 4. fluoxetine 60 mg po daily 5. metformin (glucophage) 500 mg po bid 6. simvastatin 40 mg po daily 7. omeprazole 20 mg po bid discharge medications: 1. fluoxetine 60 mg po daily 2. metformin (glucophage) 1000 mg po bid rx *metformin 1,000 mg 1 tablet(s) by mouth twice a day disp #*60 tablet refills:*1 3. omeprazole 20 mg po daily rx *omeprazole 20 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*1 4. simvastatin 40 mg po daily 5. acetaminophen 650 mg po q4h:prn pain, fever 6. aspirin ec 81 mg po daily rx *adult low dose aspirin 81 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*1 7. metoprolol tartrate 75 mg po tid hold for hr < 55 or sbp < 90 and call medical provider. *metoprolol tartrate 25 mg 3 tablet(s) by mouth three times a day disp #*270 tablet refills:*1 8. oxycodone-acetaminophen (5mg-325mg) tab po q4h:prn pain rx *oxycodone-acetaminophen 5 mg-325 mg tablet(s) by mouth every four (4) hours disp #*65 tablet refills:*0 9. enalapril maleate 20 mg po daily rx *enalapril maleate 20 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*1 10. furosemide 20 mg po bid duration: 7 days rx *furosemide 20 mg 1 tablet(s) by mouth twice a day disp #*14 tablet refills:*0 11. potassium chloride 20 meq po daily duration: 7 days rx *potassium chloride 20 meq 20 meq by mouth once a day disp #*7 tablet refills:*0 12. felodipine 2.5 mg po daily rx *felodipine 2.5 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*1 discharge disposition: home with service facility: discharge diagnosis: coronary artery disease systoilc chf diabetis mellutis, hyperlipidemia, hypertension, gout, depression, dyspepsia, tonsillectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema: trace 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: recommended follow-up: the cardaic surgery office will contact you and schedule the following appointments surgeon: dr. wound check with cardiac surgery cardiologist: please contact your primary care doctor for a referral for a cardiologist 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** md procedure: venous catheterization, not elsewhere classified single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of four or more coronary arteries diagnoses: pneumonia, organism unspecified other primary cardiomyopathies 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 depressive disorder, not elsewhere classified other and unspecified hyperlipidemia diarrhea acute systolic heart failure dyspepsia and other specified disorders of function of stomach 

Answer: The patient is high likely exposed to