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: niacin attending: chief complaint: increasing angina major surgical or invasive procedure: coronary artery bypass grafting x4, left internal mammary artery graft, left anterior descending, reverse saphenous vein graft to the marginal branch, posterior descending artery and diagonal branch. history of present illness: history of present illness: this is a 73 year old male who recently underwent cervical spine surgery. during the operation, there was evidence of ischemia. subsequent nuclear study demonstrated inferior infarction with peri-infarction ischemia. since that time, he has been stable on medical therapy. cardiac catheterization in revealed severe three vessel coronary artery disease. he is now referred for surgical revascularization. past medical history: past medical history: -hyperlipidemia -hypertension -hypothyroidism -cervical myelopathy -macular degeneration -rotator cuff tear past surgical history: -cervical laminectomy -knee arthroscopy, right knee -appendectomy -hernia repair social history: race: caucasion lives with: wife, resides in nh occupation: retired irs accountant tobacco: 30 pyh, quit 15-20 years ago etoh: glasses wine/week family history: family history: mother died of stroke in her 40's. brother died of coronary disease in his 60's. physical exam: pulse: 56 resp: 16 o2 sat: 100 b/p right: 115/64 left: 114/61 height: 70inches weight: 208lbs general: wdwn male in nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur - none abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema- none varicosities: none neuro: grossly intact pulses: femoral right: 2 left: 2 **bilateral bruits noted** dp right: 1 left: 1 pt : 1 left: 1 radial right: 2 left: 2 carotid bruit: none pertinent results: echocardiography report , (complete) done at 10:42:44 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 73 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: left ventricular function. mitral valve disease. right ventricular function. valvular heart disease. icd-9 codes: 424.1, 424.0 test information date/time: at 10:42 interpret md: , md test type: tee (complete) 3d imaging. son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2010aw04-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.0 cm <= 4.0 cm left atrium - four chamber length: 5.2 cm <= 5.2 cm left ventricle - septal wall thickness: 0.9 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 0.9 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.9 cm <= 5.6 cm left ventricle - ejection fraction: >= 55% >= 55% aorta - annulus: 2.0 cm <= 3.0 cm aorta - sinus level: 3.3 cm <= 3.6 cm aorta - sinotubular ridge: 2.7 cm <= 3.0 cm aorta - ascending: 3.0 cm <= 3.4 cm aorta - descending thoracic: 2.5 cm <= 2.5 cm findings multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: moderate la enlargement. no spontaneous echo contrast or thrombus in the body of the laa. all four pulmonary veins not identified. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. dynamic interatrial septum. no asd by 2d or color doppler. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. simple atheroma in ascending aorta. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. mild thickening of mitral valve chordae. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-bypass: the left atrium is moderately 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 normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the ascending aorta. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. post-cpb: 1. pre served -ventricular systolic function 2. no change in valvular structure and function 3. intact aorta electronically signed by , md, interpreting physician 12:52 cxr reason for examination: followup of the patient after cabg. pa and lateral upright chest radiographs were reviewed in comparison to . the right internal jugular line was removed in the interim. the post-sternotomy wires are intact. the cardiomediastinal silhouette is stable. there is interval slight improvement in bibasilar atelectasis. small amount of left pleural effusion is unchanged. anterior mediastinal air most likely related to recent surgery seen within the soft tissues on the lateral view. there is no evidence of pneumothorax. brief hospital course: mr was admitted for revascularization of 3 vessel disease. he was taken to the operating room on and underwent coronary artery bypass grafting x4, left internal mammary artery graft, left anterior descending, reverse saphenous vein graft to the marginal branch, posterior descending artery and diagonal branch. see operative note for details. post operatively he was admitted to the cvicu intubated and sedated for ongoing hemodynamic monitoring and support. he awoke neurologically intact and was weaned from the ventilator and extubated without difficulty. he was started on betablockers, diuretics, and statin therapy. he was evaluated by physical therapy for strength and condtioning. he was cleared for discharged to home on pod#4. medications on admission: multivitamin qd,imdur 30 qd,metoprolol 50 ,aspirin 81 qd,sythroid 150 , 3 fatty acid 1000 discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever/pain. 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*65 tablet(s)* refills:*0* 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. 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:*2* 6. levothyroxine 50 mcg tablet sig: three (3) tablet po daily (daily). 7. atorvastatin 20 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 5 days. disp:*10 tab sust.rel. particle/crystal(s)* refills:*0* 9. lasix 20 mg tablet sig: one (1) tablet po twice a day for 5 days. disp:*10 tablet(s)* refills:*0* 10. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease hyperlipidemia,hypertension,hypothyroidism,cervical myelopathy,macular degeneration,rotator cuff tear, discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with percocet prn discharge instructions: discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: recommended follow-up:please call to schedule appointments surgeon dr. in 4 weeks primary care dr. in weeks cardiologist: dr. in weeks wound check appointment - 6 () - your nurse will schedule 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 unspecified essential hypertension unspecified acquired hypothyroidism other and unspecified hyperlipidemia other and unspecified angina pectoris old myocardial infarction 

Answer: The patient is high likely exposed to