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: exertional chest pain major surgical or invasive procedure: - off pump cabgx3 (left internal mammary->left anterior descending artery, vein graft->diagonal artery, vein graft->posterior descending artery) - cardiac catheterization history of present illness: cc: 73 yo hispanic man admitted to holding area from exercise lab due to ekg changes and chest pain during outpt ett today. hpi: information obtained from pt. with assistance of interpreter services. this 73 yo man with no known prior hx cad, reports overall good health. approximately 3 months ago, he noted the onset of chest pressure associated with physical activity. he also had periods of doe both with and without chest pressure. he works as a janitor. initially symptoms were infrequent and relieved by rest. over the past month he has had 2-3 episodes of chest pain per week. symptoms relieved by rest. he was referred for ett today by pcp dr . he completed 11.5 min of a modified protocol. stopped due to symptoms of chest pressure and fatigue. ekg showed 2.25 mm st segment horizontal down sloping in the inferolateral leads. there were t wave inversions leads v2-v5 noted during the recovery phase. nuc imaging revealed nl lv size, mild systolic dysfunction, and distal anterior hk. past medical history: htn hyperlipidemia headaches social history: employed custodian. lives with his son. his son is not able to help with discharge to home due to work schedule. no current tobacco (quit 30 years ago) or etoh use. family history: noncontributory physical exam: appears comfortable, stating no further episodes of chest pain. vs: tele sr 50??????s bp 180/80??????s lungs: cta ant/lat heart: rrr -mrg abd: nt + bs pv: fems 2+ no bruits. dps 1+ bilaterally, no . no variocosties pertinent results: 07:10am blood wbc-8.1 rbc-3.48* hgb-11.2* hct-31.7* mcv-91 mch-32.1* mchc-35.2* rdw-14.2 plt ct-246# 01:15pm blood wbc-5.7 rbc-5.06 hgb-16.1 hct-46.2 mcv-91 mch-31.7 mchc-34.8 rdw-13.9 plt ct-222 07:10am blood plt ct-246# 01:51am blood pt-14.1* ptt-33.1 inr(pt)-1.3* 01:15pm blood plt ct-222 01:15pm blood pt-10.9 inr(pt)-0.9 07:10am blood glucose-107* urean-16 creat-0.8 na-142 k-3.8 cl-97 hco3-32 angap-17 01:15pm blood glucose-111* urean-21* creat-1.1 na-140 k-4.3 cl-98 hco3-32 angap-14 02:46am blood alt-9 ast-20 ld(ldh)-193 alkphos-35* amylase-27 totbili-0.3 04:15pm blood vitb12-268 04:15pm blood %hba1c-6.1* 04:15pm blood triglyc-83 hdl-54 chol/hd-3.1 ldlcalc-98 radiology final report chest (pa & lat) 2:27 pm chest (pa & lat) reason: evaluate ptx medical condition: 73 year old man s/p cabg reason for this examination: evaluate ptx cxr, two films history: status post cabg. findings: sternotomy noted. there are small bilateral pleural effusions and thickening of the fissures. the bibasilar atelectasis shows considerable improvement compared to the previous examination of . no heart failure. conclusion: status post cabg. improving bilateral pleural effusions and bibasilar atelectasis. dr. approved: tue 10:14 pm cardiology report echo study date of *** report not finalized *** preliminary report patient/test information: indication: abnormal ecg. aortic valve disease. coronary artery disease. left ventricular function. mitral valve disease. valvular heart disease. status: inpatient date/time: at 13:59 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw02-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. measurements: left ventricle - ejection fraction: 30% to 40% (nl >=55%) interpretation: findings: off pump cabg left atrium: normal la size. no spontaneous echo contrast or thrombus in the body of the laa. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. dynamic interatrial septum. no asd or pfo by 2d, color doppler or saline contrast with maneuvers. left ventricle: normal lv wall thickness and cavity size. moderately depressed lvef. lv wall motion: regional lv wall motion abnormalities include: basal anterior - hypo; mid anterior - hypo; basal anteroseptal - hypo; mid anteroseptal - hypo; basal inferoseptal - hypo; mid inferoseptal - hypo; basal inferior - hypo; mid inferior - hypo; basal inferolateral - hypo; mid inferolateral - hypo; basal anterolateral - hypo; mid anterolateral - hypo; anterior apex - hypo; septal apex - hypo; inferior apex - hypo; lateral apex - hypo; apex - hypo; right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: normal ascending aorta diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets. no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. mild thickening of mitral valve chordae. physiologic mr (within normal limits). tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with 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. no tee related complications. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. the patient was under general anesthesia throughout the procedure. suboptimal image quality - poor echo windows. conclusions: the left atrium is normal in size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. left ventricular wall thicknesses and cavity size are normal. overall left ventricular systolic function is moderately depressed (lvef= xx %). the right ventricular cavity is mildly dilated. right ventricular systolic function is 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 mildly thickened. physiologic mitral regurgitation is seen (within normal limits). there is no pericardial effusion. physician: cardiology report ecg study date of 5:47:06 pm sinus rhythm with ventricular premature beat. low limb lead qrs voltage, is non-specific. modest right precordial lead/anterior t wave changes are non-specific and unstable baseline makes assessment difficult. clinical correlation is suggested. compared to the previous tracing of sinus bradycardia is absent, ventricular ectopy and precordial t wave changes are now seen. read by: , w. intervals axes rate pr qrs qt/qtc p qrs t 82 158 82 356/394 52 16 50 brief hospital course: mr. was admitted to the on for further management of his angina and positive stress test. he underwent a cardiac catheterization which revealed severe three vessel coronary artery disease. given these findings, the cardiac surgical service was consulted for surgical mananagement. mr. was worked-up in the usual preoperative manner. on , mr. was taken to the operating room where he underwent off pump coronary artery bypass grafting to three vessels. please see operative note for details. postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. on postoperative day one, mr. neurologically intact and was extubated. aspirin, beta blockade and his statin were resumed. plavix was started as his surgery was performed off pump and should be continued for three months. on postoperative day two, he was transferred to the step down unit for further recovery. he was gently diuresed towards his preoperative weight. the physical therapy service was consulted for assistance with his postoperative strength and mobility. he continued to progress and was ready for discharge to rehab on pod 5. medications on admission: medications as per pharmacy: . patient unable to identify meds. states takes 4 pills a day. aspirin 81 mg daily atenolol 50 mg daily hctz 25 mg daily tylenol #3 daily for headache prazosin 1 mg daily (pt thinks this was stopped, unable to verify) discharge medications: 1. oxygen oxygen 2 l nc wean to room air for sats > 92% 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 6. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 7. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily) for 3 months. 8. furosemide 40 mg tablet sig: one (1) tablet po once a day. 9. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 10. metoprolol succinate 100 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po daily (daily). 11. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: home - discharge diagnosis: cad s/p off pump cabg systolic heart failure ef 35-40% hyperlipidemia htn headaches 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. 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. 6) no driving for 1 month. 7) call with any questions or concerns. followup instructions: please follow-up with dr. in 1 month ( please follow-up with dr. (cardiologist/pcp) after discharge from rehab md procedure: single internal mammary-coronary artery bypass coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome pure hypercholesterolemia mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension systolic heart failure, unspecified pulmonary collapse hydrocele, unspecified 

Answer: The patient is high likely exposed to