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: percocet attending: chief complaint: chest tightness major surgical or invasive procedure: cardiac catheterization cabgx4(lima-lad, svg-diag, svg-om, svg-pda) history of present illness: patient is an 81 year old male with past medical history of hypertension, and hyperlipidemia who presented to hospital on with four day history of chest tightness and shortness of breah. he reports that approx 5 days ago he started to have chest discomfort which he attributed to "the flu." he describes this as substernal chest pressure with no radiation with associated severe shortness of breath, "gasping" for air with minimal exertion on walk to mailbox. he denies diaphoresis, no nausea or lightheadedness. he denies having these symptoms in the past. reports having a fever on to 101.5 which resolved. no fever. cough productive of clear sputum. an ekg completed upon arrival to hospital demonstrated st depressions anterolaterally - leads i, v4-v6, and a troponin was found to be 20.57, down to 18, then elevated to 22.8. bnp was also elevated to 868. cxr showed mild vascular congestion and he was treated with lasix 20 mg iv overnight on due to some shortness of breath and chest pain. he put out 1100cc of urine. additionally, he received a loading dose of plavix 600mg, placed on a heparin drip, continued on atenolol, and nitropaste applied for chest pain. at time of transfer, he was chest pain free, in no distress, with bilaterally diminished lung sounds. cxr completed at osh was consistent with chf. he was transferred to for cardiac catheterization. past medical history: - hypertension - hyperlipidemia - osteoarthritis - s/p hip replacement social history: pt is a past smoker, quit in , smoked ppd for approx 10 years. no etoh. pt lives with his wife. is currently employed as an accountant and also runs a candy store. performs adl without difficulty. family history: father died of an mi at age 65. no family hx of diabetes or cancer. physical exam: vs - t 98.4 bp 107/87 hr 73 rr 24 o2 94% ra gen: wd/wn male in nad. alert & oriented x3. mood, affect appropriate. able to speak full sentences without becoming sob. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 10 cm - lying flat. cv: pmi located in 5th intercostal space, midclavicular line. rr with ectopic beats, normal s1, s2. no m/r/g. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, few crackles at bases bilaterally abd: soft, ntnd. no hsm or tenderness. no bruit, no masses, no guarding or rebound tenderness ext: no c/c/e. no femoral bruits. r groin no hematoma or thrill, pulses 2+ dp and pt bilaterally. pertinent results: cardiac cath: 1. selective coronary angiography of this right dominant system demonstrated a severe three vessel cad. the lmca had mild non-obstructive disease. the lad was completely occluded. the lcx was diffusely diseased and had a 90% mid vessel stenosis and a 90% stenosis of the om1. the rca was a tortuous vessel with a 100% mid vessel occlusion. the distal rca, as well as the lad territory, were supplied by the collaterals from the acute marginal (that itself had mild disease). rca conus branch had a separate ostium and gave collaterals to the lad as well. 2. resting hemodynamics revealed severely elevated filling pressures with an rvdp of 22 mmhg and a mean pcwp of 30 mm hg. the cardiac index was depressed at 1.84 l/min/m2. there was a moderate pulmonary systolic arterial hypertension with a pasp of 50 mm hg. the systemic arterial systolic pressure was normal at 117 mmhg. patient was noted to be in and out of atrial fibrillation during the case. 3. left ventriculography with a manual contrast injection revealed an lvef of 20% with a global lv hypokinesis. no significant mr was noted. abdominal us: 1. diffusely echogenic liver consistent with fatty infiltration. more advanced liver disease including significant hepatic fibrosis/cirrhosis cannot be excluded on this study. 2. ectasia of the distal abdominal aorta measuring up to 3 cm. one-year followup is recommended. 3. at least two simple cysts are seen within the right lobe of the liver measuring up to 1.4 cm. 4. right pleural effusion. transthoracic echo: the left atrium is moderately dilated. the right atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. the right atrial pressure is indeterminate. left ventricular wall thicknesses are normal. the left ventricular cavity size is top normal/borderline dilated. there is moderate to severe global left ventricular hypokinesis (lvef = 25-30 %) with inferior akinesis. no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. 08:45am blood wbc-11.3* rbc-3.56* hgb-10.1* hct-31.2* mcv-88 mch-28.3 mchc-32.2 rdw-15.6* plt ct-565* 07:10am blood pt-32.8* inr(pt)-3.4* 07:10am blood creat-2.1* 09:48pm urine color-straw appear-clear sp -1.014 urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg brief hospital course: mr. was admitted with nstemi. he underwent cardiac catheterization which revealed severe three vessel coronary artery disease(see result section for further detail). cardiac surgery was consulted and additional preoperative evaluation was performed. carotid ultrasound was unremarkable while abdominal ultrasound was notable for ectasia of the distal abdominal aorta measuring up to 3 cm. preoperative echocardiogram showed moderate to severe global left ventricular hypokinesis (lvef = 25-30 %) with inferior akinesis, trace aortic insufficiency and only mild mitral regurgitation. he awaited plavix washout prior to surgery and remained pain free on a heparin drip for intermittent atrial fibrillation. on , dr. performed coronary artery bypass grafting surgery. for surgical details, please see seperate dictated operative note. within 24 hours, he awoke neurologically intact and was extubated. he was intermittently transfused to maintain hematocrit near 30%. on postoperative day two, he developed rapid atrial fibrillation which was initially treated with amiodarone and beta blockade. he otherwise maintained stable hemodynamics and transferred to the sdu on postoperative day two. despite medical therapy, he continued to experience paroxsymal atrial fibrillation. he was eventually started on warfarin with a temporary heparin bridge. the ep service was consulted. cardioversions were performed on and 13th without much success. he continued to experience paroxsymal atrial fibrillation. for the remainder of his hospital stay, amiodarone and beta blockade were titrated accordingly. his inr was followed very closely and dosed for a goal inr around 2.0 - 3.0. due to a supratherapeutic inr, warfarin was held for several days to allow the inr to improve(see result section for lab values). his renal function remained relatively stable ranging between 1.5 to 2.1. the remaineder of his postoperative course was uneventful and he was discharged to rehab on postoperative day 10. on dc inr is 3.4 / start coumadin . follow closely medications on admission: - atenolol 100mg po daily - triamcinolone/hctz 50/25 po daily - simvastatin 40mg po daily - aspirin 325mg po daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 5. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 6. amiodarone 200 mg tablet sig: two (2) tablet po tid (3 times a day): x 1 week, then x 1 week, then qd there after. 7. coumadin 1 mg tablet sig: one (1) tablet po once a day: 1600 hrs / please start on . 8. lasix 20 mg tablet sig: one (1) tablet po once a day for 7 days. tablet(s) 9. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 7 days. discharge disposition: extended care facility: healthcare center - discharge diagnosis: coronary artery disease s/p cabg acute systolic heart failure pre and postoperative atrial fibrillation postoperative anemia chronic renal insufficiency hypertension hyperlipidemia discharge condition: stable. discharge instructions: 1)please shower daily. no baths. pat dry incisions, do not rub. 2)avoid creams and lotions to surgical incisions. 3)call cardiac surgeon if there is concern for wound infection. 4)no lifting more than 10 lbs for at least 10 weeks from surgical date. 5)no driving for at least one month. 6)inr should be followed several times per week until inr stablizes. coumadin should be dosed for goal inr between 2.0 - 3.0. please make arrangements with dr. who will monitor coumadin as an outpatient prior to discharge from rehab. p instructions: dr. 4-5 weeks, call for appt dr. 2-3 weeks, call for appt dr. 2-3 weeks, call for appt procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures atrial cardioversion diagnoses: subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute kidney failure, unspecified cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified other and unspecified hyperlipidemia acute systolic heart failure 

Answer: The patient is high likely exposed to