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: penicillins / bactrim / amoxicillin attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catherization coronary artery bypass graft surgery (left internal mammary artery > left anterior descending, saphenous vein graft > obtuse marginal, saphenous vein graft > posterior descending artery) history of present illness: mr. is a 81 yo m with pmh htn, ckd s/p nephrectomy for rcc admitted for prehydration for elective cardiac catheterization in the morning. he reports having about episodes of transient chest pain with exertion over the past several months. the chest pain occurred while mowing the lawn, lasted less than once minute, resolved with standing still and did not return with resuming activity. denies any associate symptoms of nausea, vomiting, dyspnea, diaphoresis. he had a nuclear stress test to further evaluate, report is not available but per dr. recent note, nuclear stress showed ef 68%, evidence of anterior and anteroapical ischemia with a preserved ef and evidence of transient ischemic dilatation. past medical history: 1. hypertension. 2. chronic renal insufficiency status post nephrectomy for 1-1/2 kidneys and history of renal cell carcinoma. baseline creatinine 1.5. 3. h/o gastroparesis 4. h/o colon adenoma polyps 5. gout 6. schatzki's ring social history: lives at home with his wife, retired tool maker, current mows lawn at golf course 5 days per week, denies any h/o tobacco or etoh. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: vs t97.3 bp 170/83 hr 80 rr 18 99% ra 77.4kg gen: well appearing, elderly caucasian male, alert and 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 with jvp flat, no carotid artery bruits cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, slight basilar crackles, no wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ventral hernia is soft and compressible ext: warm, no edema or cyanosis, dp's full skin: no stasis dermatitis, ulcers, or xanthomas. pertinent results: 06:55am blood wbc-10.8 rbc-3.06* hgb-10.4* hct-29.0* mcv-95 mch-33.9* mchc-35.8* rdw-12.8 plt ct-128* 06:52pm blood wbc-9.1 rbc-4.41* hgb-14.2 hct-41.3 mcv-94 mch-32.2* mchc-34.4 rdw-13.2 plt ct-201 11:00am blood neuts-68.3 lymphs-18.8 monos-7.2 eos-4.8* baso-0.9 06:55am blood plt ct-128* 04:50am blood k-4.1 05:45am blood glucose-119* urean-19 creat-1.6* na-136 k-3.1* cl-98 hco3-29 angap-12 06:52pm blood glucose-121* urean-25* creat-1.8* na-140 k-4.2 cl-103 05:45am blood calcium-8.1* phos-3.2 mg-2.0 11:00am blood vitb12-159* folate-15.8 hapto-125 ferritn-457* 04:58pm blood %hba1c-5.9 normal sinus rhythm with p-r interval equal to 0.14. late r wave transition. t wave abnormalities with t wave inversions and downsloping st segment depressions in leads iii and avf which are new. compared to the previous tracing of clinical correlation is suggested. read by: , intervals axes rate pr qrs qt/qtc p qrs t 76 140 72 4 echocardiography report , portable tte (complete) done at 1:36:31 pm final referring physician information , , , cardiology , 4 , status: inpatient dob: age (years): 81 m hgt (in): 68 bp (mm hg): 159/75 wgt (lb): 170 hr (bpm): 60 bsa (m2): 1.91 m2 indication: left ventricular function. preoperative assessment prior to cabg. icd-9 codes: 414.8 test information date/time: at 13:36 interpret md: , md test type: portable tte (complete) son: , rdcs doppler: full doppler and color doppler test location: west contrast: none tech quality: adequate tape #: 2008w000-0:00 machine: vivid i-3 echocardiographic measurements results measurements normal range left atrium - long axis dimension: 3.4 cm <= 4.0 cm left atrium - four chamber length: 4.6 cm <= 5.2 cm left atrium - peak pulm vein s: 0.5 m/s left atrium - peak pulm vein d: 0.3 m/s left atrium - peak pulm vein a: 0.2 m/s < 0.4 m/s right atrium - four chamber length: 4.6 cm <= 5.0 cm left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.6 cm <= 5.6 cm left ventricle - systolic dimension: 2.4 cm left ventricle - fractional shortening: 0.48 >= 0.29 left ventricle - ejection fraction: 55% >= 55% left ventricle - lateral peak e': *0.07 m/s > 0.08 m/s left ventricle - septal peak e': *0.07 m/s > 0.08 m/s left ventricle - ratio e/e': 10 < 15 aorta - sinus level: *3.8 cm <= 3.6 cm aortic valve - peak velocity: 1.1 m/sec <= 2.0 m/sec mitral valve - e wave: 0.7 m/sec mitral valve - a wave: 0.8 m/sec mitral valve - e/a ratio: 0.88 mitral valve - e wave deceleration time: 239 ms 140-250 ms tr gradient (+ ra = pasp): <= 25 mm hg <= 25 mm hg pulmonic valve - peak velocity: 1.1 m/sec <= 1.5 m/sec findings left atrium: normal la size. right atrium/interatrial septum: normal ra size. normal interatrial septum. no asd by 2d or color doppler. left ventricle: mild symmetric lvh with normal cavity size. mild regional lv systolic dysfunction. no lv mass/thrombus. no resting lvot gradient. no vsd. right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: mildly dilated aortic sinus. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. trivial mr. normal lv inflow pattern for age. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. normal pa systolic pressure. pulmonic valve/pulmonary artery: no ps. pericardium: no pericardial effusion. conclusions the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with basal inferior hypokinesis. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is mildly dilated with normal free wall contractility. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. electronically signed by , md, interpreting physician 15:43 brief hospital course: mr. is an 81 yo m with pmh of htn, ckd s/p nephrectomy for rcc admitted for elective cardiac catheterization and precath hydration. cardiac catherization revealed coronary artery disease and he was referred for surgical evaluation. he underwent preoperative workup and was transferred to the operating for coronary artery bypass surgery. see operative report for further details. he received perioperative vancomycin due to pencillin allergy. he was trasnferred to the cvicu for hemodynamic monitoring. in the first twenty four hours he was weaned from sedation, awoke, was extubated but required reintubation due to apnea. he remained intubated for a few hours, was neurologically intact and was reextubated without complications. he was started on beta blockers and diuretics, transfered to the floor pod 1. he continued to progress but developed atrial fibrillation pod 3 and was treated with beta blockers and amiodarone, and converted to normal sinus rhythm. physical therapy worked with him on strength and mobility. he was ready for discharge home pod 5 with vna services. medications on admission: nitroglycerin p.r.n. allopurinol 100mg daily aspirin 325 mg p.o. daily. simvastatin 40 mg p.o. q.h.s. metoprolol 12.5 mg p.o. b.i.d. plavix 75mg daily amlodipine 10mg qam furosemide 20mg qam discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po twice a day: please take twice a day for 5 days then decrease to once daily. disp:*60 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 3. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. 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:*0* 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 6. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* 9. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal (2 times a day) as needed. 10. ocean nasal 0.65 % spray, non-aerosol sig: one (1) nasal every six (6) hours as needed for nasal congestion. 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 5 days. disp:*5 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease s/p cabg hypertension chronic kidney disease renal cell cancer gout benign prostatic hypertrophy schatzki's ring discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr in 4 weeks () please call for appointment dr in 1 week () please call for appointment dr in weeks () please call for appointment wound check appointment 6 as instructed by nurse () provider: , : date/time: 1:30 procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries left heart cardiac catheterization diagnostic ultrasound of heart diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation chronic kidney disease, unspecified personal history of malignant neoplasm of kidney acquired absence of kidney apnea 

Answer: The patient is high likely exposed to