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: bilateral exertional shoulder pain and elevated troponin major surgical or invasive procedure: -coronary artery bypass grafting x4 with left internal mammary artery to left anterior descending coronary; reverse saphenous vein single graft from the aorta to the first diagonal coronary artery; reverse saphenous vein graft from the aorta to the first obtuse marginal coronary artery; reverse saphenous vein single graft from the aorta to the distal right coronary artery. -endoscopic left greater saphenous vein harvesting. history of present illness: 68yom with h/o hl and psoriasis transferred from for elevated troponin and bilateral exertional shoulder pain. he notes that ~ 2 months ago he began to experience bilateral shoulder pain while running - starts in his trap muscle and radiates down into both shoulders - the pain occurs ~ minutes into his usual jogs - is at worst and lessens to after resting for seconds. no sscp, no radiation to jaw. he hasn't had pain like this before and can't elicit the pain with palpation - only with significant exertion. he was webmd about these symptoms and spoke with his friend who suggested he be evaluated. he rested for 3 days and then tried to run again - had recurrence of the pain - and so finally presented to his pmd. at his pmd's office, ekg was abnormal so he was referred to - there his trop was 1.4 (range 0-0.39) - aspirin given, heparin gtt begun and so he was transferred to for further evaluation. past medical history: hl psoriasis s/p bilateral arthroscopic knee surgery hand surgery social history: lives in and in . retired from working as reporter for the globe and now freelance reporting. smoked 20 years - 1 ppd; quit in . drinks 1 beer/night. no drugs. has 2 kids, divorced. family history: no cardiac problems. died in old age, siblings healthy. physical exam: admission physical exam: vs - 98.8 159/81 80 16 96% on ra general - alert, interactive, well-appearing in nad heent - perrla, eomi, sclerae anicteric, mmm, op clear neck - supple, no jvd, no carotid bruits heart - rrr, nl s1-s2, no mrg lungs - ctab, no r/rh/wh, good air movement, resp unlabored abdomen - nabs, soft/nt/nd, no masses or hsm extremities - wwp, no c/c/e, 2+ peripheral pulses skin - no rashes or lesions neuro - awake, a&ox3, cns ii-xii grossly intact, full muscle strength throughout . discharge physical exam: pertinent results: admission labs: 07:30pm blood wbc-8.9 rbc-5.56 hgb-15.5 hct-43.6 mcv-79* mch-27.9 mchc-35.6* rdw-13.0 plt ct-162 07:30pm blood neuts-61.3 lymphs-33.8 monos-3.6 eos-0.7 baso-0.6 07:30pm blood pt-11.4 ptt-67.1* inr(pt)-1.1 07:30pm blood glucose-107* urean-16 creat-1.3* na-140 k-4.3 cl-104 hco3-25 angap-15 04:30am blood wbc-11.9* rbc-3.39* hgb-9.7* hct-27.3* mcv-80* mch-28.5 mchc-35.4* rdw-14.0 plt ct-153 04:30am blood plt ct-153 02:25am blood pt-14.2* ptt-29.8 inr(pt)-1.3* 04:30am blood glucose-92 urean-26* creat-1.2 na-138 k-4.2 cl-102 hco3-31 angap-9 04:30am blood calcium-8.2* phos-2.5* mg-2.5 pa&lat car: small bilateral pleural effusions have decreased in size since . multiple intact sternal wires and mediastinal clips denote recent cardiac surgery. a left retrocardiac opacity has worsened, likely from increased atelectasis. no focal consolidation or pneumothorax is seen. impression: 1. decreased small bilateral pleural effusions. 2. increased left basilar atelectasis. tee : pre bypass no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with mild to moderate distal anterior and anterolateral hypokinesis. overall left ventricular systolic function is normal (lvef>55%). transmitral and tissue doppler imaging suggests normal diastolic function, and a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. dr. was notified in person of the results in the operating room at the time of the study. post bypass the patient is atrially paced. there is mild to moderate hypokinesis of the basal right ventricular free wall. the interventriculay sepum displays mild dyssynchrony consistent with a new interventricular conduction delay seen on ecg. overall left ventricular systolic function is about 55%. valvular function remains normal. the thoracic aorta appears intact after decannulation . brief hospital course: this is a 68 year male who had exertional shoulder pain that was relieved with rest he was found to have positive troponins at osh (1.5) as well as (0.50 -> 0.41). timi risk . ck and ck-mb have remained flat, despite elevated troponin. the patient was started on full-dose aspirin, heparin drip, metoprolol , and home simvastatin was continued. patient was taken for left heart cath and was found to have three-vessel disease. cardiac surgery was consulted, and the decision was made to take the patient for cabg. the patient was brought to the operating room on and underwent where the patient underwent cabg x4 lima-lad, svg-, , pda. overall the patient tolerated the procedure well. of note intraop while going on bypass he became ischemic after full heparinization then developed ventricular fibrillation. just prior to fibrillating, he went into heart block and severe bradycardia. in addition there were profound st wave elevations in the inferior leads. they attempted to cardiovert the patient back to normal sinus rhythm, but were unable to do so. presumably, this was due to ischemia. please see intra-op note for further details. post-operatively he was transferred to the cvicu in stable condition for recovery and invasive monitoring. immediately post-operatively he was noted to have st elevations on ekg and elevated troponins he therefore underwent emergent cath which revealed patent grafts. ekg improved. he remained hemodynamically stable. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. beta blocker was initiated and the patient was gently diuresed initially due to slight rise in his creatinine. at the time of discharge his creat was normalized and his diuretic therapy increased. this will need adjusting while at rehab. the patient was transferred to the telemetry floor on pod #2 for further recovery. chest tubes and pacing wires were discontinued without complications. the patient was evaluated by the physical therapy service for assistance with strength and mobility. he was started on ace inhibitor which he is toletating well. by the time of discharge on pod # 5 the patient was ambulating freely, his wounds were healing and pain was controlled with ultram he became confused on dilaudid. the patient was discharged to nursing and rehab in good condition with appropriate follow up instructions. medications on admission: simvastatin 40 mg qday cialis 5 mg hs (last taken pm) fish oil discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 4. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 6. lisinopril 5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po twice a day for 7 days: then adjust to lasix dose. disp:*10 tablet, er particles/crystals(s)* refills:*0* 8. lasix oral 9. lasix 40 mg tablet sig: one (1) tablet po twice a day for 7 days: then decrease to 40mg daily and reevaluate. discharge disposition: extended care facility: tbd discharge diagnosis: postoperative diagnoses: 1. acute coronary syndrome. 2. acute myocardial infarction. 3. severe 3-vessel coronary disease. discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics svh site: cdi edema +2 lower extremity discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 until follow up with surgeon 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 followup instructions: please call to schedule appointments surgeon dr. on at 1:00p cardiologist dr. at 11:30a ( internal medicine address: , , phone: ) primary care dr. . , b. in weeks please make appointment please call cardiac surgery if need arises for evaluation or readmission to hospital procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters coronary arteriography using two catheters left heart cardiac catheterization left heart cardiac catheterization diagnostic ultrasound of heart other electric countershock of heart diagnoses: thrombocytopenia, unspecified subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery cardiac complications, not elsewhere classified personal history of tobacco use other opiates and related narcotics causing adverse effects in therapeutic use other and unspecified hyperlipidemia other specified cardiac dysrhythmias surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation acute myocardial infarction of other inferior wall, initial episode of care unspecified disorder of kidney and ureter ventricular fibrillation drug-induced delirium other psoriasis conduction disorder, unspecified 

Answer: The patient is high likely exposed to