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: dyspnea on exertion/fatigue major surgical or invasive procedure: coronary artery bypass graft x4: 1. left internal mammary artery to left anterior descending artery. 2. saphenous vein graft to posterior left ventricular. 3. saphenous vein graft to first obtuse marginal branch of the circumflex. 4. saphenous vein graft to the first diagonal branch of the left anterior descending. 5. endoscopic harvesting of the long saphenous vein. history of present illness: 76 year old man with complaint of severe fatigue and dyspnea on exertion which has been worsening over the past 3 years. he had a positive dobutamine stress echocardiogram. admitted to for prehydration prior to cardiac catheterization. past medical history: diabetes mellitus 2 hypertension hyperlipidemia chronic kidney disease(baseline creat 1.8) chronic obstructive pulmonary disease obstructive sleep apnea severe depression vertigo fatigue h/o etoh abuse obesity celiac trunk atherosclerotic disease past surgical history: tonsillectomy cervical disc surgery transurethral resection prostate nose surgery for fractured bones social history: lives with wife and mother-in-law retired irs auditor +tobacco <1 pack per day(h/o ppd x40 years) +etoh-2 martinis/day at times supplemented with beer family history: father s/p mi @52yo physical exam: hr 60 bp rt 157/65 lft 170/69 rr 14 o2 sat 100%-ra ht 5'9" wt 212 lbs gen nad skin warm and dry heent perrl-eomi neck supple, full rom chest cta bilat cor rrr, no murmur abdm soft, nt/nd/+bs ext warm well perfused, no varicosities neuro a&o x3, grossly intact. caotid- no bruits pulses fem 2+ bilat, rad 2+ bilat, dp/pt 2+ bilat pertinent results: 07:50am hgb-12.4* calchct-37 07:50am glucose-99 lactate-1.2 na+-139 k+-4.1 cl--108 12:17pm pt-15.8* ptt-36.7* inr(pt)-1.4* 12:17pm plt count-179 12:17pm wbc-8.5# rbc-2.78* hgb-9.4* hct-28.6* mcv-103* mch-33.8* mchc-32.9 rdw-15.2 12:18pm glucose-105 lactate-2.8* na+-139 k+-4.7 cl--112 01:33pm urea n-23* creat-1.2 chloride-116* total co2-21* ============================================= , m 76 radiology report ct head w/o contrast study date of 6:26 pm , csurg fa6a 6:26 pm ct head w/o contrast medical condition: 76 year old man with altered mental status/delerium reason for this examination: ischemic event contraindications for iv contrast: none. final report history: 76-year-old male with altered mental status and delirium concerning for ischemic event. comparison: mr head from . technique: mdct-axial imaging was performed through the brain without administration of iv contrast. non-contrast head ct: slight tilting of the patient's head during imaging limits evaluation for symmetry somewhat. allowing for this, no evidence of acute intracranial hemorrhage, edema, mass effect, hydrocephalus, or large vascular territory infarction is seen. study is also limited due to patient motion, particularly the imaging through the skull base. again prominence of the sulci and ventricles is consistent with age-related involutional change. periventricular white matter hypodensities are likely due to chronic small vessel ischemic disease. note is also made of likely chronic small lacunar infarcts in bilateral basal ganglia. the soft tissues, orbits, and skull appear intact. the visualized paranasal sinuses and mastoid air cells are normally aerated. vascular calcifications are noted along the cavernous carotid arteries. impression: no acute intracranial process seen. there is evidence of chronic microvascular as well as old lacunar infarction, as on the previous mr. if there is persistent concern for acute infarction, mri with diffusion-weighted imaging would be recommended for more sensitive evaluation. the study and the report were reviewed by the staff radiologist. dr. dr. ================================================= echocardiography report , (complete) done at 10:11:20 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 76 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: coronary artery disease. left ventricular function. mitral valve disease. preoperative assessment. icd-9 codes: 440.0, 424.0 test information date/time: at 10:11 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw1-: machine: echocardiographic measurements results measurements normal range left ventricle - ejection fraction: >= 55% >= 55% aorta - annulus: 2.4 cm <= 3.0 cm aorta - sinus level: 3.4 cm <= 3.6 cm aorta - sinotubular ridge: 2.9 cm <= 3.0 cm aorta - ascending: *3.5 cm <= 3.4 cm findings right atrium/interatrial septum: pfo is present. left-to-right shunt across the interatrial septum at rest. left ventricle: overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: mildly thickened aortic valve leaflets (3). trace ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions prebypass a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. 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 descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen at a systolic blood pressure of 110 mm hg.. at a systolic blood pressure of 180 mm hg and trendelenburg position the mitral regurgitation increased to mild to moderate (2+). postbypass. there is preserved biventricular systolic function. mr is now trace/mild. the remaining study is unchanged from the prebypass period. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 12:12 ===================================== brief hospital course: mr was admitted to for cardiac catheterization which revealed 3 vessel disease and preserved ejection fraction. cardiac surgery was consulted and on the patient was brought to the operating room where he had coronary artery bypass grafting. please see operative report for details. in summary he had coronary artery bypass grafts including left internal mammary to left anterior descending artery, reverse saphenous vein graft to diagonal artery, reverse saphenous vein graft to obtuse marginal and reverse saphenous vein graft to posterior left ventricular artery. his bypass time was 105 minutes with a crossclamp time of 90 minutes. he tolerated the operation well and was transferred from the operating room to the cardiac surgery icu in stable condition. once in the icu he remained hemodynamically stable his anesthesia was reversed and he was extubated. on pod1 he was transferred from the cardiac surgery icu to the stepdown floor for continued care and recovery. over the next several days his tubes, lines, and drains were uneventfully removed according to protocol. his activity level was advanced with the assistance of nursing and physical therapy. he was noted to have intermittent episodes of atrial fibrillation that were treated with beta blockers and amiodarone following which he returned to sinus rhythm. he also had some confusion, he was seen by psychiatry and had a negative head ct. the confusion cleared after stopping his narcotics. additionally he had a chest ct that revealed a 5 mm right lower lobe density that will require a follow up ct in weeks. on pod seven he was discharged to rehabilitation at on care rehabilitation center. medications on admission: effexor 75" glipizide 5" avodart 0.5' januvia 50' metoprolol 50' simvastatin 10' discharge medications: 1. 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* 2. avodart 0.5 mg capsule sig: one (1) capsule po daily (). disp:*30 capsule(s)* refills:*2* 3. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. disp:*20 tablet(s)* refills:*0* 4. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 5. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. venlafaxine 75 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 10 days. disp:*10 tab sust.rel. particle/crystal(s)* refills:*0* 8. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 10. glipizide 5 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 11. glipizide 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 12. januvia 50 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: extended care facility: on care rehab center discharge diagnosis: coronary artery disease niddm chronic renal insufficiency hyperlipidemia depression etoh abuse copd obstructive sleep apnea celiac atherosclerotic disease bph-status post turp status post cervical disc surgery discharge condition: good. discharge instructions: take medications as directed in discharge instructions. do not drive for 4 weeks. do not lift more than 10 pounds for 10 weeks. shower daily, let water flow over wounds, pat dry with a towel. do not use creams, lotions, or powders on wounds. call our office for temperature >101.5, sternal drainage or redness. followup instructions: make an appointment with dr. for 1-2 weeks. make an appointment with dr. for 3 weeks. make an appointment with dr. for 4 weeks. will need a chest ct in weeks to evaluate lung nodules seen on chest ct during your admission. your primary care physician can arrange this study. md procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery transfusion of packed cells diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery pure hypercholesterolemia tobacco use disorder diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified chronic kidney disease, stage iv (severe) atrial fibrillation hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other and unspecified hyperlipidemia long-term (current) use of insulin other and unspecified alcohol dependence, unspecified examination of participant in clinical trial alcohol withdrawal delirium 

Answer: The patient is high likely exposed to