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: history of present illness: this is a 78-year-old black female with right first toe gangrene refractory to conservative treatment x1 month with a history of right calf claudication x1 year. she denies rest pain. she claudicates at least 8 feet. underwent arteriogram on which demonstrated a left common iliac with severe stenosis. right common iliac with diffuse disease. right external iliac, common femoral, and sfa were totally occluded. the right popliteal reconstitutes below the knee level. the right tibioperoneal trunk and pt are occluded. the right at is attenuated, but refuses a dp with distal stenosis. the right peroneal reconstructs proximally, but is attenuated. review of systems: positive for angina at rest, relieved with nitroglycerin. the last episode was two weeks prior to initial assessment which was on . frequency is infrequent. she does complain of dyspnea with walking. she denies recent congestive heart failure, pnd, orthopnea, or edema. she does have a history of cva with no reoccurrence of symptoms. the patient is now admitted for elective revascularization. allergies: none. medications: 1. enteric coated aspirin 325 mg q day. 2. coumadin 3 mg q day. 3. keflex 500 mg q8h. 4. potassium chloride 200 mg . 5. digoxin 0.125 mg q day. 6. pravachol 80 mg q day. 7. trental 400 mg . 8. lasix 20 mg q day. 9. lopressor 75 mg . 10. captopril 25 mg tid. 11. nph 52 units plus 14 of r q am and nph 16 units plus 7 of r at dinnertime. past medical history: 1. coronary artery disease. 2. chronic atrial fibrillation. 3. acute myocardial infarction in . 4. congestive heart failure with an ejection fraction calculated 25-30% distal by echocardiogram in 04/96. 5. insulin dependent diabetes. 6. hypertension. 7. hypercholesterolemia. 8. cerebrovascular accident in the that manifested as right sided weakness which resolved over 24 hours. 9. history of cataracts. 10. history of fatty liver disease diagnosed by ultrasound with no ductal obstruction secondary to elevated lfts, alt 245, ast 108, alkaline phosphatase 91, total bilirubin 0.7. past surgical history: 1. cardiac catheterization in , three vessel disease. 2. a repeat cardiac catheterization in showed severe left ventricular systolic-diastolic dysfunction, pulmonary wedge pressure 22, left end diastolic pressure 27. cardiac index 2.6, ejection fraction of 24%. right coronary artery was dominant. left main trunk was patent. ad was totally occluded in mid portion, left circumflex 70% at mid portion, right coronary artery 70% at origin, and 50% mid stenosis. no intervention. 3. cholecystectomy secondary to stones. 4. remote right ureteroscopy with stent placement in . 5. bilateral cataracts. 6. appendectomy remote. social history: she lives with her family and ambulates with a cane or walker. she denies alcohol or smoking. physical examination: vital signs: 97.9, 142/72, 73, and 18, and 96% o2 saturation on room air. chest examination: lungs are clear to auscultation. heart is a regular rhythm. there are no murmurs, rubs, or gallops. abdominal examination: obese, nontender, and nondistended, bowel sounds diminished x4, no bruits. vascular examination: carotids without bruits. left brachial artery site of angio without hematoma, clean, dry, and intact. pulse examination shows brachioradial arteries on the left side 1+, 2+, ulnar 2+, femorals are absent on the left, popliteals absent on the left. dorsalis pedis and posterior tibial pulses are absent. the patient has 1+ femorals on the right with no pulses palpable distal to the femorals on the right. neurologically she is grossly intact. hospital course: the patient was admitted to the preoperative holding area on , and she underwent a right axillofem bypass which was complicated by intraoperative ischemic st changes. transesophageal echocardiogram showed essentially only lateral minimal wall motion and with lateral wall being akinetic to hypokinetic. the patient was admitted to the sicu, intubated for continued vasopressor and respiratory support. the patient required dobutamine at 3 mcg/kg/min for pressor support, iv heparin was begun, serial enzymes were obtained. postoperative hematocrit was 35.7 which drifted to 31.3. bun and creatinine remained stable at 19 and 0.4. initial ck was 105 with a mb of 1 and troponin less than 0.30 .................... troponins remaining flat. cardiology was requested to assist in patient management and management of her paroxysmal atrial fibrillation. recommendations were continue hydration, hold diuresis. they could increase her metoprolol to 75 tid. echocardiogram was obtained which showed an ejection fraction of 10%. patient was transferred after extubation to the vicu for continued monitoring and care. by postoperative day three, her diet was advanced to tolerated. she continued with aggressive pulmonary toilet. her swan was discontinued, and she remained in the vicu for continuing monitoring and surveillance. physical therapy to see the patient and felt that she would require rehabilitation once she is medically stable. as she continued to have episodes of atrial fibrillation/flutter, which eventually was controlled with increasing her beta blockade. the patient required manipulation of her ace inhibitors and beta blockers to improve her rate control. she remained on perioperative levaquin while lines were in place. she was transferred to the regular nursing floor on postoperative day number eight. often blood pressure systolically is 120-150, and they felt from their standpoint that she was at a bed at rehabilitation, they can be discharged from their standpoint. remaining hospital course is unremarkable. at the time of discharge, lungs were clear, dry, and intact. she had a functioning axobifem graft. the patient should follow up with dr. in two weeks time. she is then to followup with her primary care physician once discharged from rehabilitation. discharge medications: 1. acetaminophen 325 mg q4-6h prn as indicated. 2. protonix 40 mg q day. 3. pravastatin 80 mg q day. 4. digoxin 250 mcg q day. 5. metoprolol 50 mg tid. 6. aspirin 81 mg q day. 7. lasix 40 mg . 8. coumadin 3 mg q day. 9. captopril 50 mg tid. 10. insulin-sliding scale in six insulin doses. please see enclosed flow sheet. discharge instructions: patient's inr should be monitored on a continual basis until she is in a steady therapeutic state for her atrial fibrillation with a goal inr 2.0-2.5. patient should follow up with dr. in two weeks. discharge diagnoses: 1. aortoiliac disease status post axillobifemoral bypass. 2. myocardial infarction by enzymes, stable. 3. diabetes controlled. 4. blood loss anemia corrected. 5. paroxysmal atrial fibrillation rate controlled. , m.d. dictated by: medquist36 procedure: diagnostic ultrasound of heart other esophagoscopy other (peripheral) vascular shunt or bypass diagnoses: other primary cardiomyopathies congestive heart failure, unspecified acute posthemorrhagic anemia cardiac complications, not elsewhere classified atrial fibrillation other and unspecified angina pectoris acute myocardial infarction of unspecified site, initial episode of care atherosclerosis of native arteries of the extremities, unspecified 

Answer: The patient is high likely exposed to