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: vicodin / detrol attending: chief complaint: chest pain major surgical or invasive procedure: 1. resection of cardiac tumor on pulmonary valve. 2. coronary artery bypass grafting x4 with left internal mammary artery graft to left anterior descending, reverse saphenous vein graft to the marginal branch, ramus intermedius, and posterior descending artery. history of present illness: ms. is a very nice 75 year old female with known 3 vessel coronary artery disease who has cabg planned for (), htn, and hld who presents with sudden onset of left sided chest "tingling" and burning which radiated into the left neck while a book. she notes that she suddenly became very weak/tired and then started crying and shaking. patient doesn't know why she was crying. because of the symptoms in her chest she called 911 and took two nitros which helped alleviate the pain. no palpitations, diaphoresis, shortnes of breath, lightheadedness, abdominal pain, nausea or vomiting. . of note, patients work up for cad started in when she had chest burning across her chest while hospitalized with a urinary tract infection. after discharge patient went to pcp who scheduled stress test which was abnormal. pt went for cath at which showed 3vd. she was then referred to dr. at for evaluation for cabg - she is scheduled for surgery on . past medical history: - hypertension - dyslipidemia - obesity - gastroesophogeal reflux disease - polymyalgia rheumatica (4-5 years prior, off steroids) - osteoperosis - rheumatoid arthritis - glaucoma - cervical, lumbar disc disease - ble neuropathy . past surgical history - hysterectomy, bladder resuspension - appendectomy - cesarean section - colonoscopy - right cataract surgery social history: , ma. married for 49 years. 4 children. retired at 65, worked as a knitter and . no tobacco currently, quit 30 years prior at that time smoked cigerettes daily (from age 21). no etoh. family history: mother died of mi at age 52. one of 16 children. all living brothers and sisters with history of open heart surgery. physical exam: vs - bp 129/59 hr: 60 rr: 15 100% ra afebrile gen: oriented x3. mood, affect appropriate. heent: sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 10 cm. cv: 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, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. ext: no c/c/e. pain on palpation of lower extremity (stable for years) skin: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: cn ii-xii intact. strength upper/lower extremity normal. sensation intact to light touch upper and lower extremity. gait deferred. . pulses: right: radial 2+ dp 2+ pt 2+ left: radial 2+ dp 2+ pt 2+ pertinent results: carotid u/s: right ica stenosis <40%. left ica stenosis <40%. echo: prebypass: no atrial septal defect is seen by 2d or color doppler. there is mild regional left ventricular systolic dysfunction with mild hypokinesia of the basal portion of the inferior wall. overall left ventricular systolic function is low normal (lvef 50-55%). 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 but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. a mass is seen on the pulmonic valve. it measures 5mm and is attached to the septal leaflet of the pulmonic valve. it's appearance is suggestive of a fibroelastoma. there is no pulmonic stenosis or regurgitation associated with it. there is no pericardial effusion. dr. was notified in person of the results on at 1000am. post bypass: patient is av paced and receiving an infusion of phenylephrine. biventricular systolic function is unchanged. the mass seen prebypass on the pulmonic valve is no longer present. trace pulmonic insufficiency present. mild mitral regurgitation present. aorta is intact post decannulation. brief hospital course: 75 year old female with known 3 vessel disease scheduled for cabg on , htn, hld who presents with chest burning and lateral ekg changes which resolved with asa/nitro. the patient was evaluated by the cardiac surgery service. her chest pain resolved with a few transient episodes of neck tingling (likely her anginal equivalent). she was managed with a beta-blocker (metoprolol tartrate), aspirin, pravastatin and continued on her home ace-inhibitor. she did receive one dose of sl nitroglycerin on the floor. she underwent echocardiogram which showed a very small "mass" on the pulmonic valve - felt to be either degenerative change, or early myxoma or other benign mass. following this medical management for several days with additional pre-operative work-up, she was brought to the operating room on where she underwent resection of mass on pulmonic valve and coronary artery bypass graft x 4. please see operative report for surgical details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. within 24 hours she was weaned from surgery, awoke neurologically intact and extubated. on post-op day one chest tubes were removed. diuretics and beta blockers were initiated and she was diuresed towards her pre-op weight. she was transferred to the telemetry floor for further care on post-op day two. over the next several days she had multiple episodes of atrial fibrillation which was treated with beta blockers and diuretics. on post-op day four epicardial pacing wires were removed and she was started on coumadin. on post-op day six she had near-syncopal episode and was transferred to the cvicu for closer evaluation. she remained stable with no new episodes and was transferred back to the step-down floor the following day. coumadin was discontinued but continues on beta blockers and amiodarone as she remained in sinus rhythm for 3 days. she worked with physical therapy during her post-op course for strength and mobility. she appeared to be doing well on post-op day eight and was discharged home with vna services along with the appropriate medications and follow-up appointments. of note, she was discharged on keflex 500mg qid x 10 days for erythema on evh incision. medications on admission: pravastatin 20mg daily omeprazole 20 mg daily aspirin 81 mg daily atenolol 25 mg daily calcium 500 mg daily hctz 12.5 mg daily nifedipine er 10 mg daily ntg 2.5 mg sr cap prn cholecalciferol ( d3) 1000 units daily quinapril 40mg daily discharge medications: 1. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. 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* 4. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 5. pravastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 8. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily): please take 2, 200mg tablets x 7 days. then take 1, 200mg tablet daily until stopped by cardiologist. disp:*40 tablet(s)* refills:*2* 9. cephalexin 500 mg tablet sig: one (1) tablet po four times a day for 10 days. disp:*40 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: rescetion of cardiac tumor on pulmonary valve coronary artery bypass graft x 4 past medical history: - hypertension - dyslipidemia - obesity - gastroesophogeal reflux disease - polymyalgia rheumatica - osteoarthritis - glaucoma - history of uti - cervical, lumbar disc disease left eye hemorrhage 15 yrs ago ( followed by ophth) - ble neuropathy past surgical history - hysterectomy, bladder resuspension - appendectomy - cesarean section - colonoscopy - right cataract surgery discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, mild erythema with ecchymosis, no drainage. trace edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr. on at 1:15pm please call to schedule appointments with your primary care dr. in weeks cardiologist dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: venous catheterization, not elsewhere classified (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery other operations on valves of heart diagnoses: coronary atherosclerosis of native coronary artery polymyalgia rheumatica esophageal reflux intermediate coronary syndrome unspecified essential hypertension acute posthemorrhagic anemia atrial fibrillation mononeuritis of lower limb, unspecified other and unspecified hyperlipidemia osteoporosis, unspecified rheumatoid arthritis obesity, unspecified syncope and collapse benign neoplasm of heart degeneration of cervical intervertebral disc degeneration of lumbar or lumbosacral intervertebral disc 

Answer: The patient is high likely exposed to