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 an 81-year-old african american female with known coronary artery disease, congestive heart failure, with an ejection fraction of percent, previous cva and peripheral vascular disease who underwent a right axillary bifemoral bypass in who presents with 3-4 days of increasing left foot pain and discoloration. also noted to have mental status changes, i.e., hallucinations. head ct in the emergency room was negative. the patient now is admitted for left lower extremity acute ischemia. the patient describes pain at rest minimally with ambulation. no fevers, chills, nausea, vomiting, shortness of breath, chest pain. no dysuria. allergies: no known drug allergies. medications: 1. aspirin 325 mg daily. 2. atenolol 50 mg daily. 3. captopril 12.5 mg t.i.d. 4. digoxin 0.25 mg daily. 5. diltiazem 120 mg daily. 6. colace 100 mg b.i.d. 7. lasix 20 mg a day. 8. gemfibrozil 600 mg b.i.d. 9. coumadin 3 mg daily. 10. nph insulin 25 units q.a.m., 7 units at dinner with a regular sliding scale. past medical history: 1. coronary artery disease, three vessel disease by cardiac catheterization with a history of myocardial infarction in . 2. history of congestive heart failure with an ejection fraction of percent. 3. history of cva. 4. history of hypertension. 5. history of hypercholesterolemia. 6. history of type 2 diabetes. 7. history of nephrolithiasis. past surgical history: 1. cholecystectomy, remote. 2. right ureteral stenting in . 3. appendectomy, remote. 4. bilateral cataract surgeries, remote. 5. right axillary bifemoral bypass on . social history: the patient lives in with her family. she denies tobacco or alcohol use. physical examination: general: no acute distress. oriented x2. no jvd or carotid bruits. heart is irregular/irregular rhythm. lungs are clear to auscultation bilaterally. abdominal exam is remarkable for a ventral hernia reducible. extremities are no edema. rectal exam is guaiac negative. pulse exam shows dopplerable right axillofem graft. femoral pulses are dopplerable, monophasic bilaterally, popliteal on the right is monophasic dopplerable signal on the left absent. the dp on the right is triphasic, dopplerable and the pt is absent. on the left the dp and pt are absent bilaterally. the left leg is mottled with sensory intact and diminished motor function. the patient is admitted to the vascular service now for further evaluation and treatment. hospital course: the patient was initially evaluated in the emergency room and admitted to the vascular service. she was begun on vanco, levofloxacin for antibiotic care. her preoperative medications were continued. she did have some ekg changes with st depressions in v4-v5, questionable myocardial infarction. the patient's admitting cks were 387 and over the next 48 hours ck was 209. ck mbs were 3 and 4. troponin levels were 0.2. cardiology was requested to see the patient for preoperative assessment for evaluation. recommendations-she was a high surgical candidate with known severe ischemic cardiomyopathy with a semi-compensated left ventricular function. they felt that no further cardiac workup was indicated at this time. the patient should be restarted on her lasix, spironolactone should be added to her regimen and increase from 12.5 to 25 mg daily with monitoring of k. diltiazem should be discontinued secondary to myocardial suppression, a beta blockade, toprol, should be advanced to 150 mg a day. digoxin should be changed to 0.125 mg per day and gemfibrozil should be changed to fenofibrate. the patient's coumadin was held and she was placed on iv heparin for anticoagulation for a chronic atrial fibrillation. long discussions with the family to determine plan of action, arteriogram to see if we can reconstruct or just undergo amputation. the patient's family was undecided. the was consulted for diabetic management. the patient was preopped on for anticipated left aka and underwent a left aka without complication on . she was transferred to the pacu in stable condition. postoperatively, she remained hemodynamically stable. her postoperative crit was 31.1, bun 15, creatinine 0.7. the patient remained intubated overnight and was transferred to the sicu for continued monitoring and care. she was weaned overnight and extubated. she remained hemodynamically stable. her physical examination was unremarkable. her dressing was clean, dry, and intact. she was transferred to the vicu for continued care. she required readjustment in her regular insulin dose for her hyperglycemia with slow improvement. on postoperative day #1 the patient was converted to p.o. medications. ambulation to the chair was begun. heparin was restarted and warfarin was reinstituted. her antibiotics were discontinued on postoperative day #2. her swan line was converted to cvl on postoperative day #2. she continued to require lasix for diuresis. the a-line was discontinued. hematocrit was 28.7, bun 11, creatinine 0.7. she continued to be followed by the vascular service and her primary care physician. physical therapy evaluated the patient on postoperative day #3. the recommendations were that the patient could be discharged to home with home physical therapy and 24-hour care. the family is aware of this and this was their decision. a repeat echocardiogram will be obtained prior to the patient's discharge to determine her left ventricular function. on postoperative day #5 she continued to do well, was afebrile. her left flap was warm, pink, without erythema. the right dp and pt were dopplerable signals only. the iv heparin was continued until her inr was greater than 2.0. the patient will continue with diuresis. she is at baseline. will be planning discharge to home with services in the next 24 hours. discharge medications: 1. lopressor 25 mg t.i.d. 2. acetaminophen 325 mg tablets 2 q.6 h. 3. isosorbide dinitrate 10 mg t.i.d. 4. digoxin 125 mcg daily. 5. captopril 12.5 mg t.i.d. 6. protonix 40 mg daily. 7. colace 100 mg b.i.d. 8. senna 8.6 mg tablets 1 b.i.d. as needed. 9. warfarin 3 mg a day. 10. lasix, dosing 40 mg a day. 11. potassium 20 mg a day. 12. aspirin 325 mg daily. 13. crestor 10 mg at . 14. insulin sliding scale as follows: nph 40 units q.a.m., 20 units at , humalog sliding scale before meals and at , before meal sliding scale, glucose less than 100 no insulin; 101-150 at 6 units; 151-200 at 10 units; 201-250 at 12 units; 251-300 at 16 units; 301-350 at 18 units; 351-400 at 20 units; greater than 400 notify physician. sliding scale glucoses less than 150 no insulin; 151-200 at 7 units; 201-250 at 9 units; 251- 300 at 11 units; 301-350 at 13 units; 351-400 at 15 units; greater than 400 notify physician. discharge instructions: inr should be monitored as required. the patient should follow-up with the primary care physician. inr 2.0 to 3.0. there should be no stump shrinkage due to the amputated site. if the patient develops a fever of greater than 101.5 she should notify dr. office. if the wound becomes red, there is swelling or drainage, the patient should call dr. office. the right heel should be protected with a multi_____ splint at all times. discharge diagnosis: 1. left foot ischemia with rest pain. 2. history of peripheral vascular disease, status post right axillobifemoral bypass graft , failed. 3. coronary artery disease with history of myocardial infarction in . 4. history of congestive heart failure with ejection fraction of 10 percent. 5. history of hypertension. 6. history of hypercholesterolemia. 7. history of cerebrovascular accident. 8. history of type 2 diabetes, insulin-dependent, uncontrolled. 9. history of atrial fibrillation, anticoagulated. major surgical procedures: left above knee amputation . follow up: the patient should follow-up with dr. in weeks for an office appointment at . , procedure: amputation above knee diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation long-term (current) use of insulin diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled atherosclerosis of native arteries of the extremities with gangrene cellulitis and abscess of foot, except toes 

Answer: The patient is high likely exposed to