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: chest pain with exertion major surgical or invasive procedure: cardiac catheterization coronary bypass grafting x4 with the left internal mammary artery to the left anterior descending artery and reverse saphenous vein graft to the posterior descending artery, distal left circumflex artery and obtuse marginal artery history of present illness: 81 y/o spanish-speaking woman with diabetes mellitus, class i chronic diastolic congestive heart failure, chronic kidney disease, hypertension, hyperlipidemia presents with chest pain and shortness of breath. of note, the patient was recently seen by her pcp with the complaint of right sided chest pressure and shortness of breath, worsened by exertion. an ekg performed in the office showed twi in leads v1-v4, and an outpatient stress test was ordered. the patient states that she has been having tightness and pressure in her chest that has been present for the last 2 weeks. she states that since her visit to her pcp that her symptoms have become progressively worse with exertion, to the point that she develops symptoms while getting up to go to the bathroom. she admits that she feels fatigued throughout the day, which is worse from her baseline. she stated that last night she became markedly dyspneic while getting up to go to the bathroom, with associated r chest pressure which migrated to the substernal region. her daughter was concerned about this development and decided to bring the patient into the emergency department. cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. she was admitted for further evaluation. past medical history: - dmii c/b retinopathy and peripheral neuropathy - hypertension - hyperlipidemia - osteoporosis - nocturnal leg cramps - asthma (mild intermittent, not on any meds) - low back pain - echo () - ef 60%, impaired lv relaxation, borderline - pulmonary systolic hypertension - dobutamine stress echo () - no evidence of ischemia - multinodular goiter - s/p ccy - s/p back surgery at nbh ~ social history: lives alone, has a woman who helps to cook and clean. six children, at least 3 of whom live in area. denies etoh or tobacco use, no recreational drug use. states she doesn't move around much. family history: two children have died, two children with cancer (prostate, liver). +htn, +dm type ii physical exam: general: wdwn in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 6 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. coarse inspiratory rales heard in all lung fields. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: 2+ le edema to the mid shins bl. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp dopplerable left: carotid 2+ femoral 2+ popliteal 2+ dp dopplerable pertinent results: echocardiography report , (complete) done at 9:52:03 am final 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. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. conclusions pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. overall left ventricular systolic function is mildly depressed (lvef= 40 - 45 %). with mild global free wall hypokinesis. the apex is hypokinetic, while base and mid segments all work well. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is no pericardial effusion. post-cpb: the patient is av-paced, on no inotropes. preserved biventricular systolic fxn. no ai. mr is now mild. aorta intact. sgc tip is at the pa bifurcation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 15:15 ?????? caregroup is. all rights reserved. 05:09am blood wbc-7.4 rbc-3.02* hgb-9.0* hct-27.0* mcv-89 mch-29.7 mchc-33.3 rdw-14.2 plt ct-375 06:30am blood wbc-7.8 rbc-3.16* hgb-9.3* hct-28.1* mcv-89 mch-29.4 mchc-33.0 rdw-14.3 plt ct-404 05:09am blood glucose-64* urean-92* creat-2.8* na-138 k-4.7 cl-100 hco3-29 angap-14 01:33am blood na-137 k-5.1 cl-99 brief hospital course: on ms. was taken to the operating room and underwent coronary bypass grafting x4 (left->internal mammary artery to the left anterior descending artery and reverse saphenous vein graft to the posterior descending artery, distal left circumflex artery and obtuse marginal artery) with dr.. please refer to operative report for further surgical details. cross-clamp time:74 minutes. pump time:89 minutes. she tolerated the procedure well and was transferred to the cvicu in stable but critical condition, intubated and sedated. she remained intubated with progressive oliguric renal failure and subsequent volume overload. renal consulted and cvvh was initiated. fluid was removed and on pod# 6 she was extubated without difficulty. cvvh was discontinued. renal advised no further lasix. the following day she demonstrated markedly diminished mental status and a head ct scan per radiology revealed scattered hypodense foci in the right frontal lobe and left frontal and temporal lobes are indeterminate but may represent small vessel ischemic changes/volume averaging. ultimately her mental status improved, her urine output was adequate with resolving postoperative arf. she continued to slowly progress and on pod# 12 she was transferred to the step down unit for further monitoring. physical therapy was consulted for evaluation of strength and mobility. the remainder of her hospital course was essentially uneventful. on pod19 she was cleared for discharge to rehab. all follow up appointments were advised. electrolytes will be checked frequently at rehab. medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - 2 puffs inhaled every six (6) hours as needed candesartan - (prescribed by other provider) - 32 mg tablet - 1 tablet(s) by mouth once a day fluticasone - 220 mcg aerosol - 2 puffs oral twice daily gabapentin - 300 mg capsule - 1 capsule(s) by mouth three times a day insulin glargine - (prescribed by other provider; dose adjustment - no new rx) - 100 unit/ml solution - 25 units every am daily latanoprost - 0.005 % drops - 1 drop(s) both eyes at bedtime lidocaine - 5 % (700 mg/patch) adhesive patch, medicated - 1 patch twice a day metoprolol succinate - 100 mg tablet extended release 24 hr - 1 tablet(s) by mouth daily simvastatin - (prescribed by other provider; dose adjustment - no new rx) - 20 mg tablet - 1 (one) tablet(s) by mouth once a day tramadol - 50 mg tablet - 1 tablet(s) by mouth twice a day aspirin - (prescribed by other provider; dose adjustment - no new rx) - 81 mg tablet, delayed release (e.c.) - 1 (one) tablet(s) by mouth once a day calcium carbonate-vitamin d3 - 500 mg (1,250 mg)-200 unit tablet - 1 tablet(s) by mouth daily guaifenesin - 400 mg tablet - 3 tablet(s) by mouth twice a day guaifenesin - 1,200 mg tablet, er multiphase 12 hr - 1 tab(s) by mouth twice a day guar gum - (otc; dose adjustment - no new rx) - packet - 1 (one) packet(s) by mouth once a day as needed loratadine - 10 mg tablet - 1 tablet(s) by mouth once a day multivitamin - (otc) - capsule - capsule(s) by mouth once a day discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 4. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 5. fluticasone 110 mcg/actuation aerosol sig: four (4) puff inhalation (2 times a day). 6. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 7. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 9. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 10. ipratropium bromide 0.02 % solution sig: inhalation q6h (every 6 hours) as needed for wheezing. 11. guaifenesin 600 mg tablet extended release sig: two (2) tablet extended release po bid (2 times a day). 12. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 13. multivitamin tablet sig: 1-2 tablets po daily (daily). 14. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 15. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 16. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 17. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 18. insulin sliding scale & fixed dose fingerstick qachs insulin sc fixed dose orders breakfast glargine 25 units insulin sc sliding scale breakfast lunch dinner bedtime humalog glucose insulin dose 0-70 mg/dl proceed with hypoglycemia protocol 71-119 mg/dl 0 units 0 units 0 units 0 units 120-140 mg/dl 2 units 2 units 2 units 0 units 141-199 mg/dl 4 units 4 units 4 units 1 units 200-239 mg/dl 6 units 6 units 6 units 2 units 240-280 mg/dl 8 units 8 units 8 units 3 units > 280 mg/dl notify m.d. 19. loratadine 10 mg tablet sig: one (1) tablet po once a day. 20. outpatient lab work electrolytes daily x 3 days then 3x/week to monitor hyperkalemia and renal insufficiency 21. insulin glargine 100 unit/ml solution sig: twenty five (25) subcutaneous once a day: 25 units glargine daily am. 22. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). discharge disposition: extended care facility: for the aged - macu discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 past medical history: -chronic diastolic chf, class i by tte - insulin-dependent diabetes complicated by retinopathy and peripheral neuropathy -hypertension, difficult to control -hyperlipidemia -osteoporosis -nocturnal leg cramps -mild intermittent asthma -mild diastolic dysfunction -multinodular goiter -chronic kidney disease (baseline cr 1.5) discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema lle + 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 and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive 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 1:30pm cardiologist: dr. on at 9am please call to schedule appointments with your primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters enteral infusion of concentrated nutritional substances hemodialysis central venous catheter placement with guidance diagnoses: hyperpotassemia subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified acute on chronic diastolic heart failure other chronic pulmonary heart diseases diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) iatrogenic pneumothorax 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 osteoporosis, unspecified diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy nontoxic multinodular goiter 

Answer: The patient is high likely exposed to