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: tetracycline attending: chief complaint: chest pain x 1 day major surgical or invasive procedure: none history of present illness: this is a 75 y/o w/ mmp including recent cabg and avr , ex lap and patch for duodenal perforation who p/w chest pain x 1 day and new rbbb. pt notes that she had 1 hour of sharp sscp that was sudden in onset, but gradually subsided on its own over 1 hour time. she notes that it was similar to "gas pain" that she has /x month but did not go away with rubbing of her belly as it usually does and was associated w/sob and palpitations which her gas pain usually is not. she notes that at the time of her cabg, she did not have angina and is unable to relate this as an anginal equivalent. she is bedridden at this time and thus this was not exertional in nature. also unable to assess positional pain b/c she does not move much. she was resting, not eating or exerting herself otherwise at the time of onset. she denies associated n/v/diaphoresis/visual changes. also denies cough/fever/chills/ha/dizzyness. is depressed but denies recent new onset fatigue. . per osh records, she has had guiac + stool on and off since the beginning of her stay at nesh. she has been transfused for hct drops in the setting of guiac + stool on multiple occassions. she takes iron supplements and her stool is often dark. she denies . in the , pts vitals on presentation were t 98 hr 77 bp 126/54 rr 14 100% on her home vent settings. ekg showed a new rbbb, ck was negative, but tni was up from baseline. ct surgery was notified of her admission. she received aspirin 325mg, morphine 4mg iv x 1 for lower back pain, not for chest pain. while in the ed, she was cp free. . currently, she denies pain, notes that she did have an episode of pain en route from the ed, sharp, lasting for minutes, associated w/sob. resolved on its own once she arrived in the unit. ekg was done and was unchanged from the ones prior, still revealing new rbbb. notes that had severe edema weeks ago but it has greatly improved. denies any le cramping/pain. she has chronic lbp. . past medical history: - aortic valve replacement(. medical biocor tissue valve) for severe as - coronary artery bypass grafting x2(left internal mammary artery graft to left anterior descending and reversed saphenous vein graft to the posterior descending artery) - respiratory failure s/p tracheostomy full vent at nesh is simv 12/500 peep 8 50%fio2, but was in process of weaning - jejunostomy - perforated duodenal ulcer s/p exploratory laparotomy, patch - hypertension - hypercholesterolemia - sleep apnea (cpap dependent) - diabetes mellitus type 2 - diverticulosis - poor balance - frequent falls - fractured vertebrae (l2, l5) - recent subdural hematoma () - s/p cholecystecomy - s/p appendectomy - s/p partial colectomy for diverticulitis - knee arthroscopy x3 - s/p pilonidal cyst removal - depression social history: retired lab tech no tobacco no etoh family history: father deceased from mi at age 41 physical exam: vs: t 99.6 bp 117/52 hr 102 sat 100% 40%fio2, ps 10, peep 5 gen: obese, nad, awake, alert, appropriate heent: eomi, perrl, sclera anicteric, conjunctivae clear, op moist and without lesion neck: supple, difficult to asses jvp- lying flat and with trach collar. trach in place. cv: reg rate, normal s1, s2. +systolic murmur w/soft diastolic click. chest: sternotomy scar noted, still two small open areas w/packing, resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi, diminished bs at bases. abd: large midline scar w/multiple open areas w/small amount of serous drainage, packing inside; obese soft, nt, nd, no hsm ext: 1+ edema noted, no clubbing/cyanosis skin: unable to assess known sacral decubitus ulcer b/c of pt's size, no rashes noted neuro: cn 2-12 grossly in tact, she has difficulty writing but has good strength in both upper and lower extremities. she is oriented x 3. . pertinent results: 08:51pm glucose-124* urea n-39* creat-0.6 sodium-142 potassium-3.5 chloride-103 total co2-33* anion gap-10 08:51pm hct-29.0* 12:20pm glucose-180* urea n-40* creat-0.7 sodium-142 potassium-4.2 chloride-102 total co2-29 anion gap-15 12:20pm ck(cpk)-19* 12:20pm ck-mb-notdone ctropnt-0.14* 12:20pm albumin-2.7* calcium-10.0 phosphate-2.7 magnesium-2.3 05:25am ck(cpk)-11* 05:25am ck-mb-notdone ctropnt-0.15* 10:50pm ck(cpk)-11* 10:50pm ctropnt-0.17* 10:50pm ck-mb-notdone 10:50pm wbc-12.3*# rbc-3.31* hgb-9.6* hct-30.4* mcv-92 mch-29.0 mchc-31.6 rdw-16.1* 10:50pm pt-12.1 ptt-23.8 inr(pt)-1.0 cxr: moderate cardiomegaly is unchanged. there is increased opacity in the left, filling half of the hemithorax, likely representing an accumulation of pleural fluid. a tracheostomy tube, median sternotomy wires, and left subclavian catheter are unchanged. impression: large left pleural effusion increased in size since the most recent study dated . . there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. a bioprosthetic aortic valve prosthesis is present. the transaortic gradient is normal for this prosthesis. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. impression: normal global and regional biventricular systolic function. limited study. brief hospital course: this is a 75 y/o w/cabg and avr who p/w sharp chest pain associated w/dyspnea and palpitations x 1 day w/new rbbb, and tni elevation. ekgs: review of ekgs from - reveal nsr w/new rbbb morphology not present on - . cardiology was consulted and felt that the pt's ekgs were c/w prior imi and upon consultation of the cardiac surgery service, both services felt that there was need for heparinization and that with tte w/o focal wall motion abnormalities, no indication for surgical intervention. she was cp free throughout her course though she did have epigastric tenderness around the site of her healing wound from the perforated duodenal ulcer. general surgery was consulted and evaluated the wound. the wound was repacked and dressed. she had guiac + stools, but stable hcts, gi was consulted and recommended outpt colonoscopy. she was j tube lavage negative upon arrival. she was weaned off of the vent and did well on 40%fio2 via trach mask. medications on admission: acetaminophen paroxetine hcl 10 mg/5 ml po daily atorvastatin 20 mg po daily amitriptyline 25 mg po hs docusate sodium 50 mg/5 ml liquid : po bid (2 times a day). zestril 5 mg po daily hydrochlorothiazide 25 mg po daily spironolactone 25 mg po daily metoprolol tartrate 50 mg po tid insulin glargine 25 units subcutaneous breakfast nexium 40mg once daily bumex 2 mg po once a day roxicodone 10 mg q6 hours prn pain nystatin swish and swallow xopenex 1.25 q8h mom powder iron supplementaion vitamin c discharge medications: 1. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 2. acetaminophen 160 mg/5 ml solution : one (1) po q6h (every 6 hours) as needed. 3. aspirin 325 mg tablet : one (1) tablet po daily (daily). 4. chlorhexidine gluconate 0.12 % mouthwash : one (1) ml mucous membrane (2 times a day). 5. insulin glargine 100 unit/ml solution : one (1) 25 subcutaneous once a day. 6. insulin regular human 100 unit/ml solution : one (1) injection qachs: please see attached sliding scale. 7. lisinopril 5 mg tablet : one (1) tablet po daily (daily). 8. ferrous sulfate 325 mg (65 mg iron) tablet : one (1) tablet po daily (daily). 9. ascorbic acid 90 mg/ml drops : one (1) po daily (daily). 10. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed. 11. paroxetine hcl 10 mg tablet : one (1) tablet po daily (daily). 12. atorvastatin 10 mg tablet : two (2) tablet po daily (daily). 13. amitriptyline 25 mg tablet : one (1) tablet po hs (at bedtime). 14. ibuprofen 100 mg/5 ml suspension : one (1) po q8h (every 8 hours) as needed. 15. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 16. levalbuterol hcl 0.63 mg/3 ml solution for nebulization : one (1) ml inhalation tid (3 times a day). 17. maalox 200-200-20 mg/5 ml suspension : one (1) ml po qid (4 times a day) as needed. 18. spironolactone 25 mg tablet : one (1) tablet po daily (daily). 19. hydrochlorothiazide 12.5 mg capsule : one (1) capsule po daily (daily). 20. metoprolol tartrate 50 mg tablet : one (1) tablet po bid (2 times a day). 21. bumetanide 2 mg tablet : one (1) tablet po daily (daily). 22. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 23. trimethoprim-sulfamethoxazole 160-800 mg tablet : one (1) tablet po bid (2 times a day) for 4 days. 24. oxycodone 5 mg/5 ml solution : one (1) po q6h (every 6 hours). discharge disposition: extended care facility: - discharge diagnosis: chest pain ekg changes rbbb discharge condition: stable discharge instructions: you were admitted for chest pain, while you were here, your ekgs showed evidence of possible ischemia. however, there was no evidence that intervention was indicated while you were here. you were evaluated by the cardiac and general surgery services. you were weaned off of your ventilator and you did well. please follow up with your primary care physician and present to the hospital or call your pcp if you have chest pain/shortness of breath, fever/chills, nausea/vomiting/headache/dizzyness. followup instructions: please follow up with your primary care physician within the next 1-2 weeks. please call pcp: , . md, procedure: diagnostic ultrasound of heart diagnoses: pure hypercholesterolemia urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status depressive disorder, not elsewhere classified heart valve replaced by other means long-term (current) use of insulin unspecified sleep apnea right bundle branch block other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation pressure ulcer, buttock chronic obstructive asthma, unspecified hemorrhage of gastrointestinal tract, unspecified acute myocardial infarction of unspecified site, initial episode of care accidents occurring in residential institution gastrostomy status tracheostomy status long-term (current) use of aspirin diverticulitis of colon (without mention of hemorrhage) cardiomegaly non-healing surgical wound 

Answer: The patient is high likely exposed to