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: penicillins attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization coronary artery bypass grafting x3 (lima-lad, svg-pda, svg-om) history of present illness: 57-yo female w/ htn, dyslipidemia, and 40 pack-year smoking history transferred from cardiac cath with atypical chest pain. she initially presented with sudden onset crushing chest pain radiating to her jaw and both arms, sob and diaphoresis while at rest. she went to where she works as rn. there her pain continued with 3 nitroglycerin but resolved with morphine roughly 1 hour after onset. her enzymes were negative and she had only shallow twi in iii and avf. subsequent stress test, lenis, cta chest and ruq u/s were all negative. just before she was to go home, decision was made for trasnfer to for cardiac cath. cardiac cath today showed 90% lad occlusion with serial lesions, 90% proximal and 40% distal lcx occlusion and 50% proximal and 90% distal rca occlusion, as well as lv diastolic dysfunction. she is planned to have a cabg mid next week. shortly after the cath, she began having pressure under her left breast radiating as a sharpness to her back. pain persisted with a nipride drip but decreased to with versed. she says that she feels very anxious about the prospect of major cardiac surgery. on review of systems she denies recent cough, fever, chills, vomiting, diarrhea or constipation. at she had occasional headaches that seemed to correlate with spikes in her blood pressure. she suffers from chronic left arm pain that she typically treats with nsaids. she does not have any shortness of breath at baseline, though she admits that she rarely exerts herself. she had one other episode of chest pain 2 weeks prior to when she had sharp chest pain shortly after waking up that persisted for about half an hour and improved spontaneously. she has had no recent weight loss or gain. past medical history: hypertension hyperlipidemia familial mediterranean fever with mild iga nephropathy chronic l arm pain s/p multiple surgeries after humerus fracture bilateral cataracts pna requiring 5 day hospitalization tah/bso l 5th metatarsal surgery appendectomy social history: occupation: case manager smokes (1 pack/day x 40 years), social etoh, no illicit/recreational drugs family history: family history: father had diabetes, mi in 50s, then a fib and chf. mother had lupus and copd. physical exam: on admission vital signs: per r.n. height: 62 inches bp right arm: 116 / 74 mmhg weight: 66.5 kg t current: 37.2 c hr: 56 bpm rr: 17 insp/min o2 sat: 96 % on supplemental oxygen: 2l nc eyes: (conjunctiva and lids: wnl) ears, nose, mouth and throat: (oral mucosa: wnl), (teeth, gums and palette: abnormal, poor dentition) neck: (right carotid artery: no bruit), (left carotid artery: no bruit), (jugular veins: not visible), (thyroid: wnl) back / musculoskeletal: (chest wall structure: wnl) respiratory: (effort: wnl), (auscultation: wnl) cardiac: (rhythm: regular), (palpation / pmi: wnl), (auscultation: s1: wnl, s2: normal) abdominal / gastrointestinal: (bowel sounds: wnl), (bruits: no), (hepatosplenomegaly: no) genitourinary: (foley in place) femoral artery: (right femoral artery: catheter site clean dry and intact., no bruit) extremities / musculoskeletal: (muscle strength and tone: wnl), (dorsalis pedis artery: right: 1+, left: 1+), (posterior tibial artery: right: 1+, left: 1+) skin: (abnormal, erythematous rash on flanks) pertinent results: osh lab results: tropt : 0.08, 0.14, 0.03 lipid panel : tchol 173, hdl 28, ldl 75, trig 446. . 12.9 8.2>---<169 36.9 . 134 | 104 | 12 / 152 3.8 | 23 | 0.9 \ coag's: pt-14.0 ptt-30.0 inr(pt)-1.2 lft's: alt(sgpt)35 ast(sgot)46 ck(cpk)54 alk phos59 amylase73 tot bili-0.4 %hba1c-6.6 . micro: urine cx negative . tests ecg: (date: ), nsr at 52 bpm, left-deviated axis, tw flattening in ii and avf. echocardiogram: (date: ), ef 60%, no wall motion abnormalities, trace mr/tr . most recent pci results (): 1. selective coronary angiography of this right-dominant system revealed three-vessel coronary artery disease. the lmca had mild plaquing but no significant stenoses. the lad had serial 90% stenosis and heavy calcification. the lcx was calcified and had a 90% proximal and 40% distal stenosis. the rca had a calcified 50% proximal stenosis and a 90% distal stenosis. 2. limited resting hemodynamics demonstrated elevated left ventricular filling pressures with an lvedp of 25 mmhg, and no significant gradient across the aortic valve. . carotid u/s (): impression: no evidence of internal carotid artery stenosis on either side. 12:55pm blood wbc-12.1* rbc-3.43* hgb-10.7* hct-31.6* mcv-92 mch-31.1 mchc-33.8 rdw-14.4 plt ct-135* 04:21pm blood pt-13.9* ptt-34.0 inr(pt)-1.2* 12:55pm blood glucose-156* urean-16 creat-1.1 na-133 k-4.6 cl-98 hco3-24 angap-16 pre-bypass: no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>60 %). right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. there is no aortic valve stenosis. trace aortic regurgitation is seen. physiologic mitral regurgitation is seen (within normal limits). there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine. biventricular function is intact. aortic contours appear intact post decannulation. other findings are unchanged brief hospital course: 57-yo female w/ htn, dyslipidemia, and 40 pack-year smoking history transferred from cardiac cath with atypical chest pain. originally presented with crushing chest pain and had an extensive negative workup at before being transferred here for cardiac cath. on catheterization she was found to have three vessel disease and is scheduled for cabg next week. following cath, she began having new chest pressure and was transferred to the ccu. brief hospital course by problem list is as follows: . # chest pain: it is unclear whether the blockages in her coronary arteries are the source of her chest pain. her initial symptoms on were typical for an acute coronary syndrome, but she ruled-out by all standard criteria (enzymes, serial ecgs and stress test). other possible sources include musculoskeletal pain, pleuritic pain and gi pain. pe, gall stones, and pericardial effusion were all tested for at the . pt's pain was well-controlled in the ccu; pt was also given versed for anxiety re: upcoming cabg. cxr ruled out pleuritic sources for her cp (pneumothorax, pneumonia). . # coronaries: three vessel disease on cardiac cath, too extensive for stenting and clearly suitable for cabg. patient was continued on iv heparin in ccu. pre-op echo, cxr, carotid u/s, pfts, ua/uc were ordered per ct surgery. pre-op lfts, hba1c, coags were also ordered. pt continued to be on asa and high dose statin for her cad. also stressed the importance of smoking cessation to patient, who tolerated the nicotine patch well. . # hypertension: hypertensive at baseline, tolerated up-titration of her lisinopril at the osh. pt was continued on higher dose lisinopril (20 mg) and home dose atenolol in the ccu. she complained of headaches which she believes are associated with high blood pressures. her bp during these headaches were sbp 150-170's, and they were controlled with percocet. . # hyperlipidemia: simvastatin was increased to 80 mg daily and lipid panel checked. . # familial mediterranean fever: pt was continued on colchicine pt was transferred out to 3 on . cardiac surgery summary: the patient underwent cabgx3 on with dr. . she received vancomycin for surgical prophylaxis as she was inpatient for over 24 hours. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in critical but stable condition. by pod 1 the patient was extubated, alert and oriented and breathing comfortably. she was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. she was transferred to telemetry on pod 1 where she continued to make progress. chest tubes and pacing wires were discontinued without complication. physical therapy was consulted for post-operative strength and mobility. on the day of discharge, the patient was noted to have some erythema about the superior 3" of her sternal incision, approximately " wide. she was afebrile and there was no drainage. keflex was started. post-operative course was uneventful and the patient was discharged home with vna services in good condition on pod 4. medications on admission: colchicine 0.6mg lisinopril 2.5mg daily (increased to 10mg, then 20mg in hospital) atenolol 100mg daily premarin 1.25 mg daily magnesium oxide 400 mg simvastatin 20 mg daily discharge medications: 1. colchicine 0.6 mg tablet sig: one (1) tablet po bid (2 times a day). 2. conjugated estrogens 0.625 mg tablet sig: two (2) tablet po daily (daily). 3. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 8. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). 9. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 10. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 7 days. disp:*27 capsule(s)* refills:*0* 11. diflucan 150 mg tablet sig: one (1) tablet po once a day for 1 days. disp:*1 tablet(s)* refills:*0* 12. furosemide 40 mg tablet sig: one (1) tablet po once a day for 10 days. disp:*10 tablet(s)* refills:*0* 13. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 10 days. disp:*10 tab sust.rel. particle/crystal(s)* refills:*0* 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). discharge disposition: home with service facility: , discharge diagnosis: coronary artery disease discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month, and while taking narcotics no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr. in 4 weeks () dr. , n in 1 week dr. in weeks please call for appointments wound check appointment 6 as instructed by nurse () procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization diagnostic ultrasound of heart diagnoses: acidosis coronary atherosclerosis of native coronary artery tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension chronic airway obstruction, not elsewhere classified other and unspecified hyperlipidemia anxiety state, unspecified nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney acute coronary occlusion without myocardial infarction familial mediterranean fever 

Answer: The patient is high likely exposed to