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: patient recorded as having no known allergies to drugs attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization coronary artery bypass graft x 4 (lima to lad, svg to om, svg to om, to lpda) history of present illness: 67f smoker w/ no medical care in over 15 years was transferred from osh with nstemi. pt admitted to on with acute episode of sob and pain radiating down both arms and neck. ekg in ambulance demonstrated st depressions in v2-v4, st elevations in ii, iii, and her cardiac enzymes were positive with peak cpk 431 and troponin of 16.8. cta was negative for pe. she was placed on heparin gtt, integrillin gtt, plavix load, beta blocker, high dose statin, and aspirin. her st segment changes resolved but small q-waves present in ii and iii. she received lasix as needed for volume overload. past medical history: hyperlipidemia, hypertension, tobacco use, s/p hemorrhoidectomy social history: patient is married to her husband for 50 years. she lives in . she is retired and used to work as a buyer for a baby clothing company. she smokes ppd currently, 40-pack-year hx. she denies any current etoh use or prior abuse. she denies any ellicits. family history: her fh is notable for father with mi in his 40s and cardiac deat at age 67. mother died of old age at age and had thyroid dysfunction physical exam: admission vs - 97.2 144/86 88 16 95% ra gen: well-appearing, nad heent: ncat. sclera anicteric. sclear anicteric, conjunctivae slightly pale, op clear w/ dentures, mmm neck: supple with jvp of 8 cm. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. +s3, iii/vi blowing sem at apex chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. soft r > l crackles abd: +bs. soft, ntnd. ext: no c/c/e.. skin: no rashes. pulses: 2+ radial and 2+ dp pulses bilat discharge vs t98.4 hr 97 sr bp 167/97 rr 18 gen nad neuro oriented x3, nonfocal exam pulm scattered rhonchi cv rrr, sternum stable incision cdi abdm soft, nt/+bs ext warm, palpable pulses, 2+ pedal edema pertinent results: 08:51pm %hba1c-6.4* 05:43pm glucose-100 urea n-16 creat-0.8 sodium-141 potassium-3.8 chloride-103 total co2-27 anion gap-15 05:43pm tsh-13* 05:43pm free t4-1.2 05:43pm wbc-6.3 rbc-4.37 hgb-13.6 hct-39.4 mcv-90 mch-31.0 mchc-34.4 rdw-13.7 05:43pm plt count-206 05:43pm pt-12.5 ptt-44.1* inr(pt)-1.1 05:20am blood wbc-7.7 rbc-3.56* hgb-10.9* hct-31.8* mcv-89 mch-30.8 mchc-34.5 rdw-14.1 plt ct-265 04:06am blood pt-12.1 ptt-40.1* inr(pt)-1.0 05:20am blood glucose-112* urean-15 creat-0.7 na-141 k-4.0 cl-102 hco3-28 angap-15 cardiac cath: 1. selective coronary angiography of this left dominant system revealed 3 vessel coronary artery disease. the lmca had no angiographically apparent flow limiting epicardial coronary artery disease. the lad had a 70% mid and a 60% mid vessel stenosis with mild diffuse disease. the lcx had a 90% mid vessel stenosis. the rca had an 80% proximal and an 80% mid-vessel lesion and was a small, non-dominant vessel. 2. resting hemodynamics revealed elevated right and left filling pressures with lvedp 24 mmhg and rvedp 13 mmhg. the pulmonary artery systolic pressure was mildly elevated with a pasp of 31 mmhg. the cardiac index was at 1.93 l/min/m2. there was mild systemic systolic arterial hypertension with sbp 147 mmhg. 3. there was no transvalvular gradient upon pullback of the catheter from the left ventricle to the aorta. 4. left ventriculography reealed + mitral regurgitation. the lvef was calculated to be 25% with inferior akinesis and moderately severe anterior hypokinesis / echo: pre-cpb:1. the left atrium is markedly dilated. no spontaneous echo contrast is seen in the body of the left atrium. a left atrial appendage thrombus cannot be excluded. 2. no atrial septal defect is seen by 2d or color doppler. 3. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. there is severe regional left ventricular systolic dysfunction with infero and inferoseptal hypokinesis. lvef is 25% 4. right ventricular chamber size and free wall motion are normal. 5. there are simple atheroma in the aortic root. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 6. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. no aortic regurgitation is seen. 7. the mitral valve leaflets are mildly thickened. no mass or vegetation is seen on the mitral valve. moderate to severe (3+) mitral regurgitation is seen. there is a central jet with an annular dimension of 2.7 cm. 8. dr. was notified in person of the results. post cpb: on infusions of epi, milrinone, neo. well-seated annuloplasty ring in the mitral position. no mr. gradient of 11 mmhg on inotropes with co= 6.0, consistent with mild ms. dr. present to perform 3-d views. improved lv systolic function with lvef= 35%. no evidence of . aortic contour normal post decannulation. carotid u/s: normal carotid study ct head w/o contrast 4:49 pm ct head w/o contrast reason: eval for peri-operative cva medical condition: 67 year old woman s/p mvring and cabg now w r-sided weakness reason for this examination: eval for peri-operative cva contraindications for iv contrast: none. head ct history: 67-year-old woman status post mitral valve ring and cabg surgery, now with right-sided weakness. technique: contiguous non-contrast axial images of the head were obtained. findings: no comparisons are available. there is a hypodensity involving the right occipital lobe which is consistent with either subacute or old infarct. no acute infarcts are identified. there is a minimal amount of periventricular white matter hypodensities which likely represent chronic microangiopathic change. small perivascular spaces are seen in the basal ganglia regions bilaterally. there are no intracranial hemorrhages. the visualized orbits are normal. the visualized paranasal sinuses and mastoid air cells are clear. no suspicious bony abnormalities are seen. impression: subacute to old infarct of the right occipital lobe. chest (portable ap) 8:11 am chest (portable ap) reason: ? effusion, ptx medical condition: 67 year old woman with s/p cabg reason for this examination: ? effusion, ptx chest radiograph indication: followup. comparison: . as compared to the previous examination, there is a slight increase in retrocardiac density, presumably caused by atelectasis. the size of the cardiac silhouette is unchanged. no newly appeared parenchymal opacities. no relevant overhydration. the monitoring and support devices are in unchanged position. brief hospital course: 67f smoker w/ no medical care in over 15 years, untreated htn, was transferred from osh with acute mi and antero-lateral depressions and brief inferior elevations, and 3v-disease on cardiac cath and severe mr ef 25-30%. she was seen by cardiac surgery. she was cleared by dental. she awaited plavix washout prior to being taken to the operating room on where she underwent a cabg x 4/mv repair. she was transferred to the icu in stable condition on epi, milrnone, neo and propofol. she remained intubated overnight and was transfused for hct 20. s right chest tube was placed for pleural effusion. she was extubated on pod #1. she was followed by psychiatry for delirium and started on haldol. she initially had some right sided weakness, head ct showed old infarct. she was seen by speech and swallow and was initially cleared for pureed foods. she was transferred to the floor on pod #3. she was re-evaluated by swallow and cleared for thin liquids and ground solids. her haldol was discontinued. she was started on synthroid for tsh 21. her weakness improved. she was screened for rehab and was discharged to rehabilitation at of on pod #6. medications on admission: outpatient: none . transfer medications: heparin gtt integrillin gtt plavix 75 mg daily aspirin 325mg daily protonix 40mg daily nitroglycerin paste metoprolol 50mg tid simvastatin 80mg daily ativan prn discharge medications: 1. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily). 3. lisinopril 5 mg tablet : one (1) tablet po daily (daily). 4. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 5. levothyroxine 50 mcg tablet : one (1) tablet po daily (daily). 6. zocor 80 mg tablet : one (1) tablet po once a day. 7. citalopram 20 mg tablet : one (1) tablet po daily (daily). 8. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed. 9. metoprolol tartrate 50 mg tablet : two (2) tablet po tid (3 times a day). 10. lorazepam 1 mg tablet : one (1) tablet po hs (at bedtime) as needed. 11. lasix 40 mg tablet : one (1) tablet po once a day. discharge disposition: extended care facility: tba discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 myocardial infarction pmh: hyperlipidemia, hypertension, tobacco use psh: hemorrhoidectomy discharge condition: stable discharge instructions: 1)please shower daily. no baths. pat dry incisions, do not rub. 2)avoid creams and lotions to surgical incisions. 3)call for redness or drainage from surgical wounds 4)no lifting more than 10 lbs for at least 10 weeks from surgical date. 5)no driving for at least one month. followup instructions: dr. in 4 weeks dr. , md phone: date/time: 2:00 pcp weeks, started on synthroid while in hospital, needs tfts rechecked in 6 weeks procedure: (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 angiocardiography of left heart structures injection or infusion of platelet inhibitor open heart valvuloplasty of mitral valve without replacement diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension acute systolic heart failure 

Answer: The patient is high likely exposed to