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 a 78 year old woman who was transferred from for evaluation for a coronary artery bypass graft. she presented to for a cardiac catheterization which revealed severe two vessel disease. an echocardiogram at the outside hospital also revealed an ejection fraction of 45 to 50%. the patient does report having some shortness of breath as well as a chronic cough for the last five months and she also has dyspnea on exertion. she does not have a diagnosis of chronic obstructive pulmonary disease. she does report that she does have some loose stools but denies any melena. she does report that she does have reflux. she does have lower extremity edema and she does have a history of a stroke in the past. no current neurological deficits. past medical history: 1. coronary artery disease status post a non-q wave myocardial infarction. 2. diabetes mellitus type 2. 3. hypercholesterolemia. 4. gastroesophageal reflux disease. 5. chronic atrial fibrillation. 6. congestive heart failure. 7. carotid disease status post a cerebrovascular accident; she is on coumadin. 8. hypertension. 9. irritable bowel syndrome. 10. hypothyroidism. 11. pernicious anemia. 12. diabetic neuropathy. 13. she is blind in her right eye; she has a detached retina. social history: she lives alone. her son does check on her daily. she did have a positive smoking history but she quit 44 years ago. she does not use alcohol. in addition, she was admitted to on and was an inpatient there for four days prior to being transferred here. family history: her mother did have coronary artery disease. allergies: she is allergic to penicillin. medications at home: 1. thyrolar or liotrix which is two tablets once a day. 2. nadolol 40 mg twice a day. 3. glucophage 850 mg twice a day. 4. cozaar 50 mg twice a day. 5. glyburide 5 mg once a day. 6. coumadin 5 mg once a day. 7. clonidine 0.2 mg once a day. 8. norvasc 10 mg once a day. 9. lipitor 20 mg once a day. 10 vitamins with iron. medications at the outside hospital: 1. lasix 40 mg three times a day. 2. nitroglycerin drip. 3. lovenox 85 mg subcutaneously once a day. 4. cozaar 100 mg twice a day. 5. glyburide 2.5 mg twice a day. 6. norvasc 10 mg once a day. 7. clonidine 0.2 mg once a day. 8. feso4 325 twice a day. 9. lipitor 20 mg once a day. 10. flonase. 11. diflucan 100 mg once a day. 12. plavix 75 mg once a day. 13. enteric-coated aspirin 325 mg once a day. 14. multivitamin. 15. lopressor 50 mg twice a day. 16. clorazepate 3.25 mg q. h.s. laboratory: significant for a white blood cell count of 6.8, hematocrit 25.5, platelets 261. coagulation studies pt was 13.2 with an inr of 1.0. chem-7 was sodium 126, potassium 3.9, chloride 91, bicarbonate 22, bun 20, creatinine 1.0. ekg shows atrial fibrillation at a rate of 100; some st elevation in her inferior leads. an ekg from the 19th showed a sinus rate wave in iii and st depressions in iii, avl and avs. chest x-ray shows diffuse alveolar infiltrates consistent with congestive heart failure. carotid ultrasound showed stenosis of the right carotid artery of 46% and the left 50 to 70%. echocardiogram showed an ejection fraction of 45 to 50%. urinalysis was negative. physical examination: she is afebrile; pulse is 66 and sinus. blood pressure 158/69 and o2 saturation 98% on three liters. in general, she is in no apparent distress. she is alert and oriented times three. follows commands. her strength is five out of five in all extremities. sensation is intact. chest is clear to auscultation bilaterally. heart is regular, no s1 and no s2. her abdomen is obese with normoactive bowel sounds, nontender, nondistended. extremities were warm and well perfused. pulses are two plus and equal in her arms. her dorsalis pedis are not palpable but are dopplerable. her carotids are with no bruits. hospital course: the patient was admitted to the cardiac surgery service in preparation of having a coronary artery bypass graft surgery. because of her reportedly low outside hematocrit of 25.5, she was re-evaluated here and had a hematocrit originally of 35.0 but other preoperative values were lower. a hematology/oncology consultation was obtained. there was no evidence of any hemolysis or any acute reason for her low hematocrit. she was transfused with two units and on the morning of the 24th, the patient had adequate preoperative preparation, consented and with a hematocrit of 35.0; so she was taken to the operating room for a coronary artery bypass graft by dr. . please refer to the previous dictated operative note by dr. from . in brief, a three vessel coronary artery bypass graft was performed. the left internal mammary was connected to the left anterior descending. the saphenous vein grafts were connected to the obtuse marginal. she had a coronary artery bypass for 69 minutes and her aorta was crossclamped for 56 minutes. the patient tolerated the surgery well and was transferred to the recovery room intubated, on propofol and dobutamine drips. her intensive care unit course was relatively uncomplicated. she was extubated on the night of surgery and her drips were gradually weaned on days one and two. at various points, she required, in addition to the propofol and dobutamine drips, nitroglycerin and nipride drips. later on the afternoon of postoperative day two, , the patient was transferred to the floor during which she did well. the rest of her hospital course could be described as an organ based approach. cardiovascularly, the patient remained in atrial fibrillation for most of her admission, although she was well rate controlled for most of it. on the day that she was discharged from the unit, , that night she received her first dose of coumadin and she also received some amiodarone inadvertently that evening. on postoperative day three, the patient had a bradycardic episode down to a heart rate of 30. her amiodarone was discontinued and the patient gradually perked. her heart rate remained in a more appropriate rate for the rest of her admission. however, this episode of bradycardia did delay the removal of pacer wires. her pacer wires were kept in place for 48 hours after this episode of bradycardia. after it was seen that she did not become bradycardic and did not require pacing, the wires were discontinued on postoperative day five. during this time, the patient's coumadin was held and she was kept on heparin for her anti-coagulation. after the pacer wires were discontinued, the coumadin was restarted on postoperative day five and the patient was gradually anti-coagulated on p.o. medications until her inr was therapeutic before discharge. in addition, in response to his bradycardic episode, the patient's amiodarone was discontinued. respiratory: there were no major issues during this admission. gastrointestinal: the patient was tolerating a diabetic consistent carbohydrate and cardiac healthy diet soon after extubation and did well on this. endocrine: the patient had diabetes mellitus for which she was controlled with glyburide and her insulin sliding scale. the patient was also hypothyroid. she was continued on liotrix as an inpatient. her last tsh was 9.4. the patient was followed by physical therapy and it was deemed that she would benefit from inpatient rehabilitation prior to going home. this was arranged and the patient was discharged to rehabilitation on in good condition. on the 2nd, the patient was afebrile with stable vital signs. her wounds were clean, dry and intact. her heart rate was regular rate and rhythm with no murmurs, rubs or gallops. her lungs were clear to auscultation bilaterally. her abdomen was still obese but nontender and nondistended with normoactive bowel sounds. her lumbar epidural steroid did have one plus pedal edema. discharge diagnoses: 1. diabetes mellitus type 2. 2. hypothyroidism. 3. hypertension. 4. pernicious anemia. 5. diabetic retinopathy, right eye blindness secondary to retinal detachment. 6. cataracts. 7. skin cancer. 8. candidal esophagitis. 9. hypercholesterolemia. 10. status post transient ischemic attack. 11. goiter. 12. coronary artery disease status post a coronary artery bypass graft on . discharge instructions: 1. it is recommended to follow-up with her primary care physician in one to two weeks. 2. to follow-up with her cardiologist in two to three weeks. 3. to follow-up with dr. in four weeks. discharge medications: 1. aspirin 81 mg once a day. 2. liotrix 120 mg p.o. q. day. 3. glyburide 5 mg p.o. q. day. 4. tylenol 650 mg p.o. q. four. 5. lipitor 20 mg p.o. q. day. 6. percocet as needed for pain. 7. colace as needed for constipation. 8. ferrous sulfate 350 mg p.o. twice a day. 9. zantac 150 mg p.o. twice a day. 10. metoprolol 100 mg p.o. twice a day. 11. warfarin 3 mg p.o. q. day to maintain an inr between 2.0 and 2.5. 12. lasix 20 mg p.o. twice a day. 13. potassium chloride 20 meq p.o. q. day. please refer to the discharge paperwork for the exact doses of the discharge medications for this patient. , m.d. dictated by: medquist36 procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnostic ultrasound of heart transfusion of packed cells diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified atrial fibrillation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes occlusion and stenosis of carotid artery without mention of cerebral infarction pernicious anemia 

Answer: The patient is high likely exposed to