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: methotrexate / codeine attending: chief complaint: unstable angina major surgical or invasive procedure: - emergency coronary artery bypass graft x4: left internal mammary artery to left anterior descending artery and saphenous vein grafts to obtuse marginal-1 and 2 and the posterior descending arteries. - cardiac catheterization history of present illness: this 85 year old white female presented to an oiutsidhospital with interscapular back pain. ecg suggested ami and transferred here. cpk 900->1300 this am with recurrent pain on in ntg. ecg changes so taken to lab. in lab bp 80s with sa02 80s. bp to 100 off ivntg. referred for urgent cabg. iabp placed in lab as temporizing measure and iv lasix given. past medical history: dermatomysitis diabetes cva myocardial infarction social history: pt is remote smoker, stopped 30 yrs ago, non drinker has iddm- tests x day and uses ssi.glaucoma uses gtts- will find out which. family history: family hx: pts father died of mi in his 50s, sisiter at 40yo sx: hysterectomy and back sx. physical exam: pulse:80 resp:22 o2 sat: 88% b/p right:100/56 left: height: weight: general: skin: dry intact dermatomyositits heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right:2 left:2 dp right:2 left:2 pt :2 left:2 radial right:2 left:2 carotid bruit right: n left:n pertinent results: 02:10am blood wbc-12.0* rbc-3.98* hgb-11.7* hct-35.9* mcv-90 mch-29.3 mchc-32.5 rdw-14.2 plt ct-283 02:10am blood pt-12.7 ptt-26.3 inr(pt)-1.1 02:10am blood glucose-162* urean-35* creat-1.7* na-140 k-5.1 cl-106 hco3-24 angap-15 10:20am blood alt-29 ast-182* ck(cpk)-1203* alkphos-82 amylase-49 totbili-0.3 dirbili-0.1 indbili-0.2 06:48am blood ck-mb-166* mb indx-12.2* ctropnt-2.43* 10:20am blood %hba1c-7.1* ==================================== 06:00am blood wbc-10.7 rbc-3.28* hgb-9.6* hct-29.4* mcv-90 mch-29.2 mchc-32.6 rdw-15.9* plt ct-237 06:00am blood plt ct-237 06:00am blood glucose-100 urean-34* creat-1.4* na-144 k-4.1 cl-107 hco3-30 angap-11 =================================== cardiac catheterization 1. selective coronary angiography in this right-dominant system demonstrated three-vessel disease. the lmca had a 30 percent ostial lesion. the lad had serial 90% and 70% stenoses in the proximal and mid portions. the lcx had an eccentric thrombotic lesion in om1. the rca was totally occluded in the mid portion with left to right collaterals. the acute marginal had a 70% lesion. 2. resting hemodynamics revealed elevated right- and left-sided filling pressures with an rvedp of 17 mm hg and a pcwp of 34 mm hg. the cardiac index was preserved at 1.9 l/min/m2. there was elevated pulmonary arterial systolic pressure with a pa systolic of 53 mm hg. there was normal systemic arterial pressure with a systolic pressure of 96 mm hg. there was no gradient upon pullback of the catheter from the left ventricle to the aorta. 3. intraortic balloon pump was placed. =========================================== echo pre-bypass: the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. a patent foramen ovale is present. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is severe regional left ventricular systolic dysfunction with severe hypokinesis to akinesis in the lad and rca distribution. overall left ventricular systolic function is severely depressed (lvef= 20 %). right ventricular chamber size and free wall motion are normal. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. there is no blunting or systolic reversal in the pulmonary veins on both sides. vena contracta was measured at 4 to 5mm. no provocative measures were done due to the acute condition of the patient. there is no pericardial effusion. dr. was notified in person of the results on ms. before surgical incision. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including epinephrine 0.02mcg/kg/, iabp, vasopressin 3units/hour normal rv systolic function. moderate mr. mild to moderate tr. there is some improvement in the wall motions of the mid anterior wall. overall lvef 25%. thoracic aorta is intact.. ====================================================== radiology report chest (portable ap) study date of 7:43 am final report history: emergency cabg. chest tube removed. impression: ap chest compared to : small pleural drainage catheter is still coiled in the right hemithorax, but bilateral basal pleural tubes have been removed. tiny bilateral apical pneumothorax and equally tiny layering pleural effusions are unchanged. atelectasis at the left base is mild. left lung is otherwise clear. normal postoperative cardiomediastinal silhouette. dr. ====================================================== brief hospital course: ms. was transferred to the on for further management of her myocardial infarction. on she underwent a cardiac catheterization which revealed severe three vessel coronary artery disease. an intra-aortic balloon pump was placed for unstable angina in the setting of a myocardial infarction. the cardiac surgical service was consulted and elected to take her to the operating room emergently. on the morning of , ms. was taken to the operating room where she underwent coronary artery bypass grafting to four, please see operative report for details in summary she had emergency coronary artery bypass graft x4: left internal mammary artery to left anterior descending artery and saphenous vein grafts to obtuse marginal-1 and 2 and the osterior descending arteries. her bypass time was 91 minutes with a crossclamp of 53 minutes. she tolewrated the operation well and postoperatively she was taken to the intensive care unit for monitoring. she was kept sedated after surgery to allow for hemodynamic stability. on pod2 the intra aortic balloon pump was weaned and removed, she remained hemodynamically stable. following iabp removal her sedation was stopped she awoke neurologically intact was weaned from the ventilator and extubated. she was somewhat lethargic following extubation and remained in the icu for pulmonary toilet for another day. on pod 4 she was transferred to the stepdown floor for continued physical therapy and post-operative care. beta blockade, aspirin and a statin were resumed, her activity was advanced. because ms had a persistant airleak from her pleural chest tubes only her mediastinal chest tubes were removed. following removal of her mediastinal chest tubes she developed a right pneumothorax. thoracic surgery was consulted and a pig tail catheter was placed, however she then developed a left side pneumothorax requiring a chest tube. these remained to suction for two days then were set to water seal which she tolerated. the pleural tubes were then clamped and following chest xray were removed, the chest xray showed stable apical pneumothorax bilat. the following morning the pigtail catherter was removed per thoracic surgery recommendations, a followup chest xray was unchanged from earlier in the day. the remainder of her hospital course was uneventful and she was discharged to rehabilitation at ledgewood skilled nursing and rehab in on pod 10. medications on admission: prednisone 5mg/d, aggrenox 25/200 daily, atenolol 25mg daily, isosorbide 60mg daily, humalog ssi new meds: lopressor 25mgbid,plavix 75mg ,senna,ismn 60mg/d,asa 325mg/d discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 3. leflunomide 10 mg tablet sig: one (1) tablet po daily. 4. dorzolamide 2 % drops sig: one (1) drop ophthalmic (2 times a day). 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 6. potassium chloride 10 meq tablet sustained release sig: one (1) tablet sustained release po daily (daily). 7. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 8. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 9. tramadol 50 mg tablet sig: 0.5 tablet po q4h (every 4 hours) as needed for pain. 10. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 11. multivitamin tablet sig: one (1) tablet po daily (daily). 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 13. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 14. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 15. insulin lispro 100 unit/ml solution sig: sliding scale subcutaneous qac&hs. discharge disposition: extended care facility: rehab discharge diagnosis: cad s/p cabgx4(lima-lad, svg-om1, svg-om2, svg-pda) myocardial infarction/pre-op iabp dermatomysitis diabetes cva discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks from date of surgery. 6) no driving for 1 month or while taking narcotics for pain. 7) call with any questions or concerns. followup instructions: please follow-up with dr. in 1 month. ( please follow-up with dr. in weeks. please follow-up with dr. in weeks. md procedure: insertion of intercostal catheter for drainage (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 aortography implant of pulsation balloon nonoperative removal of heart assist system diagnoses: acidosis other iatrogenic hypotension thrombocytopenia, unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation pulmonary collapse 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 long-term (current) use of insulin family history of ischemic heart disease late effects of cerebrovascular disease, aphasia acute edema of lung, unspecified dermatomyositis 

Answer: The patient is high likely exposed to