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 / codeine / tetanus toxoid / fish oil attending: chief complaint: chest pain ans shortness of breath major surgical or invasive procedure: coronary artery bypass graft x 3 (lima to lad, svg to om, svg to pda), aortic valve replacement w/ 21mm st. tissue valve history of present illness: 83 y/o female with known coronary artery disease s/p stent in and s/p myocardial infarction in now with increased dyspnea on exertion and more frequent angina. presented to osh 2 wks ago with sob. r/o for mi and treated for community acquired pneumonia and discharged. had 2 episodes of angina and sob since that admission. transferred from rehab to mwmc for cardiac cath. cath revealed three vessel disease. she was than transferred to for surgical management. past medical history: coronary artery disease s/p lad stent, h/o aortic stenosis, diabtes mellitus, h/o breast cancer s/p radiation/chemo/implants, congestive heart failure, hypertension, chronic pleural effusion, diverticulitis, s/p colonic resection , chronic renal insufficiency, pulmonary hypertension social history: lives with son and his family. denies tobacco or etoh use. family history: father and brother with cad. physical exam: vs: 82 108/48 18 97% 68.4kg gen: nad neuro: a&o x 3, mae, non-focal heent: perrl, eomi, anicteric, nl buccosa neck: supple, from, -carotid bruit pulm: ctab cv: rrr -c/r/m/g abd: soft, nt/nd, +bs ext: warm, -edema, -varicosities pertinent results: cxr: compared with , there is new diffuse haziness over the right hemithorax consistent with a moderate pleural effusion. there is a triangular density at the right lung base, which may indicate right middle lobe collapse. the left lung remains clear. no overt chf. cnis: there is no significant common or internal carotid stenosis bilaterally. chest ct: 1. longstanding, large right pleural effusion with relaxation atelectasis. no pleural mass or other evidence of intrathoracic malignancy or infection. small left pleural effusion. 2. widespread vascular calcifications including three major coronary arteries. significant narrowing of the origin of innominate trunk may be present. calcific aortic stenosis. 3. right breast skin thickening with retroareolar mass containing clips and calcifications. all the findings might represent post- treatment appearance but in the absence of previous imaging including dedicated mammography recurrence cannot be excluded. 4. general fat stranding might represent anasarca. chest ct: 1. improving small right pleural effusion without evidence for underlying mass. 2. right breast skin thickening and retroareolar mass with clips and calcifications, most likely postoperative but indeterminate. further imaging including dedicated mammography would be necessary if there is clinical suspicion. 3. widespread atherosclerotic disease involving the aorta, its major branches, and coronary arteries. echo: pre-bypass: the left atrium is mildly dilated. moderate to severe spontaneous echo contrast is present in the left atrial appendage. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is severe regional left ventricular systolic dysfunction with focalities in the mid and apical anterior, anteroseptal, inferoseptal walls. there is severe apical akinesis and apical inferior and lateral walls as well. rest of the segments are mildly hyponetics. overall left ventricular systolic function is severely depressed with an ef of 25%. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the thoraic aorta. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). mild to moderate (+) aortic regurgitation is seen. note the low cardiac output as the peak and mean gradients are 28 and 16mm of hg only. no inotropes given pre bypass to see the change in gradient with the increase in cardiac output due to the severe coronary lesions. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is no pericardial effusion. post_bypass: patient is on milrinone (0.25mcg/kg/min), epinephrine (0.02mcg/kg/min). thoracic aortic contour is preserved. normal rv systolic function. mild improvement in the overall lv systolic function to lvef of 30%-35%. mild mr. is seen well seated in the native aortic positiion, with no leaks and a residual mean gradient of 16mmof hg. cxr: questionable new loculated right basilar pneumothorax status post chest tube removal with either atelectasis or fluid within the fissure on the right. 2. slightly increased left pleural effusion with underlying atelectasis/consolidation. 05:00pm blood wbc-8.5 rbc-3.40* hgb-9.8* hct-29.8* mcv-88 mch-28.9 mchc-33.0 rdw-17.2* plt ct-396# 06:55am blood wbc-5.5 rbc-3.66* hgb-10.4* hct-32.1* mcv-88 mch-28.5 mchc-32.5 rdw-17.7* plt ct-308 07:00am blood wbc-9.0 rbc-3.36* hgb-9.9* hct-30.0* mcv-89 mch-29.5 mchc-33.1 rdw-16.7* plt ct-165 05:00pm blood pt-12.6 ptt-53.0* inr(pt)-1.1 06:55am blood pt-13.0 ptt-73.0* inr(pt)-1.1 03:04am blood pt-13.6* ptt-35.9* inr(pt)-1.2* 05:00pm blood glucose-335* urean-62* creat-2.0* na-134 k-4.6 cl-104 hco3-21* angap-14 06:55am blood glucose-113* urean-69* creat-1.9* na-141 k-4.3 cl-105 hco3-26 angap-14 07:00am blood glucose-77 urean-82* creat-2.5* na-139 k-4.2 cl-104 hco3-25 angap-14 07:00am blood calcium-8.3* phos-4.3 mg-2.2 brief hospital course: as mentioned in the hpi, ms. was transferred to for surgical care. she underwent the routine pre-operative testing. a dental consult was performed given the planned aortic valve replacement. on her pre-op chest x-ray there was a new diffuse haziness over the right hemithorax consistent with a moderate pleural effusion. she also underwent chest ct which revealed a right breast skin thickening with retro areolar mass. the thoracic and pulmonary services were for effusion drainage and a breast surgery consult was obtained secondary to new right breast findings. her effusion was negative for malignant cells. medical management was continued for several days prior to surgery and was treated for uti with antibiotics. she was cleared for surgery by thoracic and breast surgical services. she will resume her close observation at for her history of breast cancer. on she was taken to the operating room where she underwent coronary artery bypass grafting to three vessels and aortic valve replacement with a tissue prosthesis. please see operative report for surgical details. within 24 hours she was weaned from sedation, awoke neurologically intact and was extubated. she required inotropic support for several days which was eventually weaned off. beta blockers and diuretics were started and she was gently diuresed towards he pre-op weight. chest tubes were removed on post-op day two and epicardial pacing wires on post-op day four. do to a rising creatinine her diuretics were stopped on post-op day four. on post-op day five she was transferred to the telemetry floor for further care. as her creatinine stabilized, low dose diuretics were resumed given her peripheral edema and preoperative daily requirement of 80mg daily. her electrolytres and renal function will be followed at rehab and her dose will be adjusted based on her volume status. the physical therapy service was for assistance with her postoperative strength and mobility. ciprofloxacin was started for a urinary tract infection. the nutritionist recommended supplemental shakes between meals which were started. the wound care nurse for a sacral/coccyx ulcer and recommendations were made and closely followed to protect from further skin breakdown. her plavix was continued given her recent drug eluting stents. the length of treatment with plavix will be decided by her cardiologist dr. . ms. continued to make steady progress and was discharged to rehabilitation on . she will follow-up with dr. , her cardiologist and her primary care physician. will also follow-up with the breast at for further care of her right breast mass. medications on admission: glipizide 5mg qam 2.5mg qpm, lisinopril 2.5mg qd, lasix 80mg qd, lopressor 100mg , lipitor 40mg qd, plavix 75mg qd, aspirin 325mg qd discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. glipizide 5 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 4. glipizide 5 mg tablet sig: 0.5 tablet po qpm (once a day (in the evening)). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. 8. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 10. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) neb inhalation q6h (every 6 hours) as needed. 11. tramadol 50 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. 12. plavix 75 mg tablet sig: one (1) tablet po once a day: length of treatment to be addressed by cardiologist. discharge disposition: extended care facility: rehab & nursing center - discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 3 aortic stenosis s/p aortic valve replacement pmh: diabtes mellitus, h/o breast cancer s/p radiation/chemo/implants, s/p lad stent, congestive heart failure, hypertension, chronic pleural effusion, diverticulitis, s/p colonic resection , chronic renal insufficiency, pulmonary hypertension discharge condition: stable 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. 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. 6) no driving for 1 month. 7) take lasix as directed. weigh patient daily and follow/replete electrolytes as needed. after 7 days, reassess if more diuretic needed. 8) please monitor bun/creatine at rehab. 9) take ciprofloxacin for 5 more days to stop . 10) call with any questions or concerns. followup instructions: dr. () in 1 month ( dr. (cardiologist) in weeks dr. (pcp) in weeks ( please call all providers for appointments procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries thoracentesis open and other replacement of aortic valve with tissue graft transfusion of packed cells continuous intra-arterial blood gas monitoring diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders personal history of malignant neoplasm of breast old myocardial infarction unspecified disorder of kidney and ureter primary pulmonary hypertension family history of ischemic heart disease lump or mass in breast personal history of irradiation, presenting hazards to health postmastectomy lymphedema syndrome chronic ulcer of other specified sites personal history of other diseases of digestive system breast replacement 

Answer: The patient is high likely exposed to