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: sulfa (sulfonamide antibiotics) / flagyl attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: cardiac catheterization history of present illness: ms. is a 73 year old woman who has a history of chest coronary artery disease s/p a myocardial infarction in and a large abdominal aortic aneurysm. a recent cardiac catheterization revealed 3vd. admitted for cabg last month but was unable to tolerate placement on bypass. in her cardiologists office today, she was unable to walk 10 feet and had no breath sounds in her left lung base, thus she is admitted for ?pleural effusion and for possible coronary catheterization as she could not tolerate cabg. . ros: as above. also, pt has had syncope while straining to have a bowel movement on several occasions. pt does c/o black stools which she attributes to taking iron supplements. . pt denies chest pain, pnd, ha, fevers, night sweats, joint pain, myalgias, bloody stool, dysuria. past medical history: abdominal aortic aneurysm, diabetes mellitus, myocardial infarction in , diverticulitis, neuropathy, sciatica, asthmatic, bronchitis, bursitis rt shoulder, rotator cuff tear, dry eyes social history: ms. is a former smoker who quit 17 yrs ago, with an 80 pack/yr history. she denies drinking alcohol or illicits. she lives with her daughter. family history: noncontributory physical exam: physical examination: vs: t=99.4...bp=98/58 (r), 130s systolic on l ...hr=102...rr=20...o2 sat= 99% ra general: 73f in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple, jvp does not appear elevated. cardiac: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were mildly labored, no accessory muscle use. reduced breath sounds at l base. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not palpable. extremities: no c/c. no femoral bruits. mild pitting edema l>r (s/p recent l saphenous v removal). c/o some numbness on the lateral side of her l leg. feet cool skin: thoracotomy site and saphenous v site healing well. pulses: right: carotid 2+ dp 2+ left: carotid 2+ dp 2+ pertinent results: on discharge: 140 | 102 | 15 ---------------136 4.3 | 30 | 0.9 5.3>29.7<463 inr 1 albumin 3.3 pleural fluid: wbc 400, rbc , pmns 15, lymphs 30, monos 19, eos 16, macrophages 14. tot prot 3.6 (blood tpro 5), glucose 117, ldh 193 (blood ldh 250), amylase 47, alb 2.5 cath : "1. planned pci. access was quite difficult. we used a micropuncture set to get access in rfa but had to use a glidewire to negotiate the tortuous iliacs and aorta. we ultimated were able to get into ascending aorta and exchanged for a amplatz wire and then put up a 6f 90cm shuttle sheath. 2. limited hemodynamics with bp 123/67 with hr 82 in sinus. 3. poba of om1 with 2.25mm balloon resulting in dissection with good flow. final diagnosis: 1. three vessel coronary artery disease. 2. poba of om1" brief hospital course: 73f c 3vd and aaa, as well as dm, copd and mmp now p/w increasing doe. pt does have large l pleural effusion s/p cabg which was drained on , but has been reaccumulating since then. pt also had cath on which resulted in a dissected lcx. she was admitted to the unit for hypotension on , rp bleed and pericardial effusion ruled out and hypotension resolved c ivf and decreased bblocker. c/o l shoulder pain which seems msk in origin (reproducible by pressing on her shoulder and reproducible with abduction of shoulder) . # coronaries: 3vd on cath from , attempted cabg but pt could not tolerate bypass. now s/p cath on c no stents, dissection of left circumflex. she was ruled out for mi. she was continued on aspirin and started on plavix, but the plavix was discontinued as patient did not recieves stents and may need thoracentesis or pleurex tube in the next few weeks. pt had episode of nausea and lightheadedness which was similar to her prior mi in on depressions in v4-v6. she was ruled out for mi, and the ekg had normalized by the next day. the st depressions were attributed to demand tachycardia. pt was continued on rosuvastatin. . # pump: pt c systolic chf c ef of ~40%. her metoprolol was decreased from 25 to 12.5 as her blood pressures were consistently in the 90s on the higher dose. of note, pt has hypotensive for several hours on the day following her first thoracentesis (pericardial eff and rp bleed were ruled out) and pt responded well to 1lns. . # rhythm: pt was in sinus rhythm and monitored on telemetry throughout her admission. her rate was usually in the high 90s. . # l pleural effusion: pt was found to have a large left pleural effusion believed to be her recent cabg. she received diagnostic/therapeutic thoracentesis on admission which reaccumulated over ~36 hours. pt recieved a second thoracentesis on with a small amount of reaccumulation, but less than the first time. both samples were sent for analysis and were found to be exudative which is consistent with post-cabg pleural effusion. fluid was also sent for cytology, which is pending. pt was started on lasix 20 to try to limit reaccumulation, which she tolerated well. . # copd/asthma-continued home copd/asthma medicines. pt did occasionally recieve albuterol nebs with good result. . # l shoulder pain: pt had some left shoulder pain which developed after her first thoracentesis and radiated to her elbow, likely musculoskeletal in origin (though pt was ruled out for mi again when she had this pain). she will follow up with her pcp 1 week. . # osteopenia: pt was found to be osteopenic by cxr, and was started on calcium and vitamin d. she may benefit from a dexa scan as an oupatient. . # anemia: improved from baseline, trended throughout her admission. felt to likely be her mmp. . # continued rest of home meds (allergy meds, neuropathic pain meds) . # dm: d/ced rosiglitazone and started on iss as inpt. her blood sugars were found to be in the 140s to 150s so rarely recieved coverage with humalog. she can restart her rosiglitizone. . #pt consulted and believed she would benefit from rehab. . fen: diabetic cardiac diet . prophylaxis: heparin sc 5000 tid, colace, senna prn . daughter's cell is code: full medications on admission: formoterol fumarate 12 mcg capsule, w/inhalation device sig: one (1) inhalation twice a day. loratidine sig: one (1) 10mg once a day. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: 1-2 drops ophthalmic prn (as needed) as needed for dry eyes. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). rosiglitazone 2 mg tablet sig: two (2) tablet po once a day. duloxetine 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) inhalation every four (4) hours as needed for shortness of breath or wheezing. nizatidine 150 mg capsule sig: one (1) capsule po once a day. budesonide 180 mcg/inhalation aerosol powdr breath activated sig: inhalation at bedtime. metoprolol tartrate 25 mg aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). rosuvastatin 20 mg tablet sig: one (1) tablet po daily (daily). gabapentin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours). tyelenol #3 discharge medications: 1. potassium chloride 10 meq capsule, sustained release sig: one (1) capsule, sustained release po once a day. disp:*30 capsule, sustained release(s)* refills:*2* 2. formoterol fumarate 12 mcg capsule, w/inhalation device sig: one (1) inhalation twice a day. 3. loratidine sig: one (1) 10mg once a day. 4. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dry eyes. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. rosiglitazone 2 mg tablet sig: two (2) tablet po once a day. 7. duloxetine 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 8. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) inhalation every four (4) hours as needed for shortness of breath or wheezing. 9. nizatidine 150 mg capsule sig: one (1) capsule po once a day. 10. budesonide 180 mcg/inhalation aerosol powdr breath activated sig: inhalation at bedtime. 11. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 12. aspirin 81 mg tablet enteric coated, chewable sig: one (1) tablet, chewable po daily (daily). 13. rosuvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 14. gabapentin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours). 15. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain for 7 days. disp:*25 tablet(s)* refills:*0* 16. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 17. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 18. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 19. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 20. tylenol #3 300/30 1-2 tabs po q6h prn pain 21. ranitidine 150 discharge disposition: extended care facility: academy manor of discharge diagnosis: primary diagnoses: pleural effusion, coronary artery disease, chf secondary diagnoses: aaa, diabetes, dyslipidemia, neuropathy, sciatica, asthma, copd, seasonal allergies, gerd discharge condition: fair discharge instructions: you were admitted to the hospital because of shortness of breath. we found that you had a fluid accumulation in your chest (called a pleural effusion) which can happen after heart surgery. we drained it twice and will continue to watch it. you also have some coronary disease. we tried to put a stent in one of your coronary arteries during a procedure called coronary catheterization, but we were not able to do that. lastly, you had some left arm pain after the procedures to drain fluid in your lungs, this was treated with percocet. please mention this to dr if it has not resolved by your appointment. at rehab (these instructions are for rehab not for patient): please monitor vital signs at least 4 times daily. please contact dr at for sbp < 90. please keep o2 saturations >90%. please check chem-7 on on . please also check a chest xray on friday . please fax results to dr at . once you go home (for patient): please adhere to the medicine list that they give you when you go. you will go to rehab on a water pill (called lasix) but you may not need it by the time you go home. we did start you on calcium and vitamin d for your bones, please do continue to take those when you are at home. please weigh yourself every morning, call your doctor if your weight changes by > 3 lbs. adhere to 2 gm sodium diet please do not drink more than 2 liters of fluid per day. followup instructions: please see your primary care doctor, dr , on wednesday at 11:45am you have an appointment to see your lung doctor, dr , on tuesday at 4:15pm you have an appointment to see your cardiologist, dr , at 1:45 on wednesday, you have an appointment to see your cardiac surgeon at , dr r. phone: date/time: 2:30 you have an appointment to see your vascular surgeon at , dr phone: date/time: 10:45 procedure: injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter thoracentesis thoracentesis angiocardiography of right heart structures excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery 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 accidental puncture or laceration during a procedure, not elsewhere classified hemorrhage complicating a procedure old myocardial infarction cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure chronic systolic heart failure chronic obstructive asthma, unspecified abdominal aneurysm without mention of rupture disorder of bone and cartilage, unspecified dissection of coronary artery 

Answer: The patient is high likely exposed to