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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: coronary bypass grafting x4 of left internal mammary artery to left anterior descending coronary artery; reverse saphenous vein single graft from aorta to ramus ntermedius coronary artery; reverse saphenous vein single graft from aorta to the second obtuse marginal coronary artery; reverse saphenous vein single graft from aorta to the distal right coronary artery. history of present illness: 88 year old female s/p pci to rca x 3,ptca to lad who presents with worsening chest pain over the past month. she has been experiencing intermittent chest pressure for the past year, both with activity and with rest. frequency has increased in the past month and she has been using sl nitro more frequently for pain (up to 4x/day). chest pain is a midsternal pressure radiating to right and left chest, around , lasts 10-15 minutes and comes and goes throughout the day. she has associated sob and vague feeling of fatigue, no diaphoresis, nausea, or radiation. pt says sometimes it occurs 2 days in a row and other days she is cp free, though overall increased frequency since . chest pain usually induced with exertion though has occurred at rest, it is relieved with nitro. last episode was 4 days ago while she was taking out the garbage, and she has been chest pain free since then. she called her physician and was told to come to the ed. she was admitted for further evaluation. past medical history: past medical history: dyslipidemia hypertension s/p mi , s/p pci to rca x 3, ptca to lad spinal stenosis hsv osteoarthritis monoclomal gammopathy past surgical history: s/p right total hip replacement s/p right shoulder surgery social history: widowed, house wife, lives in 1-floor home. has 1 son who live 10 min away. does her own cooking and shopping, not able to drive. former smoker cigs/day for 20 years. rare etoh use. family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: on admission: vs: 103/47 56 18 94%ra general: well-appearing woman in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple, elevated jvp, no lad cardiac: pmi located in 5th intercostal space, midclavicular line. bradycardic, normal s1, s2. no m/r/g. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. diffuse wheezing and rhonchi at bases, no rales, good inspiratory effort with decreased breath sounds at bases abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: pertinent labs: --------------- 03:15pm blood wbc-9.0 rbc-4.42 hgb-13.0 hct-38.6 mcv-88 mch-29.5 mchc-33.7 rdw-13.4 plt ct-310 03:15pm blood neuts-72.8* lymphs-19.2 monos-6.0 eos-1.4 baso-0.6 03:15pm blood pt-13.2 ptt-23.6 inr(pt)-1.1 03:15pm blood glucose-109* urean-15 creat-0.8 na-139 k-4.5 cl-97 hco3-32 angap-15 12:00pm blood alt-21 ast-27 ld(ldh)-110 ck(cpk)-29 alkphos-60 amylase-63 totbili-0.4 dirbili-0.1 indbili-0.3 03:15pm blood ctropnt-<0.01 09:10pm blood ck-mb-2 ctropnt-<0.01 06:30am blood ck-mb-2 ctropnt-<0.01 06:30am blood calcium-9.9 phos-4.3 mg-2.3 12:00pm blood %hba1c-6.0* eag-126* imaging/procedures: ------------------- cxr : no acute cardiac or pulmonary process. . cardiac cath : 1. coronary angiography in this right-dominant system demonstrated three-vessel disease. the lmca was heavily calficied with a distal 60-70% stenosis. the lad was also heavily calcified and had an ostial 80%stenosis, a proximal-mid 60% stenosis. the septal branches supplied collaterals to the rpda. the lcx had an ostial 50% stenosis and a proximal-mid 30% stenosis. the om1 had an ostial 30-40% stenosis. the lpl was occluded proximally and filled vial left-left collaterals; the distal lcx supplied collaterals to the rpl. the rca had ostial 50% in-stent restenosis extending to a recanalized total occlusion within the previously placed stents. the distal rca filled via right-right collaterals. 2. limited resting hemodynamics revealed normal left-sided filling pressures with lvedp 12mmhg. the systemic arterial blood pressure was initially normal but there was subsequent severe hypertension with sbp 170mmhg. 3. left ventriculography demonstrated an ejection fraction of 54%. there was severe posterobasal hypokinesis, inferoapical hypokinesis, anterobasal mild hypokinesis, and lateral mild hypokinesis. there was 1+ mitral regurgitation. 4. peripheral angiography revealed mild origin plaquing in the left subclavian artery. the lima was a large, patent vessel. final diagnosis: 1. severe lmca and three-vessel coronary artery disease. 2. chronic total occlusion of the rca from in-stent restenosis. 3. normal lv diastolic function. 4. mild diffuse heterogenous lv systolic dysfunction. 5. patent left subclavian artery and lima. . tte: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild to moderate regional left ventricular systolic dysfunction with anteroseptal and anterior hypokinesis. the apex is not well seen. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size is normal. with borderline normal free wall function. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. . carotid u/s: right ica with no stenosis. left ica stenosis <40%. brief hospital course: mrs. is 88 year old woman with cad s/p pci to rca x 3, ptca to lad presents with worsening chest pain over past month. on she was taken to the operating room and underwent coronary bypass grafting x4 of left internal mammary artery to left anterior descending coronary artery;reverse saphenous vein single graft from aorta to ramus intermedius coronary artery; reverse saphenous vein single graft from aorta to the second obtuse marginal coronary artery; reverse saphenous vein single graft from aorta to the distal right coronary artery with dr.. please see operative report for further details. cardiopulmonary bypass time:76 minutes.cross clamp time 59 minutes. she tolerated the procedure well and was transferred to the cvicu intubated and sedated for further invasive monitoring. she awoke neurologically intact and was exubated without incident. all lines and drains were discontinued in a timely fashion. beta- blocker/statin/aspirin and diuresis were initiated. she developed post -operative afib which was treated with amiodarone and anticoagulated with coumadin. she was very sensitve to coumadin and her inr rose quickly to 6.3- coumadn was held and ffp was administered. her inr responded appropraitely and is 2.7 today and she recieved no coumadin. she was cleared for rehab on pod#8 by dr. . she was discharged to rehab today. medications on admission: asa 325 acyclovir 400 mg imdur 120 mg daily lasix 20 mg mowefrisu; 40 mg qam/20 mg qpm tuthsat detrol la 4 mg daily toprol 150 mg daily simvastatin 80 mvi ntg sl prn discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever/pain. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 6. multivitamin tablet sig: one (1) tablet po daily (daily). 7. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 8. acyclovir 400 mg tablet sig: one (1) tablet po q12h (every 12 hours). 9. tolterodine 2 mg tablet sig: one (1) tablet po bid (2 times a day). 10. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 11. amiodarone 200 mg tablet sig: two (2) tablet po once a day: 400mg daily for 7 days then decrease to 200mg daily. 12. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 14. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day): until lower extremity edema resolves. 15. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po q12h (every 12 hours). 16. coumadin 1 mg tablet sig: tablet po once a day: cautious coumadin dosing-senstitve goal 2.0-2.5 for afib. 17. outpatient lab work check inr goal inr 2.0-2.5 for afib. *******sensitive to coumadin******cautious dosing discharge disposition: extended care facility: bay skilled nursing & rehabilitation center - discharge diagnosis: coronary artery disease s/p coronary artery by pass graft x4 dyslipidemia, htn, mi, spinal stenosis, hsv, oa, monoclomal gammopathy, s/p right tkr, s/p right shoulder surgery discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage leg right - healing well, no erythema or drainage. edema 2+ lower extremity discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** - followup instructions: you are scheduled for the following appointments surgeon: dr. phone: date/time: 1:30 please call to schedule appointments with your primary care dr. in weeks cardiologist: dr. **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication afib goal inr 2.0-2.5 first draw anticoagulation will be followed post discharge by dr. procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified essential hypertension acute posthemorrhagic anemia atrial fibrillation percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia old myocardial infarction examination of participant in clinical trial chronic total occlusion of coronary artery monoclonal paraproteinemia 

Answer: The patient is high likely exposed to