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: the patient is an 83-year-old woman whose problems began with chronic back pain usually controlled with tylenol. she noted an exacerbation on and was admitted to the for low back pain. during her work-up there she received an x-ray which confirmed a compression fracture at the l3 level. she was managed conservatively with physical therapy. the patient did, however, develop chest pain and shortness of breath on . ultimately, the patient ruled in for a myocardial infarction with a peak cpk of 120 and a peak troponin of 5.0. the patient was treated per their protocol with lovenox and plavix, given her allergy to aspirin. she was continued on her other cardiac medications including nitrates, beta blockade and ace inhibitor. the patient was diuresed and symptomatically improved within 12 hours. there was discussion about cardiac catheterization but given resolution of symptoms, the patient deferred the option of cardiac catheterization. the patient was transferred back to her facility and was otherwise asymptomatic until when the patient developed persistent severe chest pain in the morning. the patient also had palpitations. she was brought in at that time for probable cardiac catheterization and evaluation of her chest pain. past medical history: 1. congestive heart failure. 2. osteoporosis, lumbar fracture. 3. celiac sprue. 4. atrial fibrillation. 5. history of urinary retention. 6. history of syndrome of inappropriate diuretic hormone. 7. history of pneumonia. 8. myocardial infarction. medications on admission: 1. plavix 75 mg q.d. 2. magnesium oxide 400 mg b.i.d. 3. digoxin 0.125 mg q.d. 4. colace 100 mg b.i.d. 5. multivitamin q.d. 6. vitamin c 250 mg q.d. 7. tums 500 mg t.i.d. 8. lisinopril 40 mg q.d. 9. iron sulfate 325 mg q.d. 10. macrobid 100 mg p.o. q.h.s. 11. coumadin 2 mg q.d. 12. aldactone 45 mg q.d. 13. fosamax 70 mg q. week. 14. lopressor 75 mg b.i.d. 15. isordil 40 mg t.i.d. 16. salt tablets one gram t.i.d. 17. lasix 20 mg monday, wednesday, and friday. 18. percocet p.r.n. physical examination: on admission in general the patient was an elderly woman in no acute distress. vital signs: temperature 97.8, heart rate 82, blood pressure 140/80, respiratory rate 18, saturating 98% on two liters nasal cannula. heent were normocephalic, atraumatic, extraocular movements intact, pupils were equal, round, and reactive to light, anicteric, normal sclerae. neck was supple, midline without masses or lymphadenopathy. chest was clear to auscultation bilaterally. cardiovascular was irregularly irregular. abdomen was soft, nontender, nondistended without masses or organomegaly. extremities were warm, noncyanotic, nonedematous x 4. neurologic examination was alert and oriented with no gross defect. laboratory data: complete blood count was 6.7/30.2/322. chemistries were 124/4.6/92/25/11/0.3/100. inr was 1.8. hospital course: the patient was admitted for work-up of her chest pain and history of non-st elevation myocardial infarction. the patient underwent a cardiac catheterization on which revealed the ejection fraction of 45%, a right dominant coronary artery system with severe three-vessel disease. also noted was mild mitral regurgitation as well. the patient at that time had evaluation by the cardiothoracic surgery team. it was decided to proceed with coronary artery bypass grafting. on the patient was taken to the operating room for coronary artery bypass grafting x 3 with left internal mammary artery to the left anterior descending coronary artery, left radial to the obtuse marginal and right radial to the rpl. the patient tolerated the procedure well. she was subsequently extubated on postoperative day one. the patient was maintained on multiple drips including insulin, milrinone, neo-synephrine, nitroglycerin and propofol. the patient was in persistent atrial fibrillation in the csru. she did have a low urine output for which the renal service was consulted. they came up with an assessment of oliguria with hyponatremia and acute renal failure. this may be due to the dye load. in addition, the patient's low cardiac output and congestive heart failure picture prompted recatheterization. upon recatheterization, the left internal mammary artery anastomosis distally appeared to be kinked. the patient was taken back to the operating room on for reexploration of left internal mammary artery torsion. the anastomosis was repositioned to the left anterior descending coronary artery. again, the patient was subsequently taken to the csru for close monitoring. the renal service continued to follow for renal failure and mucomyst was initiated. the ultimate etiology for renal failure was thought to be atn, multifactorial, with prerenal component due to congestive heart failure, contrast nephropathy, ischemic atn from intraoperative hypoperfusion. in the evening of the patient was found to have a focal neurologic deficit with difficulty moving the left upper extremity. stroke service was consulted for likely embolic event given the patient's atrial fibrillation and occasional conversion to sinus rhythm. head ct revealed a hypodensity over the right frontoparietal area in the posterior watershed distribution. the stroke service recommended anticoagulation with coumadin, keeping the blood pressure greater than 130/80, mri and carotid ultrasound. throughout this period the patient remained in atrial fibrillation with occasional rapid response. the patient did respond to amiodarone and electrical cardioversion x 3. however, the patient ultimately remained in atrial fibrillation. the remainder of her hospital stay was largely unremarkable. she was transferred to the floor on postoperative days 11 and eight. nutrition was consulted in regards to her p.o. intake and swallowing studies were obtained which the patient passed. there was a recommendation for a soft solid diet with thin liquids. the patient also was thought to benefit from supplemental nutrition. during her period on the floor the patient's main issues were simply diuresis as well as anticoagulation for atrial fibrillation. ultimately, the patient was discharged on postoperative days 13 and 11 tolerating a regular diet, cardiac, and gluten free, with adequate pain control on p.o. pain medications and having a therapeutic inr. the patient reported no more symptoms of chest pain or angina. she had some residual left upper arm weakness with recommended follow up as an outpatient by neurology. the patient's creatinine returned to levels. physical examination on discharge, in general she was in no acute distress, pleasant. her chest was clear to auscultation bilaterally. cardiovascular was irregularly irregular. abdomen was soft, nontender, nondistended. extremities were warm, noncyanotic, with 2+ edema. there was some noted left upper extremity proximal weakness. neurologic examination was alert and oriented x 3. laboratory studies on discharge were complete blood count 12.6/11.5/35.6/280. pt was 22.6, inr 3.4, ptt 35.7. chemistries were 143/5.0/109/28/26/0.5/107. calcium was 7.9, magnesium 1.8, phosphorous 1.9. discharge medications: 1. lopressor 12.5 mg b.i.d. 2. lasix 20 mg b.i.d. 3. percocet 5/325 q. 4 hours p.r.n. 4. colace 100 mg b.i.d. 5. plavix 75 mg q.d. 6. imdur 60 mg q.d. 7. nystatin 5 ml q.i.d. 8. miconazole powder t.i.d. p.r.n. 9. coumadin 1 mg q.d., titrate as necessary for inr of between 2 and 3. discharge condition: stable. disposition: to rehabilitation. diet: cardiac, gluten free. discharge instructions: 1. the patient should follow up with cardiology within 1-2 weeks and address the need for continued diuresis as well as adjustment of cardiac medications at that time. 2. the patient should follow up with the neurology service in between 2-4 weeks for evaluation of her right-sided cerebrovascular accident. 3. the patient should follow up with dr. in four weeks' time. the patient should also have inr checks at least twice weekly with a goal inr of between . her anticipated coumadin dosage will probably be 1-2 mg q.d. 4. the patient will also require aggressive physical therapy with transfer and balance training, eventual gait training, and ambulation strengthening. the patient may ultimately need a walker. 5. the patient should also adhere to a cardiac and gluten-free diet supplemented by boost or equivalent t.i.d. , m.d. dictated by: medquist36 procedure: 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 coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization diagnostic ultrasound of heart other esophagoscopy reopening of recent thoracotomy site other repair of vessel other division of soft tissue diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified hyposmolality and/or hyponatremia cardiac complications, not elsewhere classified atrial fibrillation other complications due to other cardiac device, implant, and graft urinary complications, not elsewhere classified 

Answer: The patient is high likely exposed to