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 / chicken derived / attending: chief complaint: chest pain major surgical or invasive procedure: coronary artery bypass grafting x2 with a left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to the ramus intermedius artery history of present illness: 86 year old woman has a history of hypertension, hyperlipidemia, atrial fibrillation on coumadin and breast cancers/p lumpectomy. she reports a long history of chest discomfort that she always dismissed in the past. recently it has been occurring with increasing frequency. it occurs more often with exertion but has also occurred at rest. she describes it as a sharp pain in the mid chest that radiates to the back. recent stress testing was positive for symptoms and ekg changes but perfusion imaging was negative. she was referred for left heart catheterization. she was found to have left main disease and is emergently going to or for cabg with dr. . past medical history: hypertension hyperlipidemia atrial fibrillation on coumadin : invasive ductal left breast cancer s/p lumpectomy glaucoma osteoarthritis appendectomy pernicious anemia right jaw surgery -"lock jaw" constipation osteoporosis social history: race:caucasian last dental exam:upper dentures, several missing teeth with poor repair lives with:niece, ambulates with a cane contact: (great niece): occupation:retired cigarettes: smoked no yes hx: 2.5 packs a day for 25 years, quit 30 years ago other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use family history: premature coronary artery disease- non contributory physical exam: pulse:62 resp:12 o2 sat:98/ra b/p right:155/60 left:156/66 height:5'1" weight:145 lbs general: skin: dry intact skin tag left neck heent: perrla eomi injected right sclera neck: supple full rom x chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema - none varicosities: none superficial veins bilateral shins neuro: grossly intact pulses: femoral right: sheath in place left: 2+ dp right: 1+ left: 1+ pt : 1+ left: 1+ radial right: 2+ left: 2+ carotid bruit right: none left: none pertinent results: admission labs: 10:03am pt-11.7 ptt-28.4 inr(pt)-1.1 10:03am plt count-177 10:03am wbc-6.1 rbc-4.28 hgb-12.9 hct-38.0 mcv-89 mch-30.0 mchc-33.8 rdw-12.5 10:03am glucose-84 urea n-14 creat-1.1 sodium-140 potassium-6.6* chloride-105 total co2-25 anion gap-17 discharge labs: 05:30am blood wbc-9.9 rbc-3.06* hgb-9.0* hct-27.3* mcv-89 mch-29.4 mchc-33.0 rdw-12.7 plt ct-150 05:30am blood plt ct-150 05:30am blood pt-21.5* inr(pt)-2.0* 05:30am blood glucose-79 urean-27* creat-0.9 na-140 k-4.3 cl-104 hco3-30 angap-10 06:10am blood mg-2.4 cath: 1. coronary angiography in this right dominant system demonstrated significant left main disease. the lmca had an 80% distal stenosis. the lad had a mid 40% stenosis. the lcx had no angiographically apparent disease. the rca had a mid 40% stenosis. 2. limited resting hemodynamics revealed elevated systemic arterial pressures at the central aortic level 162/61 mmhg. 3. left ventriculography was deferred. echo: pre-bypass: no spontaneous echo contrast is seen in the body of the left atrium. mild spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with mild hypokinesis of the distal anterolateral wall as well as the anterior wall and apex, the right ventricle displays normal free wall contractility. the ascending aorta is mildly dilated. there is a small fibrinous echodensity in the left ventricular outflow tract 1 cm below the right coronary cusp. there are simple atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. 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. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results in the operating room at the time of the study. post bypass there is noemal biventricular systolic function. valvular function is unchanged. the thoracic aorta is intact after decannulation. no other significant changes from the pre-bypass exam. radiology report chest (pa & lat) study date of 11:47 am final report: in comparison with the study of , there are again bilateral pleural effusions best seen on the lateral projection. no evidence of vascular congestion or acute pneumonia. right ij catheter has been removed. brief hospital course: as mentioned in the hpi, mrs. underwent a cardiac cath on which demonstrated severe left main disease. cardiac surgery was consulted and she was emergently taken to the operating room and underwent a coronary artery bypass graft x 2. please see operative report for surgical details. in summary she had cabg x2 with: left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to obtuse marginal artery. her bypass time was 42 minutes and crossclamp time was 31 minutes. she tolerated the operation well and following surgery she was transferred to the cvicu for invasive monitoring in stable condition. later this day she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was started on beta-blockers and diuretics and gently diuresed towards her pre-op weight. on post-op day two her chest tubes were removed and she was transferred to the step-down unit for further recovery. post-op she was in atrial fibrillation (has a history of chronic atrial fibrillation) and coumadin was started. once on the stepdown floor her hospital course was uneventful. she worked with the nursing and physical therapy staff to increase strength and endurance, her progress was slow. on post-op day three epicardial pacing wires were removed. on pod4 she was cleared for transfer to rehabilitation at either rehab on the whichever the family chooses. medications on admission: alendronate - 70 mg tablet - 1 tablet(s) by mouth weekly bimatoprost - 0.03 % drops - 1 drop eye at bedtime lisinopril - 10 mg tablet - 1 tablet(s) by mouth daily metoprolol tartrate - 25 mg tablet - 0.5 (one half) tablet(s) by mouth twice a day nitroglycerin - 0.3 mg tablet, sublingual - 1 tablet(s) sublingually daily prn you may take up to three tabets five minutes apart. if the pain does not resolve, call 911. simvastatin - 10 mg tablet - 1 tablet(s) by mouth at bedtime timolol - (prescribed by other provider) - 0.5 % drops - 1 drop ou every evening warfarin - 1 mg tablet - 1 tablet(s) by mouth daily dosage adjusted by inr acetaminophen - 325 mg tablet - 1000 mg by mouth three times a day prn aspirin - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth 1 as needed for daily calcium-vitamin d3-vitamin k - 500 mg-200 unit- mcg tablet, chewable - 1 tablet(s) by mouth three times a day discharge medications: 1. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic daily (daily). 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (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. mupirocin calcium 2 % ointment sig: one (1) appl nasal (2 times a day) for 5 days: stop . 7. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 8. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/temp. 9. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 10. warfarin 1 mg tablet sig: as directed tablet po once daily at 4 pm: target inr 2-2.5. 11. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). 12. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. 13. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po daily (daily) for 2 weeks. 14. warfarin 1 mg tablet sig: one (1) tablet po once (once) for 1 doses: dose. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 2 past medical history: hypertension hyperlipidemia atrial fibrillation on coumadin : invasive ductal left breast cancer s/p lumpectomy glaucoma osteoarthritis appendectomy pernicious anemia right jaw surgery -"lock jaw" constipation osteoporosis discharge condition: alert and oriented x3 nonfocal ambulating with assistance incisional pain managed with tramadol incisions: sternal - healing well, no erythema or drainage leg right evh- healing well, no erythema or drainage. edema: 1+ bilat 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. on @1pm cardiologist: dr. on phone: date/time: 10:20 primary care: , md phone: date/time: 9:30 **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 -atrial fibrillation goal inr 2-2.5 first draw procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization (aorto)coronary bypass of one coronary artery diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified essential hypertension atrial fibrillation personal history of malignant neoplasm of breast personal history of tobacco use unspecified glaucoma constipation, unspecified other and unspecified hyperlipidemia osteoporosis, unspecified long-term (current) use of anticoagulants osteoarthrosis, unspecified whether generalized or localized, site unspecified family history of ischemic heart disease pernicious anemia 

Answer: The patient is high likely exposed to