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: lisinopril / erythromycin base attending: chief complaint: chest pain major surgical or invasive procedure: 1. urgent coronary artery bypass graft x3: left internal mammary artery to left anterior ascending artery, and saphenous vein grafts to distal circumflex and posterior descending arteries. 2. endoscopic harvesting of the long saphenous vein. history of present illness: 59 year old female with pmh significant for hypertension, dyslipidemia, tobacco use that presented to outside hospital emergency department with chest pain on . she had chest pain lasting about 1 hour the night before at home that resolved on its own and went to sleep. she felt okay in the morning and went to work were she had another episode and called her pcp. pcp referred her to the emergency room and en route she had nitroglycerin sl that resolved the pain. additionally she had nausea, shortness of breath and sweating with the chest pain episodes. she was admitted to the outside hospital and underwent workup which cardiac enzymes were negative, nuclear stress indicated ischemic changes, so she was referred for cardiac catheterization. that revealed significant coronary artery disease and additionally she was hypertensive to the 200 systolic b/p that required intravenous medications of nitroglycerin and hydralazine. she was transferred in for surgical evaluation. cardiac catheterization: date: at . right dominant lm 25% stenosis with eccentric calcification lad proximal calcification 50-60% tubular mid stenosis,om 1 sm diffusely diseased,om 2 med no stenosis rca 90% proximal, 65 % mid, 50-60% long distal pda without significant stenosis. right groin closure with mynx. cardiac echocardiogram: 9/2/3011 , mild ai no as, mitral mild to mod mr, tv mild tr,lvef 55%. persantine - stress images revealed a small sized mild intensity distal anterolateral defect past medical history: hypertension hyperlipidemia tobacco abuse abdominal aortic aneurysm (incidental finding on ct scan - with measured to 3cm) hematuria chronic diastolic dysfunction osteopenia pulmonary embolism (complication after hysterectomy) migrane (has 1 a year) s/p oopherectomy s/p hysterectomy s/p cholecystectomy s/p laminectomy s/p exploratory laparotomy for ecotpic pregnancy social history: lives with: husband contact: phone # occupation: insurance sales cigarettes: smoked no yes last cigarette hx: 30 pack year history - quit for few years 20 years ago after smoking a pack a day but restarted smoking and currently smokes half a pack a day for last 20 years etoh: 1 drink a month. illicit drug use denies family history: father massive mi deceased at 62 physical exam: general: pleasant, interactine, chest pain on arrival resolved with sl ntg x2 and restarting nitroglycerin gtt skin: dry intact right groin cath site heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr murmur grade 1/6 systolic abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema - none varicosities: none neuro: alert and oriented x2 nonfocal pulses: femoral right: mynx closure left: +2 dp right: +2 left: +2 pt : +2 left: +2 radial right: +2 left: +2 carotid bruit right: no bruit left: + bruit pertinent results: echo pre-bypass: no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). doppler parameters are most consistent with grade ii (moderate) left ventricular diastolic dysfunction. right ventricular chamber size and free wall motion are normal. there are complex (>4mm) 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. there is no aortic valve stenosis. 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 on at 11:00 am. post-bypass: the patient is on no inotropes. left ventricular function is low normal (lvef 50%). right ventricular function is unchanged. mitral regurgitation is mild (1+). trace aortic regurgitation is seen. the aorta is intact post decannulation. . carotid ultrasound: 1. a 60-69% stenosis in the right internal carotid and 70-79% stenosis in the left internal carotid artery with significant heterogeneous atherosclerotic plaques. 2. the assessment of the right system is limited due to presence of dressings and central line. . cxr: in the interim from the prior examination, a left-sided chest tube has been removed. small -apical pneumothoraces are not significantly changed. there are, however, worsening bibasilar opacities, right greater than left, which could represent aspiration or developing pneumonia. persistent perihilar opacities likely reflect atelectasis. no significant pleural effusion is seen. the cardiomediastinal silhouette is unchanged. median sternotomy wires appear intact . 10:32pm blood wbc-8.5 rbc-4.07* hgb-12.3 hct-34.8* mcv-86 mch-30.3 mchc-35.4* rdw-13.8 plt ct-159 02:59am blood wbc-9.5 rbc-2.74* hgb-8.6* hct-23.5* mcv-86 mch-31.2 mchc-36.5* rdw-14.0 plt ct-92* 06:10am blood wbc-8.4 rbc-2.84* hgb-8.8* hct-24.6* mcv-87 mch-31.1 mchc-35.9* rdw-14.0 plt ct-238# 10:32pm blood pt-12.8 ptt-25.1 inr(pt)-1.1 02:31am blood pt-13.9* ptt-25.8 inr(pt)-1.2* 10:32pm blood glucose-119* urean-16 creat-0.8 na-140 k-3.7 cl-106 hco3-24 angap-14 09:45pm blood glucose-102* urean-14 creat-0.6 na-139 k-5.2* cl-108 hco3-23 angap-13 06:10am blood glucose-101* urean-19 creat-0.8 na-137 k-4.2 cl-101 hco3-25 angap-15 10:32pm blood alt-10 ast-17 ld(ldh)-149 ck(cpk)-76 alkphos-66 amylase-37 totbili-0.3 02:31am blood calcium-8.2* phos-2.6* mg-1.7 brief hospital course: following admission he underwent pre-operative testing and was brought to the operating room on where the patient underwent urgent cabg x 3 with dr. . please see operative note for surgical details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. within 24 hours she was weaned from sedation, extubated, alert and oriented and breathing comfortably. she became agitated and confused on the evening of pod 1, requiring haldol. there are inconsistent reports of the patient's alcohol consumption, and she was given benzodiazepines for possible alcohol withdrawal as well as vitamins. carotid ultrasound was performed and revealed a 60-69% stenosis of the and a 70-79% stenosis of the . the patient is advised to follow up with vascular surgery as an outpatient. the pcp has recommended dr. of . beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued. chest x-ray's post chest tube removal revealed bilateral apical pneumothoraces. all repeat x-ray's showed stable pneumothorax. norvasc and valsartan were added for hypertension. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 6 the patient was ambulating with assistance, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to rehab in in good condition with appropriate follow up instructions. medications on admission: pravastatin 80 mg daily labetolol 200 mg twice a day vitamin d discharge medications: 1. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). 2. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 7. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 9. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 10. pravastatin 20 mg tablet sig: four (4) tablet po daily (daily). 11. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 13. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 14. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q4h (every 4 hours) as needed for wheezing. 15. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 16. furosemide 20 mg tablet sig: two (2) tablet po once a day for 1 weeks. 17. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po once a day. 18. ferrous sulfate 325 mg (65 mg iron) tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: coronary arery disease s/p coronary artery bypass graft x 3 pmh: hypertension hyperlipidemia tobacco abuse abdominal aortic aneurysm (incidental finding on ct scan - with measured to 3cm) hematuria chronic diastolic dysfunction osteopenia pulmonary embolism (complication after hysterectomy) migrane (has 1 a year) discharge condition: alert and oriented x3 nonfocal ambulating with assistance sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage edema: 1+ alert and oriented x3 nonfocal ambulating with assistance sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage edema: trace discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments: surgeon dr. on at 1:00pm please call to schedule the following: cardiologist dr. in weeks primary care dr. in weeks vascular surgery (regarding carotid stenosis): dr. **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** md procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnoses: acidosis coronary atherosclerosis of native coronary artery intermediate coronary syndrome tobacco use disorder unspecified essential hypertension other and unspecified hyperlipidemia personal history of venous thrombosis and embolism other and unspecified alcohol dependence, unspecified alcohol withdrawal heart disease, unspecified other secondary thrombocytopenia abnormal weight gain 

Answer: The patient is high likely exposed to