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 a 72 year old female status post emergent coronary artery bypass graft times two secondary to catheterization complicated by asystole and hypotension, who was transferred recently from rehabilitation for management of a pericardial effusion. the patient was admitted in for an elective catheterization at which time the procedure was complicated by a perforation with subsequent st elevations, asystole, and placement of an intra-aortic balloon pump and emergent coronary artery bypass graft times two. the patient was managed at and then discharged to on . at rehabilitation, the patient has progressed very poorly with persistent fatigue, dyspnea on exertion, tachypnea, as well as persistent pleural effusion. as part of her work-up, an echocardiogram was obtained on , which revealed a significant pericardial effusion as well as a reported right atrial compression and the patient was subsequently transferred to for further management. upon admission to the hospital, the patient was taken immediately to catheterization. tamponade was suggested by equalization of the ra, right ventricular end diastolic pressure, and wedge pressures of approximately 15; 400 cc of serosanguinous fluid was drained from the pericardial space with resolution of normal pressures. following the procedure, the patient was admitted to the cardiac care unit, for observation. on arrival to the cardiac care unit, the patient was without any complaints of shortness of breath and did not report any significant chest discomfort. past medical history: 1. hypercholesterolemia. 2. emergent coronary artery bypass graft times two in , secondary to catheterization complicated by perforation after diagnosis of 99% left anterior descending, normal circumflex, non-critical right coronary artery. course was complicated by st elevations and subsequent asystole during the catheterization, placement of an intra-aortic balloon pump and subsequent emergent coronary artery bypass graft times two (svg to the left anterior descending and obtuse marginal). allergies: the patient has no known drug allergies. medications: 1. lopressor 50 mg p.o. twice a day. 2. aspirin 325 mg p.o. q. day. 3. plavix 75 mg p.o. q. day. 4. protonix 40 mg p.o. q. day. 5. lasix 60 mg p.o. q. day. 6. lisinopril 2.5 mg p.o. q. day. 7. fentanyl patch 25 micrograms applied to skin and change q. 72 hours. 8. percocet, one tablet p.o. q. four to six hours p.r.n. break through pain. social history: the patient is a cantonese speaking female with a very involved family who lives locally. she denies any past history of smoking or alcohol use. she was transferred from rehabilitation. physical examination: vital signs were temperature 99.5 f.; heart rate 102; blood pressure 108/56; respiratory rate 20; saturating 94% on room air. weight 46.9 kilograms. in general, awake, in no acute distress. heent: pupils equally round and reactive to light. moist mucous membranes. neck: jugular venous pressure at 10 cm. cardiovascular: regular rate and rhythm; no murmurs, rubs or gallops. chest wall: thoracotomy scar clean, dry and intact. pigtail catheter intact without erythema. pulmonary: clear to auscultation bilaterally with scant crackles and decreased breath sounds at bilateral bases, left greater than right. abdomen: positive bowel sounds, soft, nontender, nondistended. extremities: one plus pitting edema bilaterally. laboratory: white blood cell count 6.8, hematocrit 32.5, platelets 327. sodium 135, potassium 3.9, chloride 97, bicarb 30, bun 15, creatinine 1.3. pt 12.8, ptt 26.2, inr 1.1. arterial blood gases: 7.44/40/60. chest x-ray: left pleural effusion, pneumopericardium, no obvious infiltrates. mild congestive heart failure. hospital course: the patient is a 72 year old female status post coronary artery bypass graft times two in , who was admitted for pericardial effusion with evidence of cardiac tamponade on catheterization status post drainage of the effusion and placement of a pigtail catheter. 1. cardiovascular: the patient recently underwent a coronary artery bypass graft times two approximately two and a half weeks prior to the time of admission. she was continued on her aspirin therapy, however, her plavix was held given the serosanguinous fluid that was removed from the pericardial space. in addition, her beta blocker and ace inhibitor were also held as the patient was mildly hypotensive at the time of admission, and these were titrated back as tolerated. the patient had no complaints of chest pain and no suggestion of anginal symptoms over the course of the hospital stay. the patient had her pericardial sac effectively drained during the catheterization and secondary to placement of pigtail catheter. over the first two hospital days, the drainage from the catheter slowly decreased in quantity. an echocardiogram was obtained on hospital day number four, which demonstrated near complete resolution of the pericardial effusion with fibrin formation, suggestive of early consolidation. since the drain put out less than 50 cc in the 24 hours prior to this time, the pigtail catheter was removed without difficulty and the patient subsequently felt subjectively less short of breath and complained of less pain. the patient's blood pressure remained stable over the remainder of the hospital stay. her beta blocker and ace inhibitor were added back to her medication regimen and titrated up as tolerated. an echocardiogram was obtained on , for evaluation of the pericardial effusion which, in addition, demonstrated a normal left atrium and left ventricle, small remnant of a pericardial effusion and ejection fraction of 70%. the patient's lasix and aldactone were held at time of admission secondary to feeling that the patient was likely on the dry side. her fluid status was monitored closely over the hospital stay. as the patient begins to take more p.o. input, she will likely need titration of her lasix back to her usual outpatient dose. in addition, the patient was maintained in telemetry and demonstrated normal sinus rhythm with only occasional pcv's on telemetry throughout the hospital stay. 2. pulmonary: the patient was noted to have persistent pleural effusions, which are likely secondary to her coronary artery bypass graft performed approximately two weeks prior to the time of admission. consideration was given to a thoracentesis, however, the patient maintained excellent oxygen saturations, a normal arterial blood gas and had no complaints of shortness of breath or respiratory discomfort once the pigtail catheter was removed. since the fluid surrounding the lung space is likely similar to the fluid surrounding the pericardial space, it was not felt warranted to perform a thoracentesis for diagnostic purposes since chemistry and culture data were to be obtained from the pericardial fluid. therefore, since the patient was asymmetric with her pleural effusions, it was felt that to monitor them closely and to hold off on aggressive therapeutic measures at this time. 3. renal: the patient had a normal creatinine at time of admission which was followed closely over the hospital stay. she maintained excellent urine output and her creatinine remained within normal limits. 4. infectious disease: the patient had a normal white blood cell count and was afebrile at the time of admission. she did not demonstrate any signs or symptoms of infection throughout the course of the hospital stay. 5. hematological: the patient's hematocrit was watched closely status post catheterization and pericardial drainage, however, her hematocrit remained stable and she had no bleeding issues during the hospital stay. 6. musculoskeletal: the patient complained of significant arthritic back pain which she reported being chronic in nature. she was provided with a fentanyl patch as well as percocet p.r.n. breakthrough pain. these medications appeared to adequately control the patient's discomfort and she had no further complaints of pain. condition at discharge: the patient was discharged to home in stable condition. discharge instructions: 1. she is to follow-up with dr. in clinic at the end of . disposition: the patient will be discharged to rehabilitation for further physical therapy and rehabilitation status post coronary artery bypass graft. medications at time of discharge: 1. aspirin 325 mg p.o. q. day. 2. lopressor 25 mg p.o. twice a day. 3. heparin 5000 units subcutaneously twice a day. 4. colace 100 mg p.o. twice a day. 5. fentanyl patch 25 micrograms per hour to be changed q. 72 hours. 6. zestril 2.5 mg p.o. q. day. 7. percocet 1 tablet p.o. q. six hours p.r.n. breakthrough pain. 8. tylenol 650 mg p.o. q. four hours p.r.n. fever or pain. 9. dulcolax suppositories one tablet p.r. q. day p.r.n. , md dictated by: medquist36 procedure: pericardiocentesis thoracentesis right heart cardiac catheterization diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified pleural effusion cardiac complications, not elsewhere classified aortocoronary bypass status unspecified disease of pericardium 

Answer: The patient is high likely exposed to