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 attending: chief complaint: substernal chest pain and throat tightness with exertion major surgical or invasive procedure: 1. off pump coronary artery bypass graft x3, left internal mammary artery to left anterior descending artery and saphenous vein grafts to diagonal, and obtuse marginal arteries. 2. endoscopic harvesting of the long saphenous vein. history of present illness: this is a 57-year-old patient with extensive coronary artery disease history with previous stenting presented again with symptoms and was investigated and found to have a significant lesion in the left anterior descending artery diagonal and the obtuse marginal arteries. left ventricular function is well preserved and she was electively admitted for off pump coronary artery bypass grafting. past medical history: coronary artery disease(s/p mi ), bms to proximal lad , des to mid lad , des to edge isr of mid lad des and stenosis distal to stent , des to om1, ). diastolic congestive heart failure hypertension dyslipidemia morbid obesity copd gerd rt rotator cuff injury/bursitis(outpt pt-2x/wk, migraines, depression/anxiety djd hemorrhoids rosacea left foot tendion repair social history: lives in with her grandchildren. she quit smoking 11 years ago. she does not drink or use drugs. family history: she was a of the state and does not know her family. physical exam: physical exam pulse: 86 resp:20 o2 sat:98% b/p right: 132/68 left: height: 5'2 weight:210 general: aaox3, nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right: +2 left:+2 dp right:+2 left:+2 pt :+2 left:+2 radial right:cath site left:+2 carotid bruit: none pertinent results: echocargiogram left atrium: normal la size. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra and extending into the rv. left-to-right shunt across the interatrial septum at rest. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal diameter of aorta at the sinus, ascending and arch levels. simple atheroma in ascending aorta. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets with trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. conclusions pre operative: the left atrium is normal in size. there is a small pfo with a left-to-right shunt across the interatrial septum. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. there are simple atheroma in the ascending aorta. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. chest x-ray ; there is mild-to-moderate cardiomegaly. bilateral pleural effusions are small. aside from atelectasis in the left lower lobe, the lungs are grossly clear. almost complete resolution of atelectasis in the left upper lobe. sternal wires are aligned. widened mediastinum has improved. a small air-fluid level in the retrosternal region suggests the presence of a tiny pneumothorax and small effusion. these are most likely located in the left side. 06:05am blood wbc-11.7* rbc-3.06* hgb-10.4* hct-30.5* mcv-100* mch-33.9* mchc-34.0 rdw-13.5 plt ct-253 06:15am blood wbc-11.1* rbc-3.23* hgb-11.1* hct-32.1* mcv-99* mch-34.4* mchc-34.6 rdw-13.3 plt ct-230 08:20am blood wbc-14.0* rbc-3.26* hgb-10.8* hct-32.3* mcv-99* mch-33.2* mchc-33.4 rdw-13.3 plt ct-192 06:05am blood na-137 k-4.1 cl-97 06:15am blood glucose-161* urean-19 creat-1.1 na-136 k-4.0 cl-97 hco3-29 angap-14 08:00am blood glucose-230* urean-14 creat-0.9 na-136 k-4.1 cl-98 hco3-26 angap-16 08:20am blood glucose-238* urean-16 creat-1.0 na-134 k-4.6 cl-100 hco3-22 angap-17 04:00am blood glucose-98 urean-13 creat-0.9 na-136 k-4.7 cl-106 hco3-23 angap-12 brief hospital course: the patient was brought to the operating room on where the patient underwent off pump coronary artery bypass graft x3, left internal mammary artery to left anterior descending artery and saphenous vein grafts to diagonal, and obtuse marginal arteries. endoscopic harvesting of the long saphenous vein. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. she required nitroglycerin for hypertension her first night post op but was transitioned to oral betablocker and diuretics. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. she was started on plavix due to being done off pump and will it need to be continued for six months. blood sugars were closely monitored and she was restarted on her home regime which have slowly improved. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 5 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged home with visiting nurse services in good condition with appropriate follow up instructions. medications on admission: preadmission medications listed are correct and complete. information was obtained from webomr. 1. atorvastatin 40 mg po daily 2. albuterol inhaler 2 puff ih q4h:prn wheezing 3. benzonatate 100 mg po tid:prn tos 4. clopidogrel 75 mg po daily 5. fluticasone propionate 110mcg 2 puff ih 6. glargine 80 units bedtime insulin sc sliding scale using hum insulin 7. isosorbide mononitrate (extended release) 60 mg po daily 8. metoprolol succinate xl 100 mg po daily 9. metronidazole gel 0.75%-vaginal 1 appl vg hs 10. naproxen 500 mg po q8h:prn pain 11. nitroglycerin sl 0.4 mg sl prn cp 12. oxycodone-acetaminophen (5mg-325mg) 1 tab po q6h:prn pain 13. pantoprazole 40 mg po q12h 14. ropinirole 0.25 mg po qpm 15. valsartan 80 mg po daily 16. aspirin 325 mg po daily 17. vitamin d 400 unit po daily discharge medications: 1. aspirin ec 81 mg po daily 2. atorvastatin 40 mg po daily rx *atorvastatin 40 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 3. clopidogrel 75 mg po daily rx *clopidogrel 75 mg 1 tablet(s) by mouth daily disp #*90 tablet refills:*1 4. fluticasone propionate 110mcg 2 puff ih rx *fluticasone 220 mcg 2 puffs twice a day disp #*1 inhaler refills:*0 5. glargine 50 units bedtime insulin sc sliding scale using hum insulin 6. oxycodone-acetaminophen (5mg-325mg) 1 tab po q6h:prn pain rx *oxycodone-acetaminophen 5 mg-325 mg 1 tablet(s) by mouth q 4 hrs disp #*30 tablet refills:*0 7. pantoprazole 40 mg po q24h rx *pantoprazole 40 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 8. ropinirole 0.25 mg po qpm 9. furosemide 40 mg po daily duration: 7 days rx *furosemide 40 mg 1 tablet(s) by mouth daily disp #*7 tablet refills:*0 10. ibuprofen 600 mg po q6h:prn pain take with food rx *ibuprofen 600 mg 1 tablet(s) by mouth three times a day disp #*90 tablet refills:*0 11. metoprolol tartrate 25 mg po tid hold for hr < 55 or sbp < 90 and call medical provider. *metoprolol tartrate 25 mg 1 tablet(s) by mouth three times a day disp #*90 tablet refills:*1 12. potassium chloride 20 meq po daily rx *potassium chloride 20 meq 1 tablet by mouth daily disp #*7 tablet refills:*0 13. albuterol inhaler 2 puff ih q4h:prn wheezing rx *albuterol 2 puffs prn q 4 hrs disp #*1 inhaler refills:*0 14. vitamin d 400 unit po daily discharge disposition: home with service facility: all care vna of greater discharge diagnosis: coronary artery disease(s/p mi ), bms to proximal lad , des to mid lad , des to edge isr of mid lad des and stenosis distal to stent , des to om1, ). diastolic congestive heart failure hypertension dyslipidemia morbid obesity copd gerd rt rotator cuff injury/bursitis(outpt pt-2x/wk, migraines, depression/anxiety djd hemorrhoids rosacea left foot tendion repair discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage 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 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: wound check at cardiac surgery office on at 10:45a surgeon dr. on at 2:15p cardiologist: fish at 2:20pm ( office) please call to schedule the following: primary care dr in weeks **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 (aorto)coronary bypass of two coronary arteries diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified unspecified essential hypertension chronic airway obstruction, not elsewhere classified atherosclerosis of aorta polyneuropathy in diabetes personal history of tobacco use depressive disorder, not elsewhere classified percutaneous transluminal coronary angioplasty status pulmonary collapse other and unspecified hyperlipidemia anxiety state, unspecified other and unspecified angina pectoris old myocardial infarction morbid obesity osteoarthrosis, unspecified whether generalized or localized, site unspecified migraine, unspecified, without mention of intractable migraine without mention of status migrainosus chronic diastolic heart failure diabetes with neurological manifestations, type ii or unspecified type, uncontrolled disorders of bursae and tendons in shoulder region, unspecified body mass index 38.0-38.9, adult 

Answer: The patient is high likely exposed to