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: patient recorded as having no known allergies to drugs attending: chief complaint: cad major surgical or invasive procedure: cabgx3/mitral valve repair/pfo closure history of present illness: 44 yo f with pmh significant for cad s/p multiple pcis and mi in who presented to with transferred to on for cardiac catheterization. it was determined that she was not a surgical candidate at that time. she was readmitted with left arm pain and chest pressure. she was found to have thrombosis of her left subclavian stent. vascular was consulted and it was determined that the left arm likely being perfused by vertebral artery and she was admitted and started on a heparin drip. follow up appointment with vascular was arranged for post cardiac surgery. csurg was reconsulted to evaluate for cabg. past medical history: 1. cardiac risk factors: iddm, dyslipidemia, hx of hypertension 2. cardiac history: - lateral nstemi; single vessel disease - ptca to d1, dx w/ severe diastolic dysfunction - ef 45;anterior, mid and distal septal, apical akniesis - cath: cypher stent to mid-lad, d1 subtotal occlusion - negative ett - nuclear stress: ecg changes at 64% hr; mod perfusion deficit - cath: moderate single vessel disease - left sublclavian stenosis with bare metal stent - cath: 40% in-stent stenosis of lad; no rca disease - lcx had mild diffuse disease and was also small - cath: imi endeavor stent x 2 to rca ischemic cardiomyopathy with ef 40% iddm: a1c 13.3% in hyperlipidemia (last lipids tc 164, trig 197, hdl 44, ldl 81) polysubstance abuse: heroin (years sober), cocaine (years sober), tobacco use hepatitis c ab, negative viral load in obesity breast abcess history of tuberculosis exposure s/p 9 months of tx ('s) left subclavian stenosis s/p stenting social history: lives with husband and 7 year old son. smokes <1ppd now, down from ppd a few months ago, but noted that she will quit today. smoked since age 12. prior h/o cocaine use. hx of substantial heroin ivdu. denies etoh or other drugs. no substance use current other than tobacco. does not work. family history: father had mi at 38, died at age 68 of esophageal cancer. also mother, brother with early cad. physical exam: admission physical exam pulse:54 resp:18 o2 sat: 98% ra b/p right: 82/45-109/61 left: height:5'3" weight:73.7 general:nad, alert, cooperative skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right: +1 left:+1 dp right: +1 left:+1 pt : +1 left:+1 radial right: +1 left:+1 carotid bruit right: none left:none pertinent results: 04:20am blood wbc-9.9 rbc-2.99* hgb-9.2* hct-25.8* mcv-86 mch-30.7 mchc-35.6* rdw-15.1 plt ct-196 02:22pm blood wbc-19.3*# rbc-3.25* hgb-9.4* hct-27.7* mcv-85 mch-29.0 mchc-34.1 rdw-14.8 plt ct-167 03:56pm blood pt-14.0* ptt-34.5 inr(pt)-1.2* 02:22pm blood pt-14.4* ptt-37.6* inr(pt)-1.2* 04:20am blood glucose-158* urean-12 creat-0.7 na-134 k-4.2 cl-99 hco3-26 angap-13 02:48am blood glucose-93 urean-15 creat-0.5 na-135 k-4.2 cl-106 hco3-21* angap-12 09:10am blood alt-16 ast-29 ld(ldh)-352* alkphos-66 amylase-18 totbili-0.5 echocardiography report , (complete) done at 11:09:50 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 44 f hgt (in): 66 bp (mm hg): 123/56 wgt (lb): 150 hr (bpm): 50 bsa (m2): 1.77 m2 indication: intraoperative tee for cabg, mitral ring annuloplasty and closure of secundum asd. aortic valve disease. chest pain. coronary artery disease. left ventricular function. mitral valve disease. myocardial infarction. preoperative assessment. right ventricular function. valvular heart disease. icd-9 codes: 786.05, 786.51, 424.1, 424.0, 424.2 test information date/time: at 11:09 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2010aw1-: machine: aw1 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *5.8 cm <= 5.6 cm left ventricle - ejection fraction: 35% to 40% >= 55% aorta - annulus: 2.0 cm <= 3.0 cm aorta - ascending: 2.8 cm <= 3.4 cm aortic valve - peak velocity: 1.6 m/sec <= 2.0 m/sec aortic valve - peak gradient: 10 mm hg < 20 mm hg findings right atrium/interatrial septum: 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. small secundum asd. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness. mild-moderate regional lv systolic dysfunction. moderately depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. simple atheroma in descending aorta. aortic valve: mildly thickened aortic valve leaflets (3). no as. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. moderate to severe (3+) mr. tricuspid valve: mild tr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions prebypass a left-to-right shunt across the interatrial septum is seen at rest. a small secundum atrial septal defect is present. left ventricular wall thicknesses are normal. there is mild to moderate regional left ventricular systolic dysfunction with akinesia of the apex, apical and mid portions of the inferior wall and hypokinesia of the inferoseptal and inferolateral walls.. overall left ventricular systolic function is moderately depressed (lvef= 35-40%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate to severe (3+) mitral regurgitation is seen. there is a stent noted in the distal arch of the aorta that has a possible clot in it. dr. was notified in person of the results on at 1015am. post bypass patient is a paced and receiving an infusion of phenylephrine and epinephrine. lvef= 35%. annuloplasty ring seen in the mitral position. there is 1+ residual mitral regurgitation. no mitral stenosis. mild aortic insufficiency persists. pledget seen at the site of the small secundum asd. no flow documented across the interatrial septum. aorta is intact post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 07:36 ?????? caregroup is. all rights reserved. brief hospital course: on ms. was taken to the operating room and underwent coronary artery bypass grafting x 3 (lima->lad/saphenous vein graft->om/pda)/mitral valve repair (#28mm cg future ring)/pfo closure with dr.. please see operative report for further details. she tolerated the procedure well and was transferred to the cvicu intubated and sedated in critical but stable condition. she was weaned off all pressors, awoke neurologically intact and was extubated without difficulty. pain service was consulted for her history of polysubstance abuse. was consulted for her uncontrolled insulin dependent diabetes. all lines and drains were discontinued in a timely fashion. beta-blocker,aspirin, statin, and diuresis were initiated. on pod# 2 she was transferred to the step down unit for further monitoring. physical therapy was consulted for evaluation of strength of mobility. the remainder of her postoperative course was essentially uneventful. on pod#5 she was cleared by dr. for discharge home with vna. all follow up appointments were advised. medications on admission: asa 325mg po daily plavix 75mg po daily lipitor 80mg po daily metformin 500mg po tid nph 28 units qam, 30units qpm humalog 2 units with breakfast, 6units with lunch, ??units with dinner albuterol 2 puffs q6h prn sob methadone 75mg po daily sl ntg prn spiriva 1 unit po daily plavix - last dose: discharge medications: 1. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). disp:*qs cap(s)* refills:*2* 2. bupropion hcl 75 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 3. furosemide 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* 4. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours). disp:*60 tab sust.rel. particle/crystal(s)* refills:*2* 5. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 6. prasugrel 10 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 9. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 10. metoprolol tartrate 25 mg tablet sig: 0.25 tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 11. clindamycin hcl 150 mg capsule sig: one (1) capsule po every six (6) hours: dc on . disp:*120 capsule(s)* refills:*2* 12. methadone 10 mg tablet sig: one (1) tablet po daily (daily): per clinic->resume preop regimen. 13. lantus 100 unit/ml cartridge sig: thirty four (34) units subcutaneous q hs. disp:*qs * refills:*2* 14. insulin lispro 100 unit/ml cartridge sig: one (1) subcutaneous achs: **per humolog sliding scale. disp:*qs * refills:*2* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: htn, hyperlipidemia, cad s/p stents, ischemic cardiomyopathy, diabetes, copd, polysubstance abuse: heroin and cocaine, hepatitis c, obesity, breast abscess , history of tuberculosis discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with dilaudid and methadone incisions: sternal - healing well, no erythema or drainage leg right - healing well, no erythema or drainage. 2+ lower extremity edema 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 for the following appointments surgeon: dr. on at 1:30pm cardiologist: dr. on at 4pm department: cardiac services when: wednesday at 1 pm department: when: tuesday at 9:20 am with: , rnc building: sc clinical ctr campus: east best parking: garage department: vascular surgery when: monday at 2:30 pm with: , md building: lm campus: west best parking: garage department: cardiac services when: monday at 3:00 pm with: echocardiogram building: sc clinical ctr campus: east best parking: garage please call to schedule appointments with your 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: venous catheterization, not elsewhere classified single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries annuloplasty other and unspecified repair of atrial septal defect diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery tobacco use disorder mitral valve disorders chronic hepatitis c without mention of hepatic coma acute posthemorrhagic anemia chronic airway obstruction, not elsewhere classified percutaneous transluminal coronary angioplasty status opioid type dependence, unspecified other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia ostium secundum type atrial septal defect long-term (current) use of insulin old myocardial infarction family history of ischemic heart disease diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled obesity, unspecified stricture of artery dental caries, unspecified postprocedural fever 

Answer: The patient is high likely exposed to