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 67 year-old woman with a history of congestive heart failure of restrictive type and aortic stenosis who was initially admitted to hospital on with complaints of worsening lower extremity edema and dyspnea on exertion. she denied any chest pain, orthopnea or paroxysmal nocturnal dyspnea. at hospital she was diuresed. an echocardiogram at that time indicated an ef of 40 to 45% with mild left ventricular hypertrophy, severe apical hypokinesis, moderate septal and distal hypokinesis and severe atrial fibrillation. her creatinine during that admission was noted to be elevated at approximately 2.1 with a baseline of approximately 1.6 by report. chest ct at the outside hospital showed an incidental finding of mediastinal lymphadenopathy and pulmonary artery prominence. she was subsequently transferred to the for further management and possible cardiac catheterization. past medical history: 1. coronary artery disease status post coronary artery bypass graft in with left internal mammary coronary artery to the left anterior descending coronary artery and saphenous vein graft to the ramus, obtuse marginal and posterior descending coronary artery. 2. history of congestive heart failure restrictive type. 3. aortic stenosis. 4. hypertension. 5. hypercholesterolemia. 6. type 2 diabetes mellitus. 7. hypothyroidism. medications at home: 1. digoxin 0.125 mg po q.d. 2. protonix 40 mg po q.d. 3. neurontin. 4. glucophage 1000 mg po b.i.d. 5. zestril 10 mg po q.d. 6. lopresor 12.5 mg po q.d. 7. lipitor 10 mg po q.h.s. 8. synthroid 100 micrograms po q.d. 9. nph insulin 26 units subq q.p.m. 10. zalatan 0.005% eye drops. 11. cosopt eye drops. 12. multi vitamins. allergies: the patient reports allergies to naprosyn, sulfa, biaxin and clindamycin. social history: the patient reports smoking approximately two to three cigarettes per day. she has previously smoked one to two packs per day for approximately forty years. she denies ethanol or intravenous drug use. physical examination: the patient was afebrile, temperature 97.8. heart rate 58. blood pressure 135/98 with an oxygen saturation of 81% on room air and 95% on 3 liters nasal cannula. she was an elderly appearing woman in no acute distress. her heent examination was unremarkable with pupils are equal, round and reactive to light. extraocular movements intact. mucous membranes are moist. sclera anicteric. her neck was supple. carotids 2+ without bruits. jvd of approximately 8 cm. no palpable thyromegaly or lymphadenopathy. she had bilateral crackles two thirds of the way up. her heart was regular rate and rhythm occasionally bradycardic with 3 out of 6 systolic murmur from the right upper sternal border radiating to the neck. her lower extremities had 2+ pitting edema bilaterally. her right groin had no bruit. her neurological examination cranial nerves iii through xii were grossly intact. the patient was alert and oriented times three. pertinent laboratory studies: white blood cells 7.2, hematocrit 26.0, platelets 152, sodium 141, potassium 3.9, chloride 101, bicarb 30, bun 36, creatinine 1.6, ck were flat at 71 and 63. electrocardiogram from the outside hospital showed sinus bradycardia at a rate of 49, normal axis, mild pr prolongation consistent with first degree block and t wave flattening in the lateral leads. hospital course: the patient was initially admitted to the coronary care unit service after cardiac catheterization. cardiac catheterization showed a proximal 100% left anterior descending coronary artery lesion, left circumflex was 70% proximal 100% mid occlusions, right coronary artery with 100% proximal and patent saphenous vein graft to obtuse marginal grafts, 70% left internal mammary coronary artery to left anterior descending coronary artery, saphenous vein graft to ramus and posterior descending coronary artery totally occluded. an left ventriculogram showed an ef of approximately 40%. her right sided filling pressures were markedly elevated with a right atrial pressure of 97/20, right ventricular 98/10, pulmonary capillary wedge pressure of 32 and 45 mm peak to peak pressure. her aortic valve area was measured as .55 cm square. she was subsequently given 120 cc of intravenous lasix in the catheterization laboratory and received a total of 276 cc of contrast during this cardiac catheterization. given these catheterization results it was decided that the patient may benefit from an aortic valve replacement with an accompanying coronary artery bypass graft. as such dr. of ct surgery was consulted. within 24 hours of cardiac catheterization the patient's creatinine began to rise and urine output fall. her creatinine peaked on at 4.6 and she was evaluated by the renal team. it was believed that her acute renal failure was secondary to contrast nephropathy on top of a chronic renal insufficiency caused by her diabetes and hypertension. by the time of discharge her renal failure was resolving with her creatinine falling to 3.3 and continuing to trend down. as part of her surgical evaluation a copy of her ct scan from the outside hospital was obtained, which showed 1 to 2 cm hilar and peritracheal adenopathy. this scan was reviewed with the pulmonary service who performed lymph node biopsy and bronchoscopy. this biopsy did not reveal any malignant cells and instead showed a hypocellular specimen with a few group of bronchial cells, pulmonary macrophages, lymphocytes, red blood cells and neutrophils. the pulmonary team recommended that she have a repeat ct scan in approximately eight weeks time to examine for any changes in her lymphadenopathy. the patient also has a known anemia, which may be secondary to her chronic renal insufficiency and required transfusion of 2 units of packed red blood cells during this hospitalization. after transfusion her hematocrit was stable and was approximately 28 at the time of discharge. given the problems listed above full surgical evaluation was deferred until her renal function returns to baseline and her pulmonary process is completely worked up as described. the patient will follow up with dr. on tuesday . at that time it is expected that after checking a repeat chem 7 and her renal function that a number of her medications that were held secondary to her renal failure will be able to be reinstituted. these medications include her ace inhibitor, digoxin and diuretic. the patient will also follow up with her primary care physician . within the next few weeks. after her repeat ct scan she will again be evaluated at her cardiologist's discretion for possible avr and coronary artery bypass graft. discharge medications: 1. nph insulin 20 units subq q.h.s. 2. synthroid 100 micrograms po q day. 3. lopressor 12.5 mg po b.i.d. 4. tums 500 mg po t.i.d. with meals. 5. lipitor 10 mg po q.h.s. 6. neurontin 300 mg po b.i.d. 7. protonix 40 mg po q.d. her other medications, which were effected by her renal function will be reinstituted as previously described when her renal function returns to baseline. discharge status: the patient was discharged to home in stable condition. discharge diagnoses: 1. congestive heart failure. 2. aortic stenosis valve area of 0.55. 3. acute on chronic renal failure secondary to contrast induced nephropathy, hypertension and diabetes. 4. anemia. secondary diagnoses: 1. hypothyroidism. 2. hypertension. 3. hypercholesterolemia. , m.d. dictated by: medquist36 d: 15:57 t: 13:36 job#: procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures closed [percutaneous] [needle] biopsy of lung diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute kidney failure, unspecified coronary atherosclerosis of autologous vein bypass graft aortic valve disorders hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease primary pulmonary hypertension urinary complications, not elsewhere classified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to