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: chest pain major surgical or invasive procedure: coronary artery bypass graft x 4 (left internal mammary artery to left anterior descending, saphenous vein graft to diagonal, saphenous vein graft to ramus, saphenous vein graft to obtuse marginal) cardiac cath history of present illness: ms. is a 81 female with multiple coronary artery disease risk factors and previous strokes with dementia who presented with acute onset chest pain. ed initially was not concerned as patient had negative mibi and was originally going to be ruled out and scheduled for a stress test. however her troponin returned elevated at 0.21 so patient was started on a heparin drip, got aspirin 325mg, and was transferred to the floor without plavix load. past medical history: stroke w/ residual left sided weakness, hypertension, hyperlipidemia, diabetes mellitus, dementia, gastroesophageal reflux disease, recurrent urinary tract infections, iron defiency anemia, recurrent falls, s/p hysterectomy social history: lives at - country club heights in . has daughter lives close by in . she needs assitance with showers. she is independent in ambulating with a walker, eating and toileting iadls: need assitance with shopping, bills, daughter does meds, food preparation. she is independent with telephone use quit smoking 30 to 40 years ago. occasional etoh. she has pre-existent home care services + h/o fall within 3 months + unsteady gait? + visual aides family history: father had afib and cva in 70s. two cousins with cancer. physical exam: admission vs - 97.0 162/77 86 18 100% on ra gen: elderly f in nad. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 3 cm at 45' angle. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: slight crackles at the bases. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: wwp, no edema. slight brawny stasis dermatitis. discharge vs t 97.4 hr 72sr bp 130/75 rr 18 o2sat 96%-ra gen nad neuro a&ox3, residual left sided weakness. able to ambulate with walker. pulm cta-bilat cv rrr, no m/r/g. sternum stable, incision cdi abdm soft, nt/+bs ext warm well perfused. 1+ pedal edema bilat. small rt arm phlebitis- improving over last few days pertinent results: 09:30pm ck(cpk)-78 09:30pm pt-12.4 ptt-32.8 inr(pt)-1.0 01:00pm glucose-135* urea n-19 creat-0.9 sodium-138 potassium-4.6 chloride-102 total co2-26 anion gap-15 01:00pm ctropnt-0.21* 01:00pm wbc-9.9 rbc-3.98* hgb-11.8* hct-34.6* mcv-87 mch-29.7 mchc-34.2 rdw-13.6 01:00pm plt count-336 01:00pm pt-11.7 ptt-22.2 inr(pt)-1.0 05:06am blood wbc-11.5* rbc-3.48* hgb-10.8* hct-31.1* mcv-89 mch-31.1 mchc-34.8 rdw-15.0 plt ct-688* 05:06am blood plt ct-688* 12:08pm blood pt-12.6 ptt-28.6 inr(pt)-1.1 05:06am blood glucose-141* urean-25* creat-1.3* na-137 k-4.4 cl-100 hco3-28 angap-13 10:10am blood %hba1c-7.2* cardiac cath: 1- selective coronary anguiography of this left-dominant system demonstrated severe diffuse three vessel coronary artery disease with markedly calcific vessels. the distal lmca/ostial lcx had 80% stenosis and the mid and distal lcx had each 70% stenosis serially. the lad had 70% diffuse bifurcation stenosis at mid vessel with 60% stenosis in the ostial major diagonal brancg. there was a small high diagonal vessel(ri) with 30% stenosis. the rca was a diminutive vessel with 40% diffuse stenosis throughout. 2- limited resting hemodynamic assessment revealed normal systemic arterial pressure (121/60 mmhg). the left-sided filling pressures were normal at baseline (lvedp 11 mmhg, increased to 16 mmhg after lv gram). 3- left ventriculography revealed normal lvef (60-65%) without regional wall motion abnormalities or mitral regurgitation. carotid u/s: less than 40% stenosis of the internal carotid arteries bilaterally. head ct:1. no significant interval change from prior mr examination from with no acute infarction or hemorrhage identified. 2. multiple old lacunar infarctions of the bilateral cerebellar hemispheres and pons, and changes consistent with chronic small vessel ischemic disease. echocardiography report , (complete) done at 10:02:05 am final referring physician information , c. , status: inpatient dob: age (years): 81 f hgt (in): bp (mm hg): 108/65 wgt (lb): hr (bpm): 75 bsa (m2): indication: intraoperative management of cabg. icd-9 codes: 440.0, 424.1, 424.0 test information date/time: at 10:02 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 #: 2008aw2-: machine: 2 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.2 cm <= 4.0 cm left atrium - four chamber length: 5.0 cm <= 5.2 cm left ventricle - septal wall thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 3.7 cm <= 5.6 cm left ventricle - systolic dimension: 2.8 cm left ventricle - fractional shortening: *0.24 >= 0.29 left ventricle - ejection fraction: 60% >= 55% aorta - sinus level: 3.2 cm <= 3.6 cm aorta - sinotubular ridge: 2.5 cm <= 3.0 cm aorta - ascending: 3.0 cm <= 3.4 cm aorta - arch: 2.5 cm <= 3.0 cm aorta - descending thoracic: 2.4 cm <= 2.5 cm aortic valve - lvot diam: 1.8 cm aortic valve - valve area: *1.4 cm2 >= 3.0 cm2 aortic valve - pressure half time: 738 ms mitral valve - pressure half time: 77 ms mitral valve - mva (p t): 2.8 cm2 mitral valve - e wave: 1.0 m/sec mitral valve - a wave: 0.9 m/sec mitral valve - e/a ratio: 1.11 findings left atrium: moderate la enlargement. elongated la. right atrium/interatrial septum: normal ra size. normal interatrial septum. no asd by 2d or color doppler. left ventricle: mild symmetric lvh. normal lv cavity size. 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. complex (>4mm) atheroma in the aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: normal aortic valve leaflets (3). no as. no as. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. mild mitral annular calcification. no ms. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets. physiologic tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. physiologic (normal) pr. pericardium: no pericardial effusion. 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. results were conclusions prebypass 1. the left atrium is moderately dilated. the left atrium is elongated. no atrial septal defect or pfo is seen by 2d or color doppler. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). 3. right ventricular chamber size and free wall motion are normal. 4. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. 7. there is no pericardial effusion. 8. dr. was notified in person of the results in the or at the time of surgery postbypass 1. patient is on xx infusions. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 14:46 radiology report chest (pa & lat) study date of 9:13 am medical condition: 81 year old woman with s/p cabg reason for this examination: evaluate effusions provisional findings impression: mlkb wed 10:50 am decrease in amount of pleural effusion. final report history: 81-year-old female, status post cabg. evaluate effusions. comparison: prior study, . findings: status post sternotomy with surgical clips post-cabg. there is decreasing amount of pleural effusion seen on the lateral views. right-sided picc line is again seen with the tip in the svc. unchanged appearance of the cardiomegaly and bilateral bibasal atelectasis. the study and the report were reviewed by the staff radiologist. dr. dr. approved: wed 12:20 pm brief hospital course: as mentioned in the hpi, mrs. was admitted from the emergency room after she was found to have a non-st segment elevation myocardial infarction. she was appropriately medically managed and worked up for cardiac surgery. on she was brought to the operating room where she underwent a coronary artery bypass graft x 4. the procedure was performed by dr. . please see operative report for surgical details. in summary she had cabg x4 with lima-lad, svg-diag, svg-ramus, svg-om. she tolerated the operation well and following surgery she was transferred to the cvicu for invasive monitoring in stable condition. she remained intubated for three days after surgery secondary to a difficult airway and fluid overload. she was weaned from her pressors and her chest tubes were removed. she was fed via a dobhoff tube after surgery secondary to somnolence. she was noted to be confused after the surgery, but also has a baseline history of dementia. her beta blockade was titrated up as tolerated. on post-operative day seven she was transferred to the surgical step down floor. she had intermitant episodes of atrial fibrillation with hypotension and was returned to the surgical intensive care unit, where she converted to sinus rhythm after adjustment of bblockers and initiation of amiodarone. her mediastinal incision was noted to have some purulent drainage and she was started on vancomycin and ciprofloxacin. she was transferred back to the step down floor on post-operative day nine. sternal drainage subsided and her sternum remained stable. as discussed with dr., cipro was discontinued and upon discharge, vancomycin will be continued for 7 days. she was seen by phyisical therapy. on post-operative day 15 she was discharged to rehabilitation at . medications on admission: alendronate 70 mg po qweekly, imipramine 20 mg po qhs, lisinopril 10 mg po qam, metoprolol xl 50 mg po qhs, mvi (noon), nitrofurantoin 100 mg po 3x/week mowfri, prilosec 20 mg po , simvastatin 20 mg po , 81 mg po daily, calcium carbonate 750 mg po tid, vitamin d3 800 po , ferrous sulfate 325 mg po , aggrenox 200-25 mg po bid, simethicone 80 mg po qid, glyburide 1.25 mg po qam, metformin 500 mg po qam, glucovance 5-500 po bid before breakfast and supper) discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed. disp:*60 tablet(s)* refills:*0* 2. simvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*0* 4. dipyridamole-aspirin 200-25 mg cap, multiphasic release 12 hr sig: one (1) cap po bid (2 times a day). disp:*60 cap(s)* refills:*0* 5. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tidac (3 times a day (before meals)). disp:*90 tablet, chewable(s)* refills:*0* 6. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. glyburide micronized-metformin 5-500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 9. furosemide 20 mg tablet sig: one (1) tablet po once a day for 5 days. disp:*5 tablet(s)* refills:*0* 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 5 days. disp:*5 tab sust.rel. particle/crystal(s)* refills:*0* 11. vancomycin 1,000 mg recon soln sig: one (1) intravenous once a day for 7 days. 12. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 15. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 16. sodium chloride 0.65 % aerosol, spray sig: two (2) spray nasal q6h (every 6 hours). discharge disposition: extended care facility: & rehab center - discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 myocardial infarction, postop atrial fibrillation pmh: stroke w/residual left sided weakness, hypertension, hyperlipidemia, diabetes mellitus, dementia, gastroesophageal reflux disease, recurrent urinary tract infections, iron defiency anemia, recurrent falls, s/p hysterectomy discharge condition: stable discharge instructions: please shower daily , no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 100.5 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for one month and off narcotics no lifting more than 10 pounds for 10 weeks please call with any questions or concerns: followup instructions: dr. in 4 weeks dr. in weeks dr. in weeks procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery angiocardiography of left heart structures left heart cardiac catheterization other and unspecified coronary arteriography transfusion of packed cells diagnoses: other iatrogenic hypotension subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery other postoperative infection unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation other and unspecified hyperlipidemia surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other late effects of cerebrovascular disease iron deficiency anemia, unspecified alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance history of fall other musculoskeletal symptoms referable to limbs psychophysical visual disturbances 

Answer: The patient is high likely exposed to