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: codeine / metformin / keflex / losartan / shellfish attending: chief complaint: complaint: bilateral shoulder and chest pain that occurs at rest. now with new ekg changes major surgical or invasive procedure: cabgx3(lima-lad,svg-diag,svg-pda) history of present illness: 84yo felame who has a history of cad with ptca to single vessel in at hospital. she since has had 2 work-up caths that have shown no significant cad. she was noted to have mild as by tte last year. she frequently gets chest pain at rest. yesterday she was admitted to the hospital after being seen by her cardiologist who noted new ekg changes. her ekg showed new anterior ischemia.today she underwent a cath which revealed significan 2 vessel disease. of note she has been taking plavix for over a year. past medical history: past medical history: depression hypercholesterolemia type 2 diabetes x20 yrs cad as mild htn gout diverticulosis gerd hemorroids past surgical history: bilateral cataracts bladder suspension cholesystectomy social history: last dental exam: native teeth in good repair lives with:alone in ranch contact:4 children: (nurse)phone h# c# occupation: retired secretary widowed and volunteers in a hospital` cigarettes: smoked no yes last cigarette _____ hx: other tobacco use:no etoh: no illicit drug use: no family history: family history: father mi < 62yr chf mother < 57 ha, sister died age 55 from heart disease, brother died age 22 from ha race:caucasian physical exam: admission: pulse:76 resp: 18 o2 sat:98% 2l b/p right:170/70 left:174/78 height: 66 weight: general:limited due to bed rest skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade _2/6_____ abdomen: soft non-distended non-tender +bs extremities: warm , well-perfused edema trace lower extremity edema varicosities: none neuro: grossly intact pulses: femoral right:cath site left:cath site dp right: doppler left:doppler pt :doppler left:doppler radial right: +2 left:+2 carotid bruit right: faint left:faint discharge: neuro a&ox3 nonfocal exam cv rrr no murmur sternum stable- incision cdi pulm cta bilat abd obese, soft nt/nd/+bs ext warm 2+le edema bilat left evh site oozing serous drainage pertinent results: admission labs 03:00pm glucose-123* urea n-22* creat-0.9 sodium-139 potassium-3.7 chloride-102 total co2-29 anion gap-12 03:00pm alt(sgpt)-16 ast(sgot)-20 alk phos-71 amylase-56 tot bili-0.2 03:00pm albumin-3.5 cholest-228* 03:00pm %hba1c-7.3* eag-163* 03:00pm triglycer-273* hdl chol-49 chol/hdl-4.7 ldl(calc)-124 03:00pm wbc-6.4 rbc-3.83* hgb-11.5* hct-34.1* mcv-89 mch-30.0 mchc-33.7 rdw-14.1 03:00pm plt count-178 discharge labs: 04:50am blood wbc-8.3 rbc-3.33* hgb-10.4* hct-30.2* mcv-91 mch-31.2 mchc-34.4 rdw-14.2 plt ct-321 04:50am blood plt ct-321 04:50am blood pt-18.9* inr(pt)-1.8* 03:36pm blood pt-16.3* inr(pt)-1.5* 04:50am blood urean-22* creat-0.9 na-130* k-4.6 cl-95* echocardiography report echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - ejection fraction: 60% to 70% >= 55% findings left atrium: mild la enlargement. good (>20 cm/s) laa ejection velocity. cannot exclude laa thrombus. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra and extending into the rv. 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 aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets (3). mild as (area 1.2-1.9cm2). no ar. mitral valve: moderate mitral annular calcification. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: trivial/physiologic pericardial effusion. general comments: the patient was under general anesthesia throughout the procedure. the patient received antibiotic prophylaxis. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. 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 pre-cpb: 1. the left atrium is mildly dilated. a left atrial appendage thrombus cannot be excluded. no atrial septal defect 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 simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). no aortic regurgitation is seen. 6. trivial mitral regurgitation is seen. 7. there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results. post-cpb: on infusion of phenylepherine briefly. av paced for transient complete heart block. initial moderate mr from cpb. resolved over 10 minutes. preserved biventricular suystolic function. mr is trace. aortic contour is normal post decannulation. electronically signed by , md, interpreting physician 13:43 radiology report chest (pa & lat) study date of 1:29 pm final report previous mild pulmonary edema has almost entirely cleared. small left pleural effusion is smaller. left lower lobe atelectasis is mild. cardiomediastinal silhouette has a normal postoperative appearance. no appreciable pneumothorax. dr. brief hospital course: patient was seen by pcp with /o chest pain and found to have ekg changes. she was then referred to for cardiac catheterization. she was found to have complex coronary disease not amenable to ptca and she was referred for coronary bypass grafting. after pre operative workup including vein mapping and carotid studies she was brought to the operating room for bypass grafting with dr on . please see operative report for details in summary she had coronary bypass grafting x3 with lima to lad, and svg to diag and svg to pda. her bypass time was 64 minutes with a crossclamp of 53 minutes. she tolerated the operation well and was transferred from the operating room to cardiac surgery icu in stable condition. in ther immediate post-op period she remained hemodynamically stable awoke neurologically intact and was extubated. she continued to be stable post-operatively but stayed in the icu for bp and glucose control. the patient had an episode of rapid atrial fibrillation that was treated with bblockers and amiodarone following which she had a long conversion pause and reverted to sinus rhythm. she was seen by ep- they recommended that bblockers and amiodarone be stopped. she was also started on warfarin at that time. she had another episode of atrial fibrillation and the bblockers were resumed at lower doses. she was transferred to stepdown floor on pod4 all tubes lines and drains were removed per cardiac surgery protocol. once on the stepdown floor the patient worked with nursing and physical therapy to increrase here strength and endurance and progress was slow, and she was cleared for reabilitation on pod7 medications on admission: aciphex 20mg daily amlodapine 10mg daily asa 81mg daily carvedilol 25mg daily fish oil 1000mg caps daily glimepiride 4mg q am levothyroxine 150mcqs daily plavix75mg daily sulfasalazine 500mg welchol 625mg 3 tabs celebrex ? dose and frequency ocuvite tabs nitro-dur 0.3mg/hr daily indomethicin 50mg prn discharge medications: 1. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po once a day. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. insulin regular human 100 unit/ml solution sig: sliding scale injection qac&hs. 6. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever, pain. 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 8. levothyroxine 75 mcg tablet sig: two (2) tablet po daily (daily). 9. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 10. omega-3 fatty acids capsule sig: one (1) capsule po daily (daily). 11. multivitamin tablet sig: one (1) tablet po daily (daily). 12. glimepiride 4 mg tablet sig: one (1) tablet po once a day. 13. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 14. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 15. polyethylene glycol 3350 17 gram/dose powder sig: seventeen (17) gm po daily (daily). 16. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 17. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for dyspnea. 18. sulfasalazine 500 mg tablet sig: one (1) tablet po bid (2 times a day). 19. colesevelam 625 mg tablet sig: three (3) tablet po bid (2 times a day). 20. metoprolol tartrate 25 mg tablet sig: tablet po bid (2 times a day). 21. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 22. lasix 40 mg tablet sig: one (1) tablet po once a day. 23. warfarin 1 mg tablet sig: as directed tablet po once a day: titrate to keep inr 1.5-2.0 . 24. warfarin 2 mg tablet sig: one (1) tablet po once for 1 doses: dose. discharge disposition: extended care facility: st. manor discharge diagnosis: s/p coronary bypass grafting x3 pmh: depression, hypercholesterolemia, niddm, coronary artery disease, aortic stenosis mild, hypertension, gout, diverticulosis, gerd, hemorroids, s/p bilateral cataracts, s/p bladder suspension, s/p cholesystectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with tramadol incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema- 2+ bilat 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 one month or while taking narcotics. driving will be discussed at follow up appointment with surgeon. 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 scheduled for the following appointments surgeon: , md date/time: 1:15 cardiologist:dr. , a. at 1:00p please call to schedule appointments with your primary care dr. , t. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication atrial fibrillation goal inr 1.5-2.0 first draw day after transfer procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries left heart cardiac catheterization aortography diagnoses: thrombocytopenia, unspecified anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux intermediate coronary syndrome pure hypercholesterolemia urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism gout, unspecified atrial fibrillation depressive disorder, not elsewhere classified other and unspecified escherichia coli [e. coli] long-term (current) use of antiplatelet/antithrombotic 

Answer: The patient is high likely exposed to