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: syncope major surgical or invasive procedure: cardiac catheterization/rca angioplasty cabg x3(lima-lad,svg-om,svg-drca) peg placement history of present illness: 66 yo f with h/o dm2, htn, cva () with residual l sided weakness, pvd, h/o dvt now on coumadin, pvd s/p abf bypass () c/b thrombectomy () who presents following syncopal episode. patient was in usoh until yesterday when patient developed onset of "indigestion" lasting for several hours, relieved on its own. patient then awoke this am feeling weak "like her legs were giving out." she thought it was secondary to low blood sugar. patient denied any chest pain, shortness of breath, palpitations at that time. she syncopized and fell and ems was called. . upon arrival to the ed, vs: bp 130-60 hr 38 rr28 fs 384. noted to have st elevations in ii,iii, avf with reciprocal depression in i and avl. code stemi was called, patient was 2mg of atropine for bradycardia, asa, sl nitro, plavix 75, integrilin, bblocker and transferred to the cath lab. patient underwent balloon angioplasty to rca for total occlusion. no other intervention was performed due to her diffuse disease. . on review of symptoms, history is positive for dvt, stroke and dyspnea on exertion. denies joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . *** cardiac review of systems is notable for absence of chest pain, + dyspnea on exertion with minimal activity. requires a walker for ambulation. denies paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. past medical history: - type ii diabetes since - cerebrovascular accident in with left-sided weakness. - hypertension. - dvt on coumadin - peripheral vascular disease s/p abf bypass graft ; thrombectomy of that graft in . - neuropathy. - history of hyperkalemia. social history: former smoker (quit ). lives alone in an elder building. attends adult day care every day. has 4 children. denies etoh use. family history: mother with htn; father with stroke. no known early coronary disease or sudden death physical exam: physical examination: vs: t 96.3, bp 149/59, hr 39, rr 17, 100 o2 on nrb gen: wdwn middle aged female wearing face mask. oriented x3. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of 8 cm. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no s4, no s3. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. no crackles, wheeze, rhonchi anteriorly abd: obese, soft, ntnd, no hsm or tenderness. no abdominial bruits. ext: no c/c/e. no femoral bruit on left. r femoral sheath in place skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 1+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 1+ dp weight on day of discharge: 61 kg pertinent results: 11:00am wbc-9.5 rbc-3.54* hgb-9.7* hct-30.6* mcv-87 mch-27.4 mchc-31.6 rdw-13.5 11:00am pt-24.0* ptt-27.6 inr(pt)-2.3* 11:00am plt count-332 11:00am urea n-57* creat-4.1* 11:14am glucose-378* lactate-3.3* na+-128* k+-4.8 cl--96* tco2-23 12:15pm %hba1c-8.2* 12:15pm vit b12-758 12:15pm albumin-3.0* calcium-7.4* cholest-97 12:15pm ck-mb-18* mb indx-3.3 ctropnt-5.64* 12:15pm alt(sgpt)-28 ast(sgot)-76* ck(cpk)-548* alk phos-90 amylase-57 tot bili-0.2 dir bili-0.1 indir bil-0.1 08:26pm ck-mb-60* mb indx-4.3 ctropnt-14.96* 08:26pm ck(cpk)-1396* . cardiac catheterization : successful poba of the mid rca. final diagnosis: 1. three vessel coronary artery disease. 2. normal ventricular function. 3. acute inferior myocardial infarction, managed by acute ptca. ptca of rca vessel. 4. referral for cabg as definitive treatment . echo . ct head : comparison: . technique: non-contrast ct of the head. findings: again demonstrated are bifrontal subdural hygromas, unchanged. there is no evidence of acute intracranial hemorrhage, mass effect, or shift of normally midline structures. there are periventricular white matter hypodensities bilaterally consistent with chronic microvascular infarctions. there are punctate hypodensities within the basal ganglia bilaterally consistent with chronic lacunar infarctions. an old cerebellar infarct is demonstrated again and is unchanged. there is no evidence of new infarction. vascular calcifications are seen within the vertebral and cavernous carotid arteries. the visualized paranasal sinuses and mastoid air cells are clear. osseous structures are unremarkable. impression: stable head ct. no evidence of intracranial hemorrhage. 06:35am blood wbc-13.2* rbc-4.17* hgb-12.2 hct-37.2 mcv-89 mch-29.3 mchc-32.9 rdw-14.5 plt ct-441* 06:35am blood plt ct-441* 09:35am blood pt-13.2 ptt-27.8 inr(pt)-1.1 06:35am blood glucose-200* urean-70* creat-2.7* na-143 k-3.7 cl-109* hco3-22 angap-16 06:30am blood calcium-8.6 phos-3.3# mg-2.4 12:15pm blood %hba1c-8.2* radiology preliminary report chest (portable ap) 8:26 am chest (portable ap) reason: eval for pleural effusions medical condition: 67 year old woman s/p cabgx3 reason for this examination: eval for pleural effusions indication: 67-year-old woman status post cabg. evaluate for pleural effusions. comparison: . single view, chest: no large pleural effusions were seen. there may be small radiographically occult pleural effusions. the right lung base demonstrates better aeration compared to prior study suggesting resolving atelectasis. bilateral lung parenchyma demonstrates good aeration. no focal areas of opacification are noted. there is no pneumothorax. cardiomediastinal silhouette, heart size are within normal limits. impression: no definitive evidence of pleural effusions. no significant changes since then . dr. dr. echocardiography report , (complete) done at 2:20:40 pm final referring physician information , w. , status: inpatient dob: age (years): 67 f hgt (in): bp (mm hg): 138/47 wgt (lb): 150 hr (bpm): 105 bsa (m2): indication: intraoperative tee for cabg icd-9 codes: 745.5, 428.0, 410.91, 427.89, 786.05, 440.0, 424.0, 424.2 test information date/time: at 14:20 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 #: 2008aw4-: machine: 4 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.6 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 3.3 cm <= 5.6 cm left ventricle - ejection fraction: 40% to 45% >= 55% aorta - annulus: 2.0 cm <= 3.0 cm aorta - sinus level: 2.7 cm <= 3.6 cm aorta - sinotubular ridge: 1.9 cm <= 3.0 cm aorta - ascending: 3.1 cm <= 3.4 cm aorta - descending thoracic: *2.7 cm <= 2.5 cm findings left atrium: good (>20 cm/s) laa ejection velocity. 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: moderate symmetric lvh. normal lv cavity size. mildly 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 aortic arch. mildly dilated descending aorta. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: mildly thickened aortic valve leaflets (3). no ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. 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. the patient received antibiotic prophylaxis. no tee related complications. the patient appears to be in sinus the patient. conclusions pre-bypass: 1. a left-to-right shunt across the interatrial septum is seen at rest. a small secundum atrial septal defect is present. 2. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is mildly depressed (lvef= 40-45 %). there is inferior wall hypokinesis from the base to the apex. 3. right ventricular chamber size and free wall motion are normal. 4. there are simple atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. 7. the tricuspid valve leaflets are mildly thickened. mild (1+) tricuspid regurgitation is seen. 8. there is a moderately sized right pleural effusion. post-bypass: patient was removed from cardiopulmonary bypass on levophed, epinephrine, dobutamine infusions and was av paced. 1. left ventricular function is unchanged, lvef 40-45%. 2. right ventricular function is moderately depressed post-bypass. 3. aortic contours are intact post-decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 17:41 brief hospital course: 67 yo w with pmh of dm, htn, hyperlipidemia, hx of dvt on anticoagulation presents with stemi and heart block. initially in complete heart block. converted to mobitz type ii and intermittently with first degree heart block. creatinine rose from 3.1 to 3.9 with acute renal failure. she was taken to the operating room on where she underwent a cabg x 3. she was transferred to the icu on levophed, epinephrine, dobutamine, and propofol. she was seen immediately post op by electrophysiology as she was in complete heart block with a slow junctional escape and her epicardial wires failed. a temporary tranvenous pacing wire was placed. she underwent brochoscopy later that evening which showed rul secretions and atelectasis. she also developed a fib/aflutter.renal team consulted . two cardioversions were attempted on pod #3 without success.low dose vasopressin started whle still pressor dependent. sq heparin started for dvt prophylaxis.zosyn continued for low grade fevers. and wbc monitored closely. converted to sr on pod #7.cvvhd had been started for volume management/ anuria.pressors slowly weaned over then next few days. extubated on pod #7. dialysis catheter placed. dobhoff placed when she failed a bedside swallow eval. transferred to the floor on pod #9. transferred back to the cvicu on pod #13 for hyperglycemia control with an insulin drip. consult done for tighter management. wound care consult also done for left heel pressure. zosyn stopped on pod #14. transferred back to the floor on pod #15. thoracic surgery consulted for peg placement.plavix held and peg done . re-evaluated by pt and rehab screening done. free water boluses done for hypernatremia. multiple adjustments made for bp control. target sbp is 120-160. pt. should get 1-1.5 liters of free water daily with daily monitoring of sodium/lytes.creatinine on day of discharge is 2.7. current fixed and sliding scale insulin dosing chart is included with discharge papers as well as instructions for leg care/wound management.will probably need transition to ace-i as an outpt. under direction of pcp . . cleared for discharge to rehab on (pod #24). pt. is to make all followup appts. as per discharge instructions. medications on admission: calcitriol 0.25 microgram tab po daily lisinopril 40 daily nicardipine 20 mg three times a day lopressor 100 b.i.d. amitryptiline 50mg qhs lasix 40 mg po bid simvastatin 40mg po daily neurontin 400 twice a day iron 325 daily coumadin 4.5mg po qhs humulin 70/30 60u qam, 40u qpm discharge medications: 1. simvastatin 40 mg tablet : two (2) tablet po daily (daily). 2. albuterol sulfate 2.5 mg/3 ml solution for nebulization : one (1) neb inhalation q6h (every 6 hours) as needed. 3. ipratropium bromide 0.02 % solution : one (1) neb inhalation q6h (every 6 hours). 4. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 5. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 6. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) units injection (2 times a day): sub q. 7. tramadol 50 mg tablet : one (1) tablet po q6h (every 6 hours) as needed. 8. docusate sodium 50 mg/5 ml liquid : one hundred (100) mg po bid (2 times a day). 9. hydralazine 10 mg tablet : two (2) tablet po q6h (every 6 hours). 10. calcitriol 0.25 mcg capsule : one (1) capsule po every other day (every other day). 11. furosemide 20 mg tablet : one (1) tablet po daily (daily). 12. metoprolol tartrate 50 mg tablet : three (3) tablet po tid (3 times a day). 13. isosorbide dinitrate 10 mg tablet : two (2) tablet po tid (3 times a day). *******14. insulin - fixed dose and sliding scale charts are included with discharge papers. discharge disposition: extended care facility: discharge diagnosis: cad s/p rca angioplasty and cabg inf. mi dm, htn, prior cva(left side weakness), dvt(coumadin), neuropathy, ao-bifem bypass ' acute renal failure peg placement left heel pressure ulcer postop afib/flutter discharge condition: stable discharge instructions: call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week, shower daily, no baths, no lotions, creams or powders to incisions. no lifting more than 10 pounds for 8 weeks. no driving until follow up with surgeon. please give 1 to 1.5 liters of free water daily while monitoring daily sodium, as she has been hypernatremic. adaptic applied to both shins and wrap in kerlix, and continue waffle boots on both legs. followup instructions: dr. 2 weeks dr. after discharge from rehab provider: , md (renal) phone: date/time: 1:00 procedure: venous catheterization, not elsewhere classified 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 injection or infusion of platelet inhibitor left heart cardiac catheterization enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis percutaneous [endoscopic] gastrostomy [peg] other intubation of respiratory tract excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation atrial flutter chronic kidney disease, unspecified pulmonary collapse cardiogenic shock acute myocardial infarction of other inferior wall, initial episode of care pressure ulcer, heel diastolic heart failure, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled mobitz (type) ii atrioventricular block 

Answer: The patient is high likely exposed to