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: worsening sob major surgical or invasive procedure: cabg x2 (svg->om1/pda)/mvr (#28 ce annuloplasty)- history of present illness: cantonese speaking female(difficult to attain hx via phone interpreter). 76 y/o female with atrial fibrillation on , chf, severe mitral regurg, cad scheduled for cabg mvr , presenting with worsening sob and wheezing since saturday. . recent admission for shortness of breath thought related to hf exacerbation. on that admission rule out and cardiac cath demonstrating moderate to severe mitral regurgitation and two vessel cad. patient had pre-op evaluation for cabg/mvr recently with dr. . on that pe, mild rales bilaterally. . saturday onset of sob, w/o palpitations, chest pain, pleuritic chest pain, nausea, vomiting, or fever. reported cough with whitish sputum, w/o rhinorrhea, sick contacts. wheezing x two days as well. + 2 pillow orthopnea. sob at rest and with ambulation. no weight gain, le edema. difficult to assess functional capacity but worsening sob, doe over past months. patient and daughter(contact by phone state sx similar but less severe then previous admission for hf exacerbation). as per daughter one week prior received from epi provider in after complaint of cough. . in ed vs 98.6, 94, 127/79, 20, 96%ra. placed on 2l. diffuse wheezing on exam, irregular rhythm. ekg unchanged. bnp 1100. ce -, cxr with no infiltrate and no visible edema. given combivent neb, lasix 20 mg iv, potassium, asa 325. pt was admitted for further evaluation and management. past medical history: severe mitral regurgitation 3+ from cardiac cath. cad systolic and iastolic chf atrial fibrillation hypertension s/p cholecystectomy s/p ercp for cbd stone removal social history: never smoked, no alcohol use, no illicit drug use. she lives at home alone. during the day she spends time with family, at night she is by herself. she is very active at baseline. no issues with adls or iadls. family history: mother- colon ca brother- liver ca copd physical exam: vs - 98, 139/81, 74, 20, 95%ra gen: wdwn middle aged female in nad. oriented x3. mood, affect appropriate. audible wheeze with speaking heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 15 cm. cv: pmi located in 5th intercostal space, midclavicular line. irregularly irregurly. iii/vi systolic murmur. audible wheeze with examination chest: no chest wall deformities, scoliosis or kyphosis. rales bases. audible expiratory wheeze. no egophany, fremitus abd: soft, ntnd. surgical scar on abdomen. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. . pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: echocardiography report , (complete) done at 10:20:27 am final referring physician information , w. , status: inpatient dob: age (years): 76 f hgt (in): 62 bp (mm hg): 120/55 wgt (lb): 140 hr (bpm): 82 bsa (m2): 1.64 m2 indication: intraop cabg mvr. evaluate valves, ventricular function, aortic contours icd-9 codes: 440.0, 424.1, 424.0 test information date/time: at 10:20 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 #: 2008aw2-: machine: aw 2 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *6.0 cm <= 4.0 cm left atrium - four chamber length: *6.7 cm <= 5.2 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.7 cm <= 5.6 cm left ventricle - systolic dimension: 4.0 cm left ventricle - fractional shortening: *0.15 >= 0.29 left ventricle - ejection fraction: 45% to 50% >= 55% aorta - annulus: 2.0 cm <= 3.0 cm aorta - sinus level: 3.6 cm <= 3.6 cm aorta - sinotubular ridge: 2.8 cm <= 3.0 cm aorta - ascending: *4.2 cm <= 3.4 cm aorta - arch: 2.7 cm <= 3.0 cm aorta - descending thoracic: *3.0 cm <= 2.5 cm aortic valve - peak velocity: 1.2 m/sec <= 2.0 m/sec aortic valve - peak gradient: 6 mm hg < 20 mm hg aortic valve - mean gradient: 3 mm hg aortic valve - lvot pk vel: 0.71 m/sec aortic valve - lvot diam: 1.9 cm aortic valve - valve area: *2.0 cm2 >= 3.0 cm2 mitral valve - peak velocity: 0.8 m/sec mitral valve - mean gradient: 2 mm hg mitral valve - pressure half time: 72 ms mitral valve - mva (p t): 3.1 cm2 mitral valve - e wave: 0.8 m/sec findings left atrium: marked la enlargement. mild spontaneous echo contrast in the laa. cannot exclude laa thrombus. right atrium/interatrial septum: mildly dilated ra. normal interatrial septum. no asd by 2d or color doppler. left ventricle: mild symmetric lvh. normal lv cavity size. mild global lv hypokinesis. mildly depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. moderately dilated ascending aorta. normal aortic arch diameter. complex (>4mm) atheroma in the aortic arch. mildly dilated descending aorta. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: three aortic valve leaflets. no as. increased transaortic velocity related to increased stroke volume due to ar. mild to moderate (+) ar. eccentric ar jet. mitral valve: mildly thickened mitral valve leaflets. no ms. to co-existing ar, the pressure half-time estimate of mitral valve area may be an overestimation of true area. moderate to severe (3+) mr. uninterpretable lv inflow pattern due to mr. tricuspid valve: tricuspid valve not well visualized. mild tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. 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. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. conclusions pre bypass: the left atrium is markedly dilated. mild spontaneous echo contrast is present in the left atrial appendage. a left atrial appendage thrombus cannot be excluded. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild global left ventricular hypokinesis (lvef = 45-50 %). overall left ventricular systolic function is mildly depressed right ventricular chamber size and free wall motion are normal. the ascending aorta is moderately dilated. there are complex (>4mm) atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. there are three aortic valve leaflets. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to increased stroke volume due to aortic regurgitation. mild to moderate (+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric. the mitral valve leaflets are mildly thickened. due to co-existing aortic regurgitation, the pressure half-time estimate of mitral valve area may be an overestimation of true mitral valve area. moderate to severe (3+) mitral regurgitation is seen. there is no pericardial effusion. post bypass: perserved biventricular function, lvef 50%. there is a #28 full annuloplasty ring in the mitral postion. mr is now trace to 1+ peak gradient , mean 3 mm hg. ai remains +. aortic contours intact. remaining exam is unchanged. all findings discussed with surgeons at the time of the exam. brief hospital course: ms. is a 76 yr old female with cad, a-fib scheduled for cabg/mvr presenting with worsening sob. some complaints of chest discomfort this morning. likely acute on chronic systolic heart failure with cardiac wheeze in setting of reported dietary indiscretion especially improved markedly after diuresis. her was held given previously planned cabg/mvr and she was started on a heparin drip for a-fib. she was transferred to cardiac surgery. she was taken to the operating room on where she underwent a cabg x 2 and mitral valve repair. she was transferred to the icu in stable condition. she was given 48 hours of iv vancomycin as she was in the hospital > 24 hours preoperatively. she remained intubated overnight secondary to low svo2. she was transfused with packed red blood cells and was extubated on post op day 1. she was started on an amiodarone gtt for rapid atrial fibrillation. she was also restarted on . she was transferred to the floor late on pod #2. she was again transfused for a hct 20. chest tubes and pacing wires removed. beta blockade was titrated and diuresis was initiated. the physical therapy service was for assistance with her postoperative strength and mobility. ms. became distended with mildly elevated lft's consistent with pancreatitis. a gi consult was obtained and she was made npo. a ct scan showed multiple stones within the extrahepatic bile ducts as well as marked intra- and extra-hepatic biliary dilatation. on , ms. became tacypneic. she was returned to the icu and reintubated for respiratory distress and aggitation. ercp was recommended for suspected cholangitis which was performed in which a few biliary stones were extracted and a biliary stent was placed. a repeat ercp was planned in 2 months for stent removal and further stone extraction. ciprofloxacin and flagyl were started. she was successfully extubated on . her abdominal discomfort greatly improved however her ng tube was left in placed for abdominal distention. aggressive diuresis was initiated with zaroxyln and diuril. a bowel regimen was also started to promote gi motility. her diet was advanced slowly beginning with liquids. on , she was transferred back to the step down unit for further recovery. her lft's continued to trend towards normal. a large right pleural effusion was noted on chest x-ray. her family originally refused drianage however she later developed respiratory distress and cardiac arrest requiring resuscitation and intubation. she was thus returned to the intensive care unit for further care. a right chest tube was placed which drained 2 liters. an echo showed no pericardial effusion and mild aortic, mitral and tricuspid insufficiency. she was again extubated successfully on . the wound care nurse for assistance with her lower extremity wound. a wick wasplaced in the dehissed portion and a dry wrap was applied. a picc line was placed for antibiotic coverage of her surgical wounds. ms. failed to void and her foley catheter was replaced. she was transferred back to the step down unit on . ms. continued to make steady progress and was discharged to home on . she will follow-up with dr. , the gi service, her cardiologist and her primary care physician. with resume with dr. as an outpatient for a goal inr of 2.0-2.5. medications on admission: from last dc, pt does not know active list -docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day) -senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. -nitroglycerin 0.3 mg tablet, sublingual : one (1) tablet, sublingual sublingual prn -amlodipine 5 mg tablet : two (2) tablet po daily (daily). -aspirin 325 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily). -toprol xl 100 mg tablet sustained release 24 hr : two (2) tablet sustained release 24 hr po once a day. -warfarin 2 mg tablet : one (1) tablet po once (once): take as directed by your primary care physician. 40 mg daily discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet : 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 3. ranitidine hcl 150 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. aspirin 81 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 5. atorvastatin 20 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. outpatient lab work inr to be drawn on tuesday with results sent to dr. at (. goal inr 2-2.5 for atrial fibrillation. spoke to dr. on . 7. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 8. warfarin 1 mg tablet : two (2) tablet po daily (daily) as needed for afib: please take 2 mg (2 pills) daily until otherwise directed by the office of dr. . disp:*60 tablet(s)* refills:*0* 9. furosemide 40 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 10. diltiazem hcl 90 mg tablet : one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*0* 11. metoprolol tartrate 25 mg tablet : 1.5 tablets po q 8h (every 8 hours). disp:*135 tablet(s)* refills:*0* 12. potassium chloride 20 meq tab sust.rel. particle/crystal : two (2) tab sust.rel. particle/crystal po daily (daily). disp:*60 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: cad s/p cabg, mr s/p mvr afib, htn, s/p chole, s/p ercp for stone removal acute on chronic systolic and diastolic heart failure discharge condition: good. 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 10 weeks. no driving until follow up with surgeon or at least 4 weeks. followup instructions: dr. 2 weeks dr. 2 weeks dr. 4 weeks dr. for repeat ercp, stent removal and stone extraction in 2 months. inr to be drawn on saturday with results sent to dr. at (. goal inr 2-2.5 for atrial fibrillation. spoke to dr. on . procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnostic ultrasound of heart insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances endoscopic removal of stone(s) from biliary tract endoscopic insertion of stent (tube) into bile duct cardiopulmonary resuscitation, not otherwise specified open heart valvuloplasty of mitral valve without replacement diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation cardiac arrest retention of urine, unspecified acute pancreatitis acute on chronic combined systolic and diastolic heart failure calculus of bile duct without mention of cholecystitis, with obstruction 

Answer: The patient is high likely exposed to