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: bactrim / tetracyclines / vasotec / isordil / procardia attending: chief complaint: chest pain major surgical or invasive procedure: cardiac cath coronary artery bypass graft x 4 (lima to lad, svg to diag, svg to om, svg to drca), mitral valve repair with 26mm ce ring history of present illness: 73 yo female with known severe cad s/p rca stent in , htn, hypothyroidism, presents with a chief complaint of chest pain. the pt reports that for the last week she has experienced several episodes of burning sscp with radiation to the neck and right shoulder in the evenings while in bed before falling asleep. prior to this she has not experienced any cp since when she had a stent placed. the pt would take sl ntg and get relief. on the evening of admission, she again experienced pain however 3 sl ntg did not improve her sxs. no associated sob, n/v or diaphoresis. she called 911 and was taken to the ed. there, her ecg was thought essentially unchaged from baseline. in the ed, she was started on ntg and heparin gtts and quickly became pain free. she is now admitted to cardiology for further care. past medical history: coronary artery disease s/p stent placement in , severe hypertension with history of hypertensive emergency, dyslipidemia, hypothyroidism, peripheral vascular disease with intermittent claudication, obesity, gout, hiatal hernia, fibroid uterus, spine scoliosis and arthritis, benign cartilage tumor (most probably an enchondroma), severe spinal stenosis social history: she does not smoke or drink alcohol. quit tob >40 yrs ago. retired real estate . family history: positive family history of early cad in multiple relatives. physical exam: vitals: t 97.4 p 60 r 18 149/70 97% on 2l gen: well appearing adult female, no acute distress. heent: perrl, eomi. mmm. conjunctiva well pigmented. neck: supple, without adenopathy or jvd. no tenderness with palpation. chest: ctab anterior and posterior. cor: normal s1, s2. rrr. no murmurs appreciated. abdomen: soft, non-tender and non-distended. mildly obese. +bs, no hsm. extremity: warm, without edema. neuro: alert and oriented. cn 2-12 intact. motor strength intact in all extremities. sensation intact grossly. pulses: right: carotid 2+ femoral 2+ dp 2+ left: carotid 2+ femoral 2+ dp 2+ pertinent results: cath: 1. selective coronary angiography of this right dominant system revealed diffuse three vessel coronary artery disease. the lmca had a 50% stenosis at its origin, and a 70% stenosis distally. the mid lad had a 70% stenosis, with diffuse disease distally. the let circumflex had a 99%stenosis in the proximal and mid portions. the rca had a 50% stenosis in the mid portion and a 80% stenosis distally. 2. resting hemodynamic measurements revealed severe systemic arterial hypertension with a sbp ranging from 150-180 during nitroglycerine infusion. 3. there was a 50mm hg gradient noted across a stenotic segment of the right iliac artery at the level of the aortic bifurcation. echo: pre-cpb: this study was limited by poor gastric windows. no spontaneous echo contrast is seen in the left atrial appendage. the rv shows mild global free wall hypokinesis. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate to severe (3+) mitral regurgitation is seen. in the face of mr, lv systolic fxn appears mildy depressed, with an ef of 45 -50%. there is hypokinesis of the inferior, infero-septal and posterior walls. there is no pericardial effusion. post-cpb: the patient is a-paced, on low-dose epi and ntg infusions. there is a well-seated and functioning prosthetic mitral annular ring. there is no mr . the residual peak gradient is 4, and area is 3.1. there is good rv systolic fxn. the lv systolic fxn is good, with residual inferior, inf-septal and posterior hk. aorta intact. 05:07am blood wbc-9.9 rbc-2.82* hgb-8.6* hct-25.6* mcv-91 mch-30.5 mchc-33.6 rdw-14.1 plt ct-253 02:17am blood pt-13.5* ptt-31.1 inr(pt)-1.2* 05:07am blood glucose-106* urean-38* creat-0.8 na-140 k-3.4 cl-102 hco3-33* angap-8 , f 73 radiology report chest (pa & lat) study date of 9:45 am , csurg fa6a sched chest (pa & lat) clip # reason: ? effusion medical condition: 73 year old woman with s/p cabg reason for this examination: ? effusion provisional findings impression: lcpc tue 12:59 pm pfi: since , right internal jugular now ends in mid svc. left lower lobe alveolar opacity and less marked right lower lobe opacity slightly increased. bilateral pleural effusions mostly on the left are small and unchanged. preliminary report !! pfi !! pfi: since , right internal jugular now ends in mid svc. left lower lobe alveolar opacity and less marked right lower lobe opacity slightly increased. bilateral pleural effusions mostly on the left are small and unchanged. dr. dr. pfi entered: tue 12:59 pm echocardiography report , (complete) done at 11:12:46 am final referring physician information , , status: inpatient dob: age (years): 73 f hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: cabg/?mvr icd-9 codes: 786.05, 786.51, 799.02, 440.0, 424.0 test information date/time: at 11:12 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: suboptimal tape #: 2008aw-1: machine: aw3 echocardiographic measurements results measurements normal range left ventricle - inferolateral thickness: 0.9 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.4 cm <= 5.6 cm aorta - ascending: 2.8 cm <= 3.4 cm aorta - descending thoracic: 2.4 cm <= 2.5 cm findings left atrium: no spontaneous echo contrast is seen in the laa. right atrium/interatrial septum: normal interatrial septum. right ventricle: mild global rv free wall hypokinesis. aorta: normal ascending aorta diameter. 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 mitral annular calcification. moderate to severe (3+) mr. tricuspid valve: mild tr. pulmonic valve/pulmonary artery: 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-cpb: this study was limited by poor gastric windows. no spontaneous echo contrast is seen in the left atrial appendage. the rv shows mild global free wall hypokinesis. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate to severe (3+) mitral regurgitation is seen. in the face of mr, lv systolic fxn appears mildy depressed, with an ef of 45 - 50%. there is hypokinesis of the inferior, infero-septal and posterior walls. there is no pericardial effusion. post-cpb: the patient is a-paced, on low-dose epi and ntg infusions. there is a well-seated and functioning prosthetic mitral annular ring. there is no mr . the residual peak gradient is 4, and area is 3.1. there is good rv systolic fxn. the lv systolic fxn is good, with residual inferior, inf-septal and posterior hk. aorta intact. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 14:03 brief hospital course: as mentioned in the hpi, ms. was admitted from the ed with chest pain. she was brought for a cardiac cath on which revealed left main and three vessel disease. she was appropriately worked up for surgery and on she was brought to the operating room. echo in or showed moderate to severe mitral regurgitation. in addition to undergoing coronary artery bypass surgery, she also had a mitral valve repair. this procedure performed by dr. . please see operative note for further details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. her chest tubes were removed and she was gently diuresed. the cardiology service saw her in consultation. by post-operative day 2 she was extubated. her epicardial wires were removed on the following day and she was transferred to the step down floor. her blood pressure medications were titrated up as tolerated. by post-operative day 5 she was discharged to rehab. medications on admission: atorvastatin 40 mg daily, plavix 75 mg daily, triameterene-hctz 37.5-25 daily, asa 325 mg daily, atenolol 100 mg daily, verapamil 300 mg daily, amlodipine 5 mg daily, benzapril 20 mg daily, labetalol 400 mg , levothyroxine 200 mcg daily, allopurinol 150 mg qhs, triavil, colace, senna, mvi daily discharge medications: 1. furosemide 40 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days. 2. potassium chloride 20 meq packet sig: one (1) packet po q12h (every 12 hours) for 7 days. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 6. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 7. amitriptyline 10 mg tablet sig: one (1) tablet po bid (2 times a day). 8. perphenazine 2 mg tablet sig: one (1) tablet po bid (2 times a day). 9. clonidine 0.1 mg tablet sig: one (1) tablet po tid (3 times a day). 10. levothyroxine 100 mcg tablet sig: two (2) tablet po daily (daily). 11. multivitamin tablet sig: one (1) tablet po daily (daily). 12. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 13. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 14. labetalol 200 mg tablet sig: two (2) tablet po tid (3 times a day). 15. allopurinol 300 mg tablet sig: 0.5 tablet po daily (daily). 16. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 17. hydromorphone 2 mg tablet sig: 1-2 tablets po every hours as needed. 18. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 19. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: - discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 mitral regurgitation s/p mitral valve repair myocardial infarction pmh: s/p stent placement in , severe hypertension with history of hypertensive emergency, dyslipidemia, hypothyroidism, peripheral vascular disease with intermittent claudication, obesity, gout, hiatal hernia, fibroid uterus, spine scoliosis and arthritis, benign cartilage tumor (most probably an enchondroma), severe spinal stenosis discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 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 approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr. in 4 weeks dr. dr. phone: date/time: 9:30 am radiology phone: date/time: 10:30 am ortho xray (scc 2) phone: date/time: 8:00 am md procedure: venous catheterization, not elsewhere classified (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization annuloplasty diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome mitral valve disorders unspecified essential hypertension atherosclerosis of native arteries of the extremities with intermittent claudication gout, unspecified percutaneous transluminal coronary angioplasty status diaphragmatic hernia without mention of obstruction or gangrene 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 oliguria and anuria 

Answer: The patient is high likely exposed to