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: history of present illness: this 43-year-old female had a known history significant for coronary artery disease. she had a non-st elevation myocardial infarction in with stenting of her lad and circumflex. she returned two weeks after that with angina and a positive exercise tolerance test. had a stent placed to the rca at that time. a stress test on depressions with partially reversible defect to the lateral wall, which was new since the study in . she reported ongoing angina mostly at rest relieved with sublingual nitroglycerin and shortness of breath with exertion. she had a cardiac catheterization done on , which showed patent prior stents and a 70 percent left main stenosis. past medical history: coronary artery disease with stents to the lad, circumflex, and rca as above. hypertension. hypercholesterolemia. status post tonsillectomy. status post tubal ligation. history of d and c status post stillborn birth. allergies: codeine which caused vomiting. meds prior to cath: 1. aspirin 325 mg daily. 2. lisinopril 5 mg p.o. daily. 3. toprol xl 100 mg p.o. daily. 4. lipitor 80 mg p.o. daily. 5. plavix 150 mg p.o. daily. 6. paxil 10 mg p.o. daily. 7. ambien 5 mg p.o. q.h.s. social history: the patient lives in with family, her husband and two children ages 17 and 20. she quit smoking in with a 30 plus pack year history. she admits to one alcoholic drink per week. family history: her family history was positive. her mother had coronary artery disease at 47 years of age. is still living. her father had a myocardial infarction in his 60's. review of systems: weight is stable. she was sleeping well with the ambien with no difficulty with her appetite at this time. she was negative for psoriasis, pruritus, or sores. she had positive history of rare migraines, but negative for cataracts, glaucoma, sinusitis, rhinorrhea, or epistaxis. she had no history of asthma, pneumonia, bronchitis, tuberculosis; other than a remote episode of pneumonia more than 20 years ago. her cardiovascular systems review is positive for palpitations and angina and myocardial infarction, but negative for chf, pnd, orthopnea, or edema. she also had a history of claudication. she had no history of nausea, vomiting, diarrhea, or constipation, problems with or hemorrhoids as well as negative for dysuria, frequency, or burning. her musculoskeletal system was negative for arthritis, fractures, or dislocations. neurologically: she was intact with no neurologic history. negative for cva, seizures, syncope, and tias. she had no history of bleeding problems or bruising, and was on paxil for her smoking cessation with no history of depression or anxiety. physical examination: on exam, she is 5'3" tall, 153 pounds with a heart rate of 47. blood pressure 102/98. saturating 98 percent on room air. she was lying in bed in no apparent distress. she was alert and oriented times three, appropriate, and neurologically grossly intact. her lungs were clear bilaterally. heart had good tones at s1, s2, regular rate and rhythm, bradycardic with no murmurs, rubs, or gallops. her abdomen was soft, obese, nontender, and nondistended and had positive bowel sounds. her extremities were warm and well perfused with no varicosities or edema. she had 2 plus bilateral radial, dp and pt pulses. preoperative labs: white count 9.3, hematocrit 33.7, platelet count 320,000. sodium 138, k 4.1, chloride 104, co2 21, bun 13, creatinine 0.9 with a blood sugar of 162. pt 14.3, ptt 131.8 on heparin, inr 1.3. alt 23, ast 20, alkaline phosphatase 122, amylase 32, total bilirubin is 0.3, and albumin 4.2. hospital course: the patient was referred to dr. of cardiothoracic surgery for coronary artery bypass grafting. of note on prior cardiac catheterization in , the patient had complication of left superficial femoral artery occlusion in the cath lab. in addition, echocardiogram performed preoperatively showed ejection fraction of approximately 50-55 percent and on , the patient underwent coronary artery bypass grafting x2 with a lima to the lad and a vein graft to the om by dr. . the patient was taken to the cardiothoracic icu in stable condition on an epinephrine drip at 0.02 mcg/kg/minute, nitroglycerin drip at 0.3 mcg/kg/day, and a neo-synephrine drip at 1.5 mcg/kg/minute. approximately 1-2 hours after arrival on the cardiothoracic icu, the patient displayed a depressed cardiac index with very high normal filling pressures. echocardiogram was performed, which showed the distal of the lv to be severely hypokinetic at the apex, which appeared to be akinetic and ejection fraction of approximately 25 percent. the rv size was normal. rv systolic function was mild-to- moderately depressed. there was trace mr, no ai, mild tricuspid regurgitation, no pr, no asd, pfo by 2-d color doppler. decision was made to take the patient emergently back to the cardiac catheterization laboratory fearing the patient had suffered an acute mi approximately two hours after bypass surgery. the hemodynamics in the cath lab were consistent with cardiogenic shock and a depressed cardiac index. aortogram did show diffuse aortoiliac disease with a minimum diameter of 2 mm in bilateral common femoral arteries which was too small for any intra-aortic balloon pump to be safely placed. cardiac catheterization showed that the vein graft to the om had 100 percent proximal occlusion with thrombus and the lima to lad was widely patent with 40 percent anastomotic lesion and diffuse spasm in the lad beyond the touchdown. in the cath lab, the distal rca was stented with a cypher stent and dilatation in the area of spasm. left main was also stented with a cypher stent and the distal om occlusion was crossed, dilated, and intracoronary nitroglycerin was given via balloon to relieve spasm. please refer to the final cardiac catheterization report from . the patient was then transported back to the cardiothoracic icu. on postoperative day one, the patient remained on a neo- synephrine drip at 1.5 mcg/kg/minute and milrinone drip at 0.375 mcg/kg/minute, insulin drip at 10, lidocaine drip at 2.0, propofol drip at 20, nitroglycerin drip at 0.05. she was a-paced with a blood pressure of 131/72 and heart rate of 90, most a-paced. her cardiac index was 2.4. she remained intubated and sedated. postoperative laboratory work revealed a white count of 11.6, hematocrit of 27.4, platelet count of 207,000. bun 10, creatinine 0.8. she had decreased breath sounds bilaterally and decreased bowel sounds and 2 plus edema in her extremities. she began iv lasix for diuresis. her inr was 2.9. on postoperative day two, she remained on propofol drip, neo- synephrine drip, milrinone at 2.5, and nitroglycerin at 0.5, as well as a lidocaine drip at 1 mg/minute. she remained on pressure support and simv. her white count rose slightly to 15 and her laboratories remained relatively stable. her lungs had coarse breath sounds bilaterally. heart was regular rate and rhythm. she continued on her perioperative vancomycin with monitoring to try and wean some drips. on postoperative day three, she remained on insulin drip, milrinone at 0.25. neo-synephrine was turned off. a nitroglycerin drip at 0.8. precedex at 0.4. she continued with her plavix at 75 mg p.o. daily and was receiving lasix also intravenously. her white count came down to 9.8 with a hematocrit of 29.6. k of 3.6, bun 12, creatinine 0.6. blood pressure 115/60 in sinus rhythm in the 90s. she had no crackles, but decreased breath sounds bilaterally. heart was regular rate and rhythm and the plan was to wean and extubate her. she continued on her lasix diuresis. on postoperative day four, she was in sinus rhythm in the morning with some previous ectopy on amiodarone overnight, which continued. she was saturating 90 percent on 2 liters nasal cannula, continued on an insulin drip, and milrinone drip at 0.125, and nitroglycerin drip at 0.2. amiodarone drip at 1. her laboratory work was stable. she had crackles bilaterally. her sternum was stable. her incisions were clean, dry, and intact. she had 2 plus peripheral edema, significant amount of fluid on board, and continued her lasix diuresis. she was screened by the clinical nutrition team and evaluated by physical therapy. also on postoperative day five, she remained on amiodarone orally now. captopril was started at 6.25 mg p.o. t.i.d. as well as diltiazem 30 mg p.o. q.d. to help prevent spasm. she also continued on her plavix for her stents. she had a blood pressure of 111/88. her creatinine rose slightly to 1.0. she was hemodynamically stable and was transferred out to the floor. she was evaluated again by physical therapy while she was out there. pulmonary toilet was begun as well as ambulation. on postoperative day six, she had some pain only when she was coughing. was hemodynamically stable with good blood pressure. she had decreased breath sounds bilaterally and 2 plus peripheral edema, but otherwise her examination was unremarkable. she was encouraged to have aggressive physical therapy as well as chest physical therapy and work with her incentive spirometer. she was also seen by the case management team to evaluate her ability to go home with vna or to go to the facility in . on postoperative day seven, she was awake and alert with a t max of 97.9, blood pressure of 120/76, a heart rate of 74 in sinus rhythm with a respiratory rate of 20. her lungs were clear. her heart sounds were normal. incisions were clean, dry, and intact. sternum was stable. patient was doing very well. repeat echocardiogram revealed an ejection fraction of 50 percent with a plan for the patient to go home that day. she was ambulating well. was taking p.o. dilaudid for pain relief an to be followed by vna. she was discharged on in stable condition. discharge diagnoses: status post coronary artery bypass grafting times two. status post emergent cardiac catheterization with placement of coronary stents. hypertension. hypercholesterolemia. status post tonsillectomy. status post tubal ligation. history of dilatation and curettage for status post stillborn birth. status post stent placements in . discharge medications: 1. lasix 20 mg p.o. twice a day x7 days. 2. potassium chloride 20 meq p.o. twice a day for seven days. 3. docusate sodium 100 mg p.o. twice a day. 4. enteric coated aspirin 325 mg p.o. once a day. 5. isosorbide mononitrate 30 mg sustained release p.o. once a day. 6. amiodarone 400 mg p.o. twice a day x7 days, then amiodarone 400 mg p.o. once a day x7 days, then amiodarone 200 mg p.o. once a day x2 weeks. 7. lipitor 80 mg p.o. once a day. 8. paxil 10 mg p.o. once a day. 9. captopril 12.5 mg p.o. 3x a day. 10. hydromorphone/hydrochloride 2 mg 1-2 tablets p.o. prn q.4-6h for pain. 11. plavix 150 mg p.o. once a day. 12. diltiazem 120 mg p.o. once a day. follow-up instructions: the patient was instructed to make a follow-up appointment with dr. , her primary care physician and cardiologist in approximately 1-2 weeks after discharge and to followup with dr. for her postoperative surgical visit in the office in approximately four weeks post discharge. condition on discharge and disposition: patient was discharged in stable condition to a home with vna services on . , m.d. procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters left heart cardiac catheterization coronary arteriography using a single catheter diagnostic ultrasound of heart other and unspecified coronary arteriography other electric countershock of heart (aorto)coronary bypass of one coronary artery transfusion of packed cells transfusion of other serum insertion of drug-eluting coronary artery stent(s) diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified cardiogenic shock other complications due to other cardiac device, implant, and graft ventricular fibrillation family history of ischemic heart disease 

Answer: The patient is high likely exposed to