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: penicillins / sulfa (sulfonamide antibiotics) attending: chief complaint: dyspnea on exertion/ paroxysmal nocturnal dyspnea major surgical or invasive procedure: coronary artery bypass grafting x4 (left internal mammary artery grafted to left anterior descending artery/saphenous vein grafted to obtuse marginal #1/#2/posterior descending artery)- history of present illness: 56 year old female with known coronary artery disease, status post stenting, cardiomyopathy, and two recent chf admissions (/)reports progressive dyspnea on exertion and paroxysmal nocturnal dyspnea referred for cardiac catheterization for further evaluation.cath report revealed multivessel coronary disease. dr. was consulted for coronary revascularization. past medical history: cad s/p mi and lad stenting in with repeat stenting for isr pvd le claudication s/p left leg angioplasty for an ischemic leg per patient report ? cardiomyopathy chronic systolic heart failure s/p admissions and diabetes mellitus hypertension per records from outside md (patient reports this to be inaccurate) hyperlipidemia past surgical history= cholecystectomy s/p abdominal aortic aneurysm repair at the hospital approximately 15 years ago (per patient report) social history: lives with:husband & daughter :caucasian tobacco:quit 1month ago: 2ppd x40 yrs etoh:none family history: family history: (parents/children/siblings cad < 55 y/o):father s/p mi and died age 55 physical exam: physical exam pulse:64 resp:18 o2 sat: 99%ra b/p right: 161/63 left:168/61 height:5'4" weight:150 lbs general:alert & oriented skin: dry intact heent: perrla eomi , no dentures neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular no murmur, gallops or rubs. abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right:2+ left:2+ dp right:1+ left:1+ pt :1+ left:1+ radial right:2+ left:2+ carotid bruit right:no left:no pertinent results: 06:15am blood wbc-10.9 rbc-3.90* hgb-11.3* hct-34.6* mcv-89 mch-28.9 mchc-32.5 rdw-15.4 plt ct-290 12:45pm blood wbc-15.3*# rbc-2.40*# hgb-7.1*# hct-20.5*# mcv-85 mch-29.4 mchc-34.4 rdw-15.6* plt ct-310 01:09am blood pt-13.8* ptt-29.5 inr(pt)-1.2* 12:45pm blood pt-14.7* ptt-34.3 inr(pt)-1.3* 06:15am blood glucose-78 urean-43* creat-1.7* na-139 k-3.9 cl-102 hco3-25 angap-16 03:29am blood glucose-77 urean-19 creat-1.3* na-140 k-4.2 cl-112* hco3-20* angap-12 04:56pm blood alt-18 ast-27 ld(ldh)-374* alkphos-58 amylase-16 totbili-0.8 echocardiography report , (complete) done at 9:39:05 am final referring physician information , c. , status: inpatient dob: age (years): 56 f hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: aortic valve disease. coronary artery disease. left ventricular function. mitral valve disease. valvular heart disease. icd-9 codes: 440.0, 424.1, 424.0 test information date/time: at 09:39 interpret md: , md test type: tee (complete) 3d imaging. son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw01-: machine: echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 30% to 40% >= 55% findings multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: mild la enlargement. no spontaneous echo contrast or thrombus in the body of the laa. all four pulmonary veins identified and enter the left atrium. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. no asd by 2d or color doppler. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness and cavity size. moderately depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets (?#). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic 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 tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-bypass: the left atrium is mildly dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. overall left ventricular systolic function is moderately depressed (lvef=35-40 %). there is moderate anterior wall and antero-septal hypokinesia. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. post cpb: 1. slightly improved global and focal lv systolci function with background inotropic support. 2. trace mr and trace tr. 3. intact aorta electronically signed by , md, interpreting physician 17:12 , f 56 radiology report renal u.s. port study date of 10:20 am , csru 10:20 am renal u.s. port; duplex dop abd/pel limited clip # reason: low uo sp cabg,eval for stenosis medical condition: 56 year old woman with low uo s/p cabg reason for this examination: stenosis provisional findings impression: gwp sat 4:52 pm pfi: 1. limited portable renal ultrasound demonstrating no hydronephrosis, no nephrolithiasis and no solid renal mass. 2. right renal artery resistive index measured at 0.85, 0.76, 0.78 and infrarenal flow with resistive indices 0.77, 0.79 and 0.80. 3. left renal artery resistive index measured at 0.87, 0.88 with elevated velocities measured at 160, 200 cm/sec. velocities and resistive indices in the intrarenal portion appear normal at 0.71, 0.84, and 0.84. final report indication: 56-year-old woman with low urine output status post cabg, query stenosis. comparison: none available. portable renal ultrasound: grayscale and color doppler son images were obtained that demonstrate the right kidney to measure 10.8 cm pole to pole and the left 10.3 without evidence for hydronephrosis, nephrolithiasis, or renal mass. on the right main renal artery demonstrates flow velocity between 71 and 87 cm/sec and resistive index measured at 0.85 and 0.76. infrarenally, the upper, mid, and lower velocities are measured at 76, 62 and 103 cm/sec and the resistive indices 0.79, 0.77 and 0.80. right renal venous flow is normal. on the left, the main renal artery velocity is measured at 200 and 166 cm/sec, with resistive index at 0.88 and 0.87. the interlobar velocities are measured in the upper, mid and lower pole at 83, 56 and approximately 40 cm/sec. resistive indices are measured at 0.84, 0.71, and 0.70. a foley catheter is demonstrated within the decompressed bladder. impression: 1. no son evidence for hydronephrosis, left nephrolithiasis, or renal mass. 2. normal arterial and venous flow demonstrated at the right kidney. 3. in this limited portable son study, there are elevated velocities and elevated ris demonstrated in the left renal artery concerning for stenosis. consider mra for further evaluation. a non contrast mra examination is possible if patient's renal function precludes administration of contrast. the study and the report were reviewed by the staff radiologist. dr. dr. approved: sun 4:17 pm imaging lab brief hospital course: on mrs. underwent coronary artery bypass grafting x4 (left internal mammary artery grafted to left anterior descending artery/saphenous vein grafted to obtuse marginal #1/#2/posterior descending artery) with dr.. cross clamp time= 97 minutes/ cardiopulmonary bypass time= 132 minutes. please refer to dr operative report for further details. she was transferred to the cvicu hemodynamically stable requiring milrinone to optimize cardiac output. she awoke neurologically intact and was extubated on pod#1. she was weaned off inotropes. beta-blockers optimized per blood pressure tolerance. all lines and drains were discontinued in a timely fashion. psychiatry was consulted for postoperative delirium. she continued to progress and on pod# 4 was transferred to the step down unit for further monitoring. her rhythm went into rapid atrial fibrillation and was treated with amiodarone. she converted to sinus rhythm, no anticoagulation required. she was diuresed for right pleural effusion evident on chest xray. the remainder of her postoperative course was essentially uncomplicated and on pod# 6 she was cleared for discharge to rehab for further strength, endurance and increase in daily activities. all follow up appointments were advised. pt. should have a mra as an outpt. for follow up of possible left renal artery stenosis. please restart metformin when creatinine has normalized. medications on admission: glyburide 5mg one tablet twice a day *plavix 75mg daily every morning atenolol 25mg daily every morning imdur 30mg daily every morning lisinopril 5mg daily every morning furosemide 40mg one tablet every morning simvastatin 20mg one tablet every morning metformin 500mg one tablet twice a day ecotrin 81mg daily every morning discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 5. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 6. glyburide 5 mg tablet sig: one (1) tablet po bid (2 times a day). 7. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 5 days: 400 mg until , then 400 mg daily for 7 days, then 200 mg daily ongoing. 8. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 9. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 10. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 2-4 puffs inhalation q4h (every 4 hours) as needed for wheezing/sob. 11. hydralazine 25 mg tablet sig: two (2) tablet po q6h (every 6 hours). 12. furosemide 40 mg tablet sig: one (1) tablet po twice a day: please assess for dose reduction after one week. 13. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours): please assess for dose reduction when oral lasix is decreased. 14. humalog insulin per sliding scale qid. discharge disposition: extended care facility: life care center - discharge diagnosis: status post coronary artery bypass grafting x4 (left internal mammary artery grafted to left anterior descending artery/saphenous vein grafted to obtuse marginal #1/#2/posterior descending artery)- -myocardial infarction /lad stenting ' -lower extremity claudication, s/p left leg angioplasty ' -cardiomyopathy -chf: .& -diabetes mellitus -hypertension -hyperlipidemia - postop acute renal failure -s/p choleycystectomy' discharge condition: good discharge instructions: no lotions, creams or powders on any incision shower daily and pat incision dry no driving for one month no lifting greater than 10 pounds for 10 weeks call for fever greater than 100, redness, drainage, or weight gain of 2 pounds in 2 days or 5 pounds in one week followup instructions: dr. in 4 weeks, please call for appointment# dr. in weeks, please call for appointment dr , m. , please call for appt to be scheduled in weeks; *** note: should have mra as outpatient to follow up on possible left renal artery stenosis procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery diagnoses: other primary cardiomyopathies acidosis anemia, unspecified coronary atherosclerosis of native coronary artery intermediate coronary syndrome acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia atrial fibrillation unspecified transient mental disorder in conditions classified elsewhere peripheral vascular disease, unspecified percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia atherosclerosis of renal artery old myocardial infarction acute on chronic systolic heart failure bipolar disorder, unspecified 

Answer: The patient is high likely exposed to