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: ace inhibitors attending: chief complaint: chest pain major surgical or invasive procedure: coronary atrtery bypass grafts x4(lima-lad,svg-dg,svg-om,svg-drca) left heart catheterization, coronary angiogram history of present illness: 79 year old female with hx of colon cancer s/p r colectomy on folfax presented to the ed with chest pain. she reports intermittent anginal chest pain over the last few months. she recently saw pcp and was c/o severe chest discomfort. at that time she described the pain as substernal and nonradiating to arms, jaw or back. the pain woke her from sleep at times and was usually relieved with warm water and tums. in addition, she also endorsed reflux symptoms, and pain associated with meals. on the morning of presentation patient woke up with severe chest pain and called ems. she was found to have coronary artery disease upon cardiac catheterization and is now being referred to cardiac surgery for revasculariztion. cardiac catheterization: date: place: lad: long 95% ostial, 70% mid, 70% major diagonal lcx: 60% major om1 rca: 60% ostial past medical history: - glaucoma - ckd/cri - chronic hip and low back pain - see podiatry for foot issues - multiple bumions - gout - shingles - hypothyroidism - hypertension - hyperlipidemia - diabetes mellitus - chronic kidney disease (baseline 1.8-2.0) - gastritis - hypothyroidism - glaucoma - osteoarthritis - stage iii (t2 n1a m0) colon (cecal) adenocarcinoma s/p right hemicolectomy and currently on adjuvant chemotherapy with folfox. surghx: status post right ankle surgery status post right hand surgery right hemicolectomy social history: divorced. lives alone. has 5 children (4 live nearby). previously worked in a laundromat. -tobacco history: 30 pack year history - quit 37 years ago -etoh: denies -illicit drugs: denies family history: mother with hypertension maternal grandmother with cancer of unknown primary and diabetes father had an mi at the age of 98 brother with diabetes no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: pulse:74 resp:16 o2 sat:100/ra b/p right:131/58 left:131/60 height:5'3" weight:168 lbs general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema none varicosities: none neuro: grossly intact pulses: femoral right: 1+ left: 1+ dp right: 1+ left: 1+ pt : 1+ left: 1+ radial right: 2+ left: 2+ carotid bruit right:- left:- pertinent results: 10:40am blood neuts-49.7* lymphs-36.7 monos-6.7 eos-6.7* baso-0.1 03:48am blood wbc-6.8 rbc-3.24* hgb-9.9* hct-28.4* mcv-88 mch-30.4 mchc-34.7 rdw-15.5 plt ct-92* 09:03am blood pt-15.3* inr(pt)-1.4* 12:33am blood pt-20.1* ptt-34.7 inr(pt)-1.9* 03:02pm blood pt-15.6* ptt-26.2 inr(pt)-1.5* 02:07pm blood pt-17.4* ptt-22.5* inr(pt)-1.6* 02:30pm blood pt-13.1* ptt-57.3* inr(pt)-1.2* 03:48am blood glucose-102* urean-30* creat-2.4* na-129* k-4.3 cl-94* hco3-26 angap-13 10:40am blood glucose-230* urean-29* creat-1.8* na-141 k-3.8 cl-104 hco3-28 angap-13 02:30pm blood alt-19 ast-34 ck(cpk)-110 alkphos-119* amylase-54 totbili-0.3 dirbili-0.1 indbili-0.2 07:33am blood ck-mb-10 ctropnt-0.93* 10:31pm blood ck-mb-17* ctropnt-0.99* 10:40am blood ctropnt-0.44* 04:17am blood wbc-10.8 rbc-3.42* hgb-10.3* hct-30.3* mcv-89 mch-30.1 mchc-34.0 rdw-15.0 plt ct-183 01:58am blood wbc-8.9 rbc-3.33* hgb-10.1* hct-29.1* mcv-88 mch-30.4 mchc-34.7 rdw-15.4 plt ct-142*# 03:48am blood wbc-6.8 rbc-3.24* hgb-9.9* hct-28.4* mcv-88 mch-30.4 mchc-34.7 rdw-15.5 plt ct-92* 04:17am blood glucose-97 urean-30* creat-1.9* na-133 k-3.8 cl-95* hco3-29 angap-13 01:58am blood glucose-84 urean-30* creat-2.0* na-133 k-4.1 cl-95* hco3-32 angap-10 03:48am blood glucose-102* urean-30* creat-2.4* na-129* k-4.3 cl-94* hco3-26 angap-13 tte pre-cpb: the left atrium is markedly dilated. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. mild hypokinesis is seen in the basal septal and anteroseptal segments. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are complex (>4mm) atheroma with mobile component in the distal aortic arch, maximum height measuring 1.1cm. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta, maximum height measuring 0.8cm. no thoracic aortic dissection is seen. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. mild (1+) central aortic regurgitation is seen. the mitral valve leaflets are structurally normal. trivial mitral regurgitation is seen. post-cpb: the patient is on a phenylephrine infusion. left ventricular systolic function appears mildly improved. estimated ef>55%. right ventricular function is preserved. valvular function is unchanged from pre-bypass. there continues to be a pfo now with bidirectional shunt. the mobile atheroma in the distal arch appears unchanged. there is no evidence of aortic dissection. brief hospital course: mrs was admitted to the hospital with unstable angina and after admission she remained pain free. catherization was done on and this revealed 95% osteal lad and triple vessel disease. she was referred for surgical revascularization. she was brought to the operating room on where the patient underwent coronary bypass grafting x4 with left internal mammary artery left anterior descending coronary; reverse saphenous vein single graft from the aorta to the first diagonal coronary artery; reverse saphenous vein single graft from the aorta to the first obtuse marginal coronary; as well as reverse saphenous vein single graft from aorta to the distal right coronary artery. see operative note for full details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated and breathing comfortably. she was lethargic with a tenuous resiratory status initially post op and therefore kept in the cvicu until pod 4. the patient was neurologically intact but percocet was stopped and ultram was given for pain medications due to lethargy. she was hemodynamically stable on no inotropic or vasopressor support. her wbc fell to 1.7 initally post op and then rose to 5-6,000 and was normal at discharge. oncology was consulted given her recent chemotherapy and recommendations ade to follow anc and temperature and to have low index of suspicion for infection. heme-onc outpatient follow up was arranged. the cts were removed on pod 2 and wires on pod 3 per cardiac surgery protocol. she spiked a fever on pod 1 night was pan cultured but all cultures were negative or pending at the time of discharge. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery with an improved mental and respiratory status. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod #6 the patient was ambulating with assistance, the wound was healing well and pain was controlled with ultram and tylenol. the patient was discharged to rehab in good condition with appropriate follow up instructions. medications on admission: colchicine - 0.6 mg tablet - 0.5 (one half) tablet(s) by mouth daily esomeprazole magnesium - 20 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth daily furosemide - 20 mg tablet - 1 tablet(s) by mouth daily gabapentin - 800 mg tablet - 1 tablet(s) by mouth at bedtime insulin glargine - (dose adjustment - no new rx) - 100 unit/ml solution - 25 units daily at night insulin lispro - 100 unit/ml insulin pen - please take according to sliding scale at lunch and dinner sliding scale: 150-199 2u 200-249 4u 250-299 6u 300-349 8u > 350 10u levothyroxine - 25 mcg tablet - one tablet(s) by mouth daily metoclopramide - 10 mg tablet - 1 tablet(s) by mouth four times a day thirty minutes before meals and at bedtime metoprolol succinate - 25 mg tablet extended release 24 hr - 1 tablet(s) by mouth twice daily ondansetron hcl - 8 mg tablet - 1 tablet(s) by mouth q 8 hour take q8hour for 2 days after chemotherapy, then as needed for nausea/vomiting oxycodone - 5 mg tablet - tablet(s) by mouth q4-6 hours as needed for pain prochlorperazine maleate - 10 mg tablet - 1 tablet(s) by mouth q 8 hour as needed for nausea/vomiting simvastatin - 10 mg tablet - one tablet(s) by mouth taken in the evening spironolacton-hydrochlorothiaz - 25 mg-25 mg tablet - 1 tablet(s) by mouth once a day sucralfate - 1 gram tablet - 1 tablet(s) by mouth before each meal and before bed acetaminophen - (prescribed by other provider) - 500 mg tablet - 1 tablet(s) by mouth three times a day calcium carbonate-vitamin d3 - (otc) - 500 mg calcium (1,250 mg)-400 unit tablet - tablet(s) by mouth discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temperature >38.0. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 7. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 10. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 11. hydralazine 50 mg tablet sig: one (1) tablet po q6h (every 6 hours). 12. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 13. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 14. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dryness. 15. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily). 16. colchicine 0.6 mg tablet sig: two (2) tablet po daily (daily). 17. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 18. gabapentin 400 mg capsule sig: two (2) capsule po q24h (every 24 hours). 19. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 20. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: two (2) tablet, chewable po daily (daily). 21. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 22. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 23. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 24. lasix 20 mg tablet sig: one (1) tablet po once a day. 25. lantus 25 units sq qam 26. humalog humalog insulin per sliding scale discharge disposition: extended care facility: - discharge diagnosis: unstable angina s/p coronary artery bypass insulin dependent diabetes mellitus stage 3 colon cancer chronic kidney disease hypertension hypothyroidism gout s/p right hemicolectomy glaucoma osteoarthritis discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with ultram and tylenol incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema: trace discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments: surgeon: dr. () on at 1:15pm in the medical office building suite2a cardiologist: dr. date/time: 10:30 provider: , : date/time: 12:40 provider: , md phone: date/time: 10:30 please call to schedule appointments with: primary care: dr. . (in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: (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 diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery intestinal bypass or anastomosis status acute posthemorrhagic anemia unspecified acquired hypothyroidism chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified other and unspecified hyperlipidemia long-term (current) use of insulin delirium due to conditions classified elsewhere diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled leukocytopenia, unspecified malignant neoplasm of colon, unspecified site other secondary thrombocytopenia body mass index 31.0-31.9, adult 

Answer: The patient is high likely exposed to