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: lipitor / zetia attending: chief complaint: chest pain major surgical or invasive procedure: coronary artery bypass grafting x4 with a left internal mammary artery to left anterior descending artery and reverse saphenous vein grafts to the posterior descending artery, the distal left circumflex artery and the first diagonal artery history of present illness: 77 year old female transferred from with 3 vessel disease for potential cabg. patient has a long-standing history of cad s/p angioplasty twice in the past, in and . her last cath was in showing total rca occlusion, 65% proximal lad, 20% lm, ef 65%. she presented yesterday to hfh with 1 hour of severe midsternal chest pain radiated to the right jaw. ekg with poor rv progression and t inversion in v1, troponins slightly elevated. cardiac catheterization showed 85% proximal lad stenosis, 99% rca lesion with left to right collaterals and 75% stenosis of the circumflex with normal ef. she was advised to have a cabg and she agreed to proceed, and was transferred to . past medical history: coronary artery disease mild mitral regurgitation peripheral vascular disease paroxysmal a.fib anxiety pre-renal azotemia/renal insufficiency chronic diarrhea non-insulin dependent diabetes mellitus hypertension hyperlipidemia h/o right thyroid nodule (benign by biopsy) osteopenia lipoma pilonidal cyst cataracts aortobifem bypass bilateral cataract extractions excision of lipomas on back and right thigh social history: race: caucasian last dental exam: 7 months ago lives with: alone, widowed, has 2 children contact: daughter phone # occupation: retired cigarettes: smoked no yes last cigarette _____ hx: other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use family history: mother died of complications from dm father died of tuberculosis, young brothers died under 60 from heart disease physical exam: pulse: 58 resp: 18 o2 sat: b/p right: 134/62 weight: 164.68 lbs, 74.7 kg general: nad, aaox3 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 extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right: palp left: palp dp right: palp left: palp pt : palp left: palp radial right: palp left: palp carotid bruit right: none left: none discharge exam: vs: t: 98.1 hr: 59 sr bp: 107/53 sats: 93% ra wt: 76.9 kg general: 77 year-old female in no apparent distress heent: normocephalic, mucus membranes moist neck: supple no lymphadenopathy card: rrr normal s1,s2 no murmur resp: clear breath sounds throughout gi: benign extr: warm bilateral with trace edema incision: sternal clean dry intact no erythema or click. left lower extremity vasoview incisions clean dry intact no erythema neuro: awake, alert oriented. moves all extremities pertinent results: chest ct : 1. substantial enlargement of the right thyroid lobe that potentially may contribute to the abnormality demonstrated on the chest radiograph. the assessment of the right thyroid lobe with ultrasound is suggested. 2. mild centrilobular emphysema. pulmonary nodules as described that should be reevaluated in three months for assessment of their stability based on the size of the largest nodule. 3. sparing of the ascending aorta from calcifications. 4. enlarged kidney cyst. 5. small hiatal hernia. . echo : pre-bypass: 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 normal (lvef>55%). there are simple atheroma in the aortic arch. there are both simple and complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets are moderately thickened. the left coronary cusp has poor leaflet excursion. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). trace aortic regurgitation is seen. trivial mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results in the operating room. post-bypass: patient is av paced and receiving an infusion of phenylephrine. biventricular systolic function is unchanged. aorta is intact post decannulation. rest of the examination is unchanged. . cxr: : he small left apical pneumothorax is no longer seen and has resolved. there is atelectasis at the left base. there are small bilateral pleural effusions. there is cardiomegaly and mediastinotomy wires identified. there are no signs for overt pulmonary edema. lab: wbc-9.6 rbc-3.83* hgb-9.9* hct-32.3* mcv-85 mch-25.9* mchc-30.7* rdw-15.7* plt ct-216 wbc-7.5 rbc-4.53 hgb-11.1* hct-35.5* mcv-78* mch-24.5* mchc-31.3 rdw-15.1 plt ct-208 glucose-117* urean-29* creat-1.1 na-138 k-4.5 cl-102 hco3-28 glucose-149* urean-26* creat-1.0 na-140 k-3.8 cl-106 hco3-23 alt-10 ast-17 ld(ldh)-133 alkphos-49 totbili-0.4 %hba1c-6.2* eag-131* brief hospital course: as mentioned in the hpi, ms. was transferred from outside hospital after cath revealed severe coronary artery disease. upon admission she was surgical worked up and received medical management. following work-up she was brought to the operating room on and underwent a coronary artery bypass graft x 4. please see operative note for surgical details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. later this day she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was started on beta-blocker and diuretics and gently diuresed back to her pre-op weight. later this day she was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. she remained in sinus rhythm 50-60's, blood pressure 100-118. she was restarted on her metform 500 mg with blood sugars 116-160's. her actos was held and should be restarted as an outpatient. she noted to have mild confusions while on narcotics. she was changed to tramadol with improvement in her mental status and good pain control. she worked with physical therapy for strength and mobility. she continued to make steady progress and was discharged to in nh . she will follow-up as an outpatient. medications on admission: actos 30mg daily, metformin 500mg , metoprolol 50mg , isdn 120mg am, 60mg pm, hyzaar 50/12.5 , simvastatin 80mg hs, vitamin d 400iu daily, asa 162mg daily discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. simvastatin 80 mg tablet sig: one (1) tablet po once a day. 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. acetaminophen 325 mg tablet sig: two (2) tablet po every six (6) hours as needed for fever, pain. 6. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 7. furosemide 20 mg tablet sig: one (1) tablet po once a day for 4 days. 8. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 9. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 10. potassium chloride 10 meq tablet extended release sig: one (1) tablet extended release po q12h (every 12 hours) for 4 days. 11. tramadol 50 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 13. regular insulin sliding scale ac & hs 71-149 mg/dl 0 units 0 units 0 units 0 units 150-179 mg/dl 2 units 2 units 2 units 2 units 180-199 mg/dl 4 units 4 units 4 units 4 units 200-219 mg/dl 6 units 6 units 6 units 6 units 220-239 mg/dl 8 units 8 units 8 units 8 units 240-260 mg/dl 10 units 10 units 10 units 10 units 14. losartan-hydrochlorothiazide 50-12.5 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: discharge diagnosis: coronary artery disease s/p coronary artery bypass graft x 4 past medical history: mild mitral regurgitation peripheral vascular disease paroxysmal a.fib anxiety pre-renal azotemia/renal insufficiency chronic diarrhea non-insulin dependent diabetes mellitus hypertension hyperlipidemia h/o right thyroid nodule (benign by biopsy) osteopenia lipoma pilonidal cyst cataracts aortobifem bypass bilateral cataract extractions excision of lipomas on back and right thigh discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg right/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: , md phone:: 1:45 in the building cardiologist: dr. at 11:45a (, ste#404, ,ma) please call to schedule appointments with your primary care dr. in weeks please follow up with oral surgeon for outpatient tooth extraction vs. restoration **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 diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified atrial fibrillation peripheral vascular disease, unspecified other and unspecified hyperlipidemia anxiety state, unspecified osteoporosis, unspecified diarrhea dental caries, unspecified 

Answer: The patient is high likely exposed to