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: iodine / penicillins / oxycodone/apap / niaspan attending: chief complaint: exertional chest pain major surgical or invasive procedure: cardiac catheterization opcabg x3 (lima to lad, svg to diag, svg to pda) history of present illness: 64 year old female with history of cad x 16 years (known 3vd, medically managed) who presented with exertional angina x 2 week. she has had stable angina for the past 16 years with only very occasional chest tightness. (roughly q6months) over the past two weeks she has had 3 episodes of chest discomfort with minimal activity. chest tightness w/ radiation down both upper arms that also felt like a tightness, relieved with 2 slntg. she has chest discomfort with activity such as doing yard/garden work, going up and down the stairs twice or walking about 4 blocks. she denies symptoms at rest. no other associated symptoms (no sob, n/v, diaphoresis). she underwent p. mibi on which was positive for chest pain and ecg changes. nuclear imaging revealed new, small inferior infarct. she was taken to cardiac catheterization on which demonstrated 3 vessel coronary artery disease . denies orthopnea, pnd. she has stable pedal edema r>l, chronic. occasional r leg discomfort. no urinary problems, no in stool, normal bms. referred for cabg. past medical history: cad 3vd pvd s/p lower extremity stents (total of 7)including bilateral common iliac stenting, right "fem-" bovine patch angioplasty and stenting gi bleed 1.5 year ago with 3 unit transfusion while on plavix andasa- at that time had a normal colonscopy as well as enteroscopy at . right carotid endarterectomy at (note records from indicate bilateral cea's, however patient denies this) carotid angio : 50% subclavian stenosis, 90% carotid siphon lesion, 60-70% right internal carotid stenosis, less than 50% left internal carotid stenosis, type i aortic arch. hyperlipidemia hypertension recurrent vasovagal syncope "lypodystrophy" (decreased fat cell distribution) as a child s/p plastic surgery with fat flaps transferred from stomach to face and women??????s) peripheral neuropathy hypothyroidism bone spurs removed from right arm total abdominal hysterectomy hyponatremia social history: no history of tobacco use or alcohol abuse lives with husband retired accountant family history: mother had chf, brother had mi at age 56 and died of brain cancer at 58. physical exam: 5'4" 138# vs: bp 117/62 hr 70 rr 18 o2 98% ra gen: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 7-8cm. + bilateral bruits. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. cresc-decresc sem which is soft sounding and radiates to the carotids without delayed carotid upstroke, hsm @ apex and llsb w/o radiation, no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. ext: no c/c/e. no femoral bruits. fem cath site on r c/d/i, no hematoma or ecchymoses. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: admission hct 36.9, wbc 4.7, plts 174. admission bun 17, cr 0.8. sodium 124 on admission, ****** on discharge. serum osm 280, uosm 480, u sodium 30. tsh 0.97. lfts were normal. folate>20, vit b12: 1333, ferritin 173. hbaic: *********** u/a: large , 26 rbc, 100 protein. neg nitrites and leuk es, 0 wbcs. ph 7.0, spec 1.053. ekg demonstrated nsr w/ rate 65, nl axis, rbbb. pr and qtc normal. lae, new t-wave inversions in iii, avf. when compared to previous () and twi are new- no other significant change. cardiac catheterization: () 3 vessel coronary disease (90% rca, 70% diag, 50% mid-lad) with normal lv function. (report in system is reportedly wrong in stating "two vessel disease") ct chest w/o contrast: 1. extensive atherosclerotic calcification within the aortic arch, descending aorta, and coronary vascular system. no abnormal dilatation to the aorta identified. the ascending aorta appears relatively free of mural calcification. 2. 5-mm left lower lobe nodule. recommend followup chest ct examination in approximately three months to assess for stability given slightly suspicious margins. 3. sub-3-mm pulmonary nodules along the left major fissure likely represent intraparenchymal lymph nodes. radiology preliminary report carotid series complete 1:38 pm carotid series complete reason: please evaluate carotids pre-op cabg medical condition: 64 year old woman with 3 vessel coronary artery disease reason for this examination: please evaluate carotids pre-op cabg study: carotid series complete. reason: preop cabg. findings: duplex evaluation was performed of bilateral carotid arteries. on the right, there is moderate plaque seen in the proximal ica. peak velocities are 155, 68, and 181 cm/sec in the right ica, cca and eca respectively. the ica end-diastolic velocity is 39. the ica/cca ratio is 2.3. this is consistent with 40-59% stenosis. on the left, there is bulky heterogeneous plaque with calcification seen in the proximal ica and distal cca. peak velocities are 274, 75, and 101 cm/ sec in the ica, cca, and eca respectively. the ica end-diastolic velocity is 100. the ica/cca ratio is 3.7. this is consistent with 70-99% stenosis. there is antegrade vertebral flow bilaterally. impression: 40-59% right ica stenosis. 70-99% left ica stenosis with calcified plaque. dr. cardiology report echo study date of patient/test information: indication: intra-op tee for opcab height: (in) 64 weight (lb): 135 bsa (m2): 1.66 m2 bp (mm hg): 154/74 hr (bpm): 68 status: inpatient date/time: at 10:37 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw01-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. r. measurements: left ventricle - ejection fraction: 55% (nl >=55%) interpretation: findings: right atrium/interatrial septum: normal interatrial septum. no asd by 2d or color doppler. left ventricle: normal lv wall thickness and cavity size. overall normal lvef (>55%). lv wall motion: basal anterior - normal; mid anterior - normal; basal anteroseptal - normal; mid anteroseptal - normal; basal inferoseptal - normal; mid inferoseptal - normal; basal inferior - normal; mid inferior - normal; basal inferolateral - normal; mid inferolateral - normal; basal anterolateral - normal; mid anterolateral - normal; anterior apex - normal; septal apex - normal; inferior apex - normal; lateral apex - normal; apex - normal; right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. normal ascending aorta diameter. focal calcifications in ascending aorta. normal aortic arch diameter. complex (>4mm) atheroma in the aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets. no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. no ms. mild (1+) mr. tricuspid valve: physiologic tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. the patient was under general anesthesia throughout the procedure. the patient appears to be in sinus rhythm. results were personally conclusions: pre-cpb: 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%). right ventricular chamber size and free wall motion are normal. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) 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. post-cpb: preserved biventricular systolic fxn. trivial mr. i. aorta intact. other parameters as pre-bypass. electronically signed by , md on 09:15. physician: () brief hospital course: 1. cad: history of stable angina x 16 years with a cath in showing 3 vessel disease, no intervention at that time. worsening of stable angina over the past 2 weeks or so, with no rest symptoms. she had a persantine mibi which revealed chest pain and ecg changes, new small inferior infarct on nuclar imaging. she subsequently had a cath on which revealed 3 vessel disease (90% rca, diag 70%, and 50% mid lad). patient underwent cabg on . 2. hyponatremia- history of chronic hyponatremia. urine osms were higher than would be expected with her level of hyponatremia. tsh was normal, patient was not high and she was not hypotensive as would be expected with adrenal insufficiency. other possibilties include siadh, reset osmostat or drug effect. when diuretics (hctz and spironolactone) were held the sodium increased to the low 130s from 124. on day of discharge sodium was 131. 3. htn: pressure was 118/64 at discharge, well controlled while in house on home dose of lopressor and norvasc, as stated above hctz and spironolactone were held. 4. lung nodule on ct scan: there was a 5mm left lower lobe lung nodule found on ct scan, a recommended 3 month follow up ct scan should be set up by the patients primary care physician. were also some small 3mm (or less) nodules found at the left major fissure which likely represent intraparenchymal lymph nodes. 5. hematuria/proteinuria: her urinalysis revealed protein and red cells in here urine without evidence of infection. she should have an outpatient workup with her primary care / a urologist to help rule out a malignancy or to search for the cause of these u/a findings such as nephrolithiasis or renal disease. underwent off pump cabg x3 on with dr. . transferred to the csru in stable condition on phenylephrine and propofol drips. extubated that afternoon and transferred to the floor on pod #1 to begin increasing her activity level. chest tubes removed on pod #2. seen by pt on pod#3; cleared to go home from pt perspective. on pod4 hct was stalbe at 25; hyponatremia resolving na 131. patient discharged home in good condition with no new medications. medications on admission: patient fills medications at avapro 300mg daily in the am actonel 35mg weekly synthroid 100mcg daily metoprolol 25mg norvasc 5mg daily spironolactone 25mg daily mwf hctz 25mg daily isosorbide mn 120mg daily pravachol 80mg daily in the pm zyrtec 10mg daily calcium with vitamin d 600mg fish oil 1000mg aspirin 81mg daily flonase nasal spray 1 spray each nostril daily discharge medications: 1. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 4. pravastatin 20 mg tablet sig: four (4) tablet po daily (daily). 5. cetirizine 10 mg tablet sig: one (1) tablet po daily (). 6. omega-3 fatty acids 550 mg capsule sig: two (2) capsule po bid (2 times a day). 7. fluticasone 50 mcg/actuation aerosol, spray sig: one (1) spray nasal daily (daily). 8. cholecalciferol (vitamin d3) 400 unit tablet sig: 0.5 tablet po daily (daily). 9. calcium carbonate 500 mg (1,250 mg) tablet sig: two (2) tablet po daily (daily). 10. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 11. actonel 35 mg tablet sig: one (1) tablet po once a week. discharge disposition: home with service facility: vna discharge diagnosis: cad s/p opcabg x3 hypercholesterolemia htn pvd s/p right cea, bil. le stents gi bleed ( while on plavix and asa) lipodystrophy with fat transfer to face as a child peripheral neuropathy hypothyroidism hyponatremia discharge condition: stable discharge instructions: please call your doctor or return to the hospital if you experience chest pain, shortness of breath or any other symptoms that concern you, fever greater than 100.5, redness, drainage. no driving for one month. no lotions, creams, powders or ointments on any incision. shower daily and pat incisions dry. no lifting greater than 10 pounds for 10 weeks. followup instructions: see dr. in weks see dr. in weeks see dr. in 4 weeks procedure: single internal mammary-coronary artery bypass coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures left heart cardiac catheterization diagnostic ultrasound of heart aortography diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension hyposmolality and/or hyponatremia unspecified acquired hypothyroidism atherosclerosis of aorta peripheral vascular disease, unspecified mononeuritis of lower limb, unspecified occlusion and stenosis of carotid artery without mention of cerebral infarction acute myocardial infarction of other inferior wall, initial episode of care other diseases of lung, not elsewhere classified occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction proteinuria 

Answer: The patient is high likely exposed to