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: diltiazem attending: chief complaint: shortness of breath major surgical or invasive procedure: coronary artery bypass grafting x3: left internal mammary artery graft to left anterior descending, reverse saphenous vein graft to the right coronary artery and the marginal branch. cardiac cath history of present illness: 81 yo f with h/o paf s/p multiple cardioversions and failed drug therapy with increasing chf symptoms and recent drop in ef to 30%. the patient states that she has had increased dyspnea on exertion, fatigue, and cough without sputum. also has had increasing abdominal girth, but has lost 7 lbs in the past couple of months due to poor appetite. she is referred for cardiac catheterization today which revealed 3vd and we are asked to consult for surgical revascularization. past medical history: hypertension paroxysmal atrial fibrillations/p failed treatement with sotalol and dronedarone s/p multiple dccv nonischemic cardiomyopathy osteoporosis, recent lumbar compression fracture , s/p pelvic fracture 5 years ago lumbar degeneration s/p injections h/o papillary thyroid carcinoma syndrome basal cell ca s/p excisions rotator cuff injury without repair hiatal hernia gastroesophageal reflux disease s/p total thyroidectomy with lymph node resection s/p oral chemotherapy and radiation s/p radioactive iodine pelvic organ prolapse, s/p hysterectomy with anterior/posterior colporrhaphy s/p bilateral cataract surgery s/p tonsillectomy social history: - widowed, ex-office manager - has 1 son, () - smoked - no etoh - no illicit drug use family history: there is family history of premature coronary artery disease or sudden death. - father died from mi at 53 - younger brother had cabg and catheterization at age 76 physical exam: pulse:100 resp:18 o2 sat:94%ra, 97% 2l b/p right:149/85 left:135/70 height:5'0" weight:49kg general:nad, alert and cooperative skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended x non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right:+1 left:+1 dp right: +1 left:+1 pt : +1 left:+1 radial right:+1 left:+1 carotid bruit right: none left:none pertinent results: 05:10am blood wbc-9.3 rbc-4.22 hgb-12.6 hct-36.8 mcv-87 mch-29.9 mchc-34.4 rdw-18.1* plt ct-192 04:00pm blood wbc-8.9 rbc-3.99* hgb-12.2 hct-34.4* mcv-86 mch-30.6 mchc-35.5* rdw-18.3* plt ct-160 05:10am blood pt-30.5* ptt-33.7 inr(pt)-3.0* 03:06am blood pt-17.7* ptt-31.8 inr(pt)-1.6* 01:55pm blood pt-15.2* ptt-40.0* inr(pt)-1.3* 12:30pm blood pt-15.0* ptt-29.4 inr(pt)-1.3* 05:50am blood pt-14.0* ptt-68.6* inr(pt)-1.2* 04:50am blood glucose-85 urean-23* creat-0.8 na-134 k-3.7 cl-98 hco3-27 angap-13 05:10am blood glucose-84 urean-24* creat-1.0 na-132* k-4.5 cl-96 hco3-26 angap-15 cath: 1. selective coronary angiography of this right dominant system demonstrated three vessel coronary artery disease. the lmca had no angiographically apparent coronary artery disease. the lad had a calcific proximal 80% lesion. there was mild disease in the distal vessel. the lcx had a proximal 80% lesion after a severely retroflexed takeoff. the distal vessel was widely patent. the rca had diffuse disease with serial 50% lesions in the proximal, mid and distal portion. 2. limited resting hemodynamics revealed mildly elevated right sided filling pressures with rvedp 14 mmhg. the left sided filling pressures were moderately elevated with pcwp of 18 mmhg. the cardiac index was calculated using an assumed oxygen consumption and was 2.1 l/min/m2. the central aortic pressure was normal at 136/60 mmhg. carotid u/s: there is less than 40% stenosis within the internal carotid arteries bilaterally. chest ct: 1. minimal calcification dilated ascending aorta. 2. possible right upper lobe bronchogenic carcinoma. 3. severe cardiomegaly, predominantly left atrial and left ventricular, possible pulmonary arterial hypertension, severe coronary atherosclerosis. 4. severe left basal atelectasis due to a combination of moderate left pleural effusion and lower lobe bronchomalacia. 5. cystic liver lesions, not clearly benign biliary cysts. further evaluation recommended. 6. possible 4 mm mid esophageal polyp (4:80). head mri: no evidence of acute infarcts or enhancing brain lesion. no mass effect or hydrocephalus. mild changes of small vessel disease and a small right parietal cortical chronic infarct. intra-op tee pre bypass: the left atrium is dilated. the right atrium is dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is moderate global left ventricular hypokinesis (lvef = 30% %). the right ventricular cavity is mildly dilated with normal free wall contractility. the ascending aorta is mildly dilated. there are complex (>4mm) atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is no aortic valve stenosis. moderate (2+) eccentric aortic regurgitation is seen. the aortic regurgitation jet is eccentric and therefore difficult to quantify; unable to obtain a useable pressure half time or decleration time on the aortic valve. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. there are pericardial calcifications. post bypass: patient is av paced on epinepherine 0.03 mcg/kg/min. biventricular function appears slightly improved lvef 40% on ionotropes. ventricular septum appears diskinetic, consistent with ventricular pacing. mitral regurgitation and aortic regurgitation are unchanged from baseline. tricuspid regurgitation is now mild to moderate. aortic contours intact. remaining exam is unchanged. all findings discussed with surgeons at the time of the exam. date inr coumadin dose 7/7 -- 3mg 1.6 3 3.0 0.5 2.5 1 2.7 0.5 brief hospital course: 81 year old female who was admitted on complaining of shortness of breath with paf s/p multiple cardioversions and failed drug therapy with increasing chf symptoms and recent drop in ef to 30%. on she underwent a cardiac cath which revealed severe coronary artery disease and she was referred for surgical intervention. she was appropriately medically managed and underwent extensive pre-operative work-up. on she was brought to the operating room where she underwent a coronary artery bypass graft x 3. please see operative report for surgical details. within 24 hours she was weaned from sedation, awoke neurologically intact and extubated. chest tubes were removed on post-op day one. beta-blockers and diuretics were initiated and she was diuresed towards her pre-op weight. on post-op day two she was transferred to the telemetry floor for further care. she did develop post-operative a-fib and was started on amio and dig. she had an episode of bradycardia, and amiodarone and digoxin were discontinued. electrophysiology was consulted for assistance with medical management. she was anti-coagulated with coumadin. she worked with physical therapy for strength and mobility. she was not started on an ace inhibitor, as her blood pressure would not tolerate it, and the primary goal was to titrate her beta-blocker as tolerated. this will be addressed as an outpatient. by the time of discharge on pod 5, the wound was healing and pain was controlled with oral analgesics. she was discharged to rehab for further recovery. all follow up instructions and appointments were advised. medications on admission: - esomeprazole magnesium (nexium) ec, 40 mg, 1 cap, qd - furosemide 20 mg, 2 tabs, qam - levothyroxine (synthroid), 150 mcg, 1 tab, 6 days/wk; 0.5 tab on sundays - metoprolol succinate sr, 25 mg, 1 tab, qd - ranitidine hcl 150 mg, 1 cap, qd - risedronate (actonel) 35 mg, 1 tab, once weekly - warfarin 3 mg, 1 tab, qd (last dose on pre cardiac cath) - calcium citrate- vit d3, 315mg-200 unit, 2 tab, - cyanobalamin (vit b12), 1000 mcg, 1 tab, qd - mvi- minerals- lutein (centrum silver), 1 tab, 3x wkly - vit c- vit e- copper- znox- lutein (preservision)- 226mg-200u-5mg-0.8mg-34.8mg cap, qd discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. warfarin 1 mg tablet sig: one (1) tablet po daily (daily): md to dose daily for goal inr , for dx: a-fib. 5. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 7. levothyroxine 75 mcg tablet sig: one (1) tablet po qsun (every sunday). 8. levothyroxine 150 mcg tablet sig: one (1) tablet po q mon-sat (). 9. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 10. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 11. furosemide 40 mg tablet sig: one (1) tablet po twice a day: 40mg x 1 week, then 40mg daily ongoing. 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po once a day: 40meq daily x 1 week, then 20meq daily ongoing. 13. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 14. actonel 35 mg tablet sig: one (1) tablet po once a week. 15. vitamin b-12 1,000 mcg tablet sig: one (1) tablet po once a day. 16. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 17. multivitamin tablet sig: one (1) tablet po once a day. 18. preservision 226-200-5 mg-unit-mg capsule sig: one (1) capsule po once a day. 19. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 20. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). discharge disposition: extended care facility: newbridge on the - discharge diagnosis: coronary artery disease s/p coronary artery bypas graft x 3 hypertension paroxysmal atrial fibrillations/p failed treatement with sotalol and dronedarone s/p multiple dccv nonischemic cardiomyopathy osteoporosis, recent lumbar compression fracture , s/p pelvic fracture 5 years ago lumbar degeneration s/p injections h/o papillary thyroid carcinoma syndrome basal cell ca s/p excisions rotator cuff injury without repair hiatal hernia gastroesophageal reflux disease s/p total thyroidectomy with lymph node resection s/p oral chemotherapy and radiation s/p radioactive iodine pelvic organ prolapse, s/p hysterectomy with anterior/posterior colporrhaphy s/p bilateral cataract surgery s/p tonsillectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - no erythema or drainage, black eschar at inferior pole leg -left - healing well, no erythema or drainage. edema 1+ bilateral les 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 until follow up with surgeon 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 thursday, at 1:15 provider: , md phone: date/time: 1:00 please call to schedule appointments with your primary care dr. in weeks cardiologist dr. or in weeks thoracic surgery dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** check inr , md to dose coumadin daily for goal inr for a-fib 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 (aorto)coronary bypass of two coronary arteries fiber-optic bronchoscopy diagnoses: other primary cardiomyopathies coronary atherosclerosis of native coronary artery esophageal reflux unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation other and unspecified angina pectoris osteoporosis, unspecified other diseases of lung, not elsewhere classified acute on chronic systolic heart failure raynaud's syndrome postsurgical hypothyroidism personal history of malignant neoplasm of thyroid interstitial emphysema 

Answer: The patient is high likely exposed to