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 / azithromycin attending: chief complaint: shortness of breath major surgical or invasive procedure: off-pump coronary bypass grafting x1 with the left internal mammary artery to left anterior descending artery history of present illness: 74m p/t osh w chest pain, exertional dyspnea. ruled in for nstemi. echo revealed decline in ef to 10% (from 30% in ) and as with 0.8cm2. he has a h/o 2vessel cad on cath in . cardiac cath will be performed on monday, . cardiac surgery is asked to evaluate for avr, cabg. past medical history: past medical history: cad chronic systolic heart failure dm cri (baseline cr 1.9) ^lipids htn right foot w diabetic ulcer pvd depression past surgical history left cea right fem- bypass prostatectomy partial colectomy for adenoma social history: race: caucasian last dental exam: 50 yrs. ago lives with: wife occupation: retired, sales tobacco: 60 pack yrs, quit 2 weeks ago etoh: denies family history: family history: father, chf, d. age 54 pneumonia mother dm, d. age myocardial infarction brother ca unknown brother bladder ca no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death physical exam: pulse: 63 resp: 18 o2 sat: 98%ra b/p right: left: 90/50 height: weight: 79kg general: nad, appears stated age skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: 1+pedal edema bilaterally varicosities: none well healed incision of rle fem- bypass right lateral foot w 3mm round ulcer- no erythema, minimal drainage on dressing, does not appear infected neuro: grossly intact x pulses: femoral right: left: dp right: np left: np pt : np left: np radial right: 1+ left: 1+ carotid bruit right: left: no bruits pertinent results: introp tee pre-procedure: no spontaneous echo contrast is seen in the left atrial appendage. overall left ventricular systolic function is severely depressed (lvef= 10 - 15 %). with moderate global free wall hypokinesis. there is significant calcification of the ascending aorta. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen. there is no pericardial effusion. the patient was started on ntg and his pa pressures came down from 70/35 to 55/30 with modest improvement of rv fxn. lv remained severely depressed. based on the epi-aortic scan and the surgeon's assessment of the ascending aorta, the procedure was changed to an off-pump lima - lad cabg only. the plan was to refer the patient for a trans-vascular aortic valve replacement. post-procedure:: the patient is on low-dose phenylephrine. rv systolic fxn remains mildly depressed. lv systolic fxn is severly depressed. ai remains trace. mr is trace. 04:27am blood wbc-13.6* rbc-3.18* hgb-10.0* hct-29.3* mcv-92 mch-31.5 mchc-34.2 rdw-14.1 plt ct-496* 08:15am blood pt-45.0* ptt-37.4* inr(pt)-4.8* 04:27am blood glucose-82 urean-25* creat-1.5* na-135 k-4.5 cl-100 hco3-27 angap-13 05:08am blood wbc-11.5* rbc-3.05* hgb-9.5* hct-28.3* mcv-93 mch-31.3 mchc-33.7 rdw-13.9 plt ct-615* 05:24am blood pt-22.2* inr(pt)-2.1* 05:24am blood urean-24* creat-1.3* na-134 k-4.8 cl-99 brief hospital course: this is a 74-year-old male who presented to an outside hospital with chest pain, exertional dyspnea, and ruled in for non-st-elevated myocardial infarction. he had an echocardiogram that revealed a decline in his ejection fraction to 10% from 30% in . he also had aortic stenosis with an aortic valve area of 0.8 cm2. cardiac catheterization demonstrated 3-vessel coronary artery disease with 60% left anterior descending artery stenosis, 70-95% left circumflex artery stenosis, an occluded right coronary artery with poor left-to-right collaterals. he was taken to the operating room on and underwent an off-pump coronary bypass grafting x1 with the left internal mammary artery to left anterior descending artery. the aorta was palpated and found to be heavily calcified throughout the entire ascending aorta all the way down to the annulus. intraoperatively dr. was asked to evaluate the level of calcific anatomy, and confirmed dr findings. a discussion was carried out as to what options the patient had. it was felt that it would be a prohibitively high risk to replace the aortic valve, since there was no safe place to clamp on the aorta. at this point, it was elected to do the left internal mammary artery to left anterior superior descending artery bypass off pump. see operative note for full details. post operatively he was extubated and epinephrine was slowly weaned. he went into rapid atrial fibrillation on pod#1 and dropped his systolic blood pressure into the 70's. he was cardioverted x 3 with 200/360/360 joules and converted to sinus rhythm. he was weaned from all vasoactive medications over the next 3 days and was hemodynamically stable in sinus rhythm. he did have post operative acute renal failure with a peak creatinine of 2.0 and this was decreasing at the time of discharge. he was started on coumadin for paroxysmal atrial fibrillation and received 2 doses of 5 mg and inr went to 4.8. he was resumed with coumadin at a lower dose and inr was therapurtic at the time of discharge. he was evaluated by physical therapy for strength and mobility and cleared for home. he was transferred to the step down floor on post operative day 5. chest tubes and pacing wires were removed per cardiac surgery protocol. he was tolerating a full oral diet, ambulating with assistance and his wounds were healing well. it was felt that he was safe for discharge home with services on pod # 8. the patient will be advised to follow up with dr in 3 weeks and at that time discuss corevalve options for aortic stenosis. all follow up appointments were advised. medications on admission: aspirin 325mg daily atenolol 50mg daily glyburide 5mg daily lovastatin 40mg daily metformin lisinopril discharge medications: 1. amiodarone 200 mg sig: two (2) po bid (2 times a day): x 3 days, then decrease to 1 tab twice daily x 7 days, then dcrease to 1 tab daily . disp:*120 (s)* refills:*2* 2. atorvastatin 80 mg sig: one (1) po daily (daily). disp:*60 (s)* refills:*2* 3. glyburide 2.5 mg sig: one (1) po bid (2 times a day). disp:*60 (s)* refills:*2* 4. aspirin 81 mg , delayed release (e.c.) sig: one (1) , delayed release (e.c.) po daily (daily). disp:*60 , delayed release (e.c.)(s)* refills:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 6. furosemide 20 mg sig: one (1) po bid (2 times a day) for 14 days. disp:*28 (s)* refills:*0* 7. potassium chloride 10 meq extended release sig: two (2) extended release po q12h (every 12 hours) for 14 days. disp:*56 extended release(s)* refills:*0* 8. warfarin 1 mg sig: md once daily at 4 pm: inr goal= for atrial fibrillation. disp:*150 (s)* refills:*2* 9. carvedilol 3.125 mg sig: one (1) po bid (2 times a day). disp:*60 (s)* refills:*2* discharge disposition: home with service facility: home health care discharge diagnosis: 1. coronary artery disease. 2. aortic valve stenosis. 3. calcified ascending aorta. discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage 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 **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: date/time: 1:30 cardiologist: , md phone: date/time: 8:00 please draw inr for coumadin dosing to be called into dr. #, fax # coumadin indication:postoperative atrial fibrillation inr goal= 1st inr draw on please call to schedule appointments with your 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: single internal mammary-coronary artery bypass combined right and left heart cardiac catheterization coronary arteriography using two catheters other electric countershock of heart extraction of other tooth central venous catheter placement with guidance diagnoses: other iatrogenic hypotension subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified hyposmolality and/or hyponatremia atherosclerosis of aorta hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortic valve disorders peripheral vascular disease, unspecified chronic kidney disease, unspecified diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled acute on chronic systolic heart failure surgical or other procedure not carried out because of contraindication ulcer of heel and midfoot chronic periodontitis, unspecified 

Answer: The patient is high likely exposed to