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 attending: chief complaint: shortness of breath major surgical or invasive procedure: lv apico-aortic valved conduit via left thoracotomy(16mm lv apical connector with a 18mm porcine valved conduit) history of present illness: mr. is an 81 year-old gentleman with an extensive history of coronary artery disease, s/p ami at age 37, cabg in (lima-lad, svg-pda, svg-om1) with redo in (occuded lima-lad and svg-pda, rima-lad,svg-pda, svg-om2). he had a catheterization for nstemi and underwent pci of 90% lesion in the om1 with a 3 x 8 mm cypher des. his rima-lad, svg-pda and svg-om2 were all patent. history also significant for chf with an an ef of 25% s/p cardiac resynchronization and biventricular pacemaker placement, hypertension and hyperlipidemia. at his baseline (a few months back), the patient was able to work in the yard for 10 minutes+ after which time he would become sob. after resting for 10-15 minutes he would again be okay to work. over the last few weeks, he has noticed sob at rest. some of these episodes are associated with "chest tightness". the tightness was across his chest with no radiation. he would occasionally have nausea with it but no diapheresis. usually lasted a few minutes and would be relieved, at times, with burping or walking. he did not note any of the tightness with exertion. he notes that the pain is not like that of his mi, which was back pain and much more severe. over the last week he has noticed that the symptoms are increasing in frequency (now occuring daily). on the day of admission, he awoke at 6am and felt sob. this did not abate and given the duration of symptoms, he went to his pcp who then referred him to an osh. his symptoms improved with intravenous lasix and he was eventually transferred to the for cardiac surgical evaluation. past medical history: systolic congestive heart failure coronary artery disease - prior cabg , anterior mi at age 37 biventricular pacemaker and cardiac resynchronization hypertension hyperlipidemia history of abscess excision cholecystectomy history of remote mva social history: retired sales officer. lives alone in . history of remote tobacco, and admits to occasional etoh family history: no premature coronary artery disease physical exam: vitals: 98.2, 113/66, 73, 18, 93% on 3l general: elderly male in no acute distress heent: oropharynx benign, eomi neck: supple, no jvd lungs: cta bilaterally heart: iregular rate and rhythm, 3/6 systolic murmur abdomen: soft, nontender with normoactive bowel sounds ext: warm, no edema. well healed bilateral scars pulses: 1+ distally neuro: alert and oriented, cn 2- 12 grossly intact, no focal deficits noted pertinent results: 11:05pm blood wbc-7.8 rbc-3.90* hgb-11.9*# hct-35.5* mcv-91 mch-30.4 mchc-33.4 rdw-15.6* plt ct-212 11:05pm blood pt-17.3* ptt-39.2* inr(pt)-1.6* 11:05pm blood glucose-178* urean-25* creat-1.4* na-140 k-4.1 cl-98 hco3-31 angap-15 11:05pm blood ck-mb-notdone ctropnt-0.02* 09:30am blood triglyc-78 hdl-33 chol/hd-5.3 ldlcalc-125 ldlmeas-129 06:00am blood tsh-2.2 11:05pm blood digoxin-2.0 echocardiogram: the left atrium is markedly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. there is severe regional left ventricular systolic dysfunction with severe hypokinesis/akinesis of the inferolateral, lateral, anteroseptal and apical segments. there is hypokinesis of the remaining segments, with relative preservation of only the basal and mid-inferior segments and basal anterior segment (lvef = 25%). no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic arch is mildly dilated. there are three severely thickened aortic valve leaflets. there is severe aortic valve stenosis (area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. the left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. cardiac catheterization: 1. selective coronary angiography of this right dominant system demonstrates severe native vessel disease. the lmca has a patent stent into the ramus. the plad is 100 occluded. the av groove lcx is a small vessel- om1 is 90% occluded and beyond om1 there is a subtotal occlusion. om2 fills via the patent svg graft. the rca is known occluded and is not engaged. 2. arterial conduit angiography of the rima to lad showed the graft to be widely patent. of note, the rigth subclavian artery originates distal to the origin of the left subclavian artery. the rima graft travels in front of the heart, directly behind the sternum to anastomose with the lad. 3. bypass graft angiography shows that the svg to pda that was patent in is now proximally occluded. the svg to om2 remains patent and fills the om2 distally. chest ct scan: 1. widespread ground-glass opacities with upper lung distribution. radiological pattern is consistent with respiratory bronchiolitis (in a smoker), hypersensitivity pneumonitis, or acute viral infection such as viral, less likely pulmonary hemorrhage. 2. extensive atherosclerotic coronary and aortic calcifications. 3. severe aortic valve calcifications consistent with known aortic stenosis. 4. hypodense liver lesions, some of them too small to be precisely characterized. evaluation with ultrasound is recommended . status post cholecystectomy. 5. bilateral left more than right pleural effusions. 6. cardiomegaly. possible left ventricular aneurysm carotid ultrasound: minimal plaque with bilateral less than 40% carotid stenosis. wbc 9.3, hct 29.9, plt 229 inr 2.2 inr 2.7 inr 1.8 inr 1.3 na 134, k 4.7, cl 92, hco3 36, bun 29, cr 1.0 mg 3.1 brief hospital course: mr. was admitted to cardiology service. he was noted to be in atrial fibrillation and started on intravenous heparin. cardiac surgery was consulted and extensive preoperative evaluation was performed. an echocardiogram revealed substantial increase in aortic stenosis and pulmonary pressures, while left ventricular function and the severity of mitral regurgitation appeared similar in comparison to - see result section for additional details. cardiac catheterization was performed which showed patent rima to lad and patent vein graft to obtuse marginal. the vein graft to the pda was occluded. (see result section for additional cath results.) additional preoperative workup included chest ct scan and carotid non invasive studies - see result section. he was also cleared by the dental service after clinical and radiographic examinations showed no obvious infection. given the location of the rima and extensive aortic calcifications, it was decided to proceed with lv apico-aortic valved conduit approach via thoracotmy rather than median sternotomy. his preoperative course was otherwise uneventful and he remained pain free on medical therapy. on , dr. performed an lv apico-aortic valved conduit operation via left thoractomy. please see seperate dictated operative note for details. following the operation, he was brought to the cvicu for invasive monitoring. within 24 hours, he awoke neurologically intact and was extubated. he was initially maintained on amiodarone for ventricular ectopy while warfarin anticoagulation was initiated for atrial fibrillation. due to persistent postop hypotension, it took several days to wean from inotropic support. once his hemodynamics stablized, he eventually transferred to the sdu for further care and recovery. he remained in atrial fibrillation with improvement in ventricular ectopy. amiodarone was eventually discontinued while beta blockade was advanced as tolerated. warfarin was dosed for a goal inr between 2.0 - 2.5. over several days, he continued to make clinical improvements with diuresis and made steady progress with physical therapy. by postperative day seven, he was medically cleared for discharge to rehab. at discharge, his bp was 96/50 with a hr of 71. his oxygen saturations were 95% on room air and the discharge chest x-ray showing a slight element of fluid overload. at discharge, he will continue to require diuresis. if there is improvement in blood pressure, an ace inhibitor should be resumed given his congestive heart failure. medications on admission: aspirin 325 qd, lopressor 50 qam and 25 qpm, lasix 40 qd, fosinopril 20 qd, digoxin 0.25 qd, zetia 10 qd, prilosec, fish oil, xanax 0.25 qhs discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 4. warfarin 1 mg tablet sig: one (1) tablet po daily (daily): goal inr 2-2.5 please check inr mon-wed-fri. 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 6. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po bid (2 times a day): twice a day for 1 week then decrease to daily . 7. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. furosemide 20 mg tablet sig: one (1) tablet po twice a day: twice a day for 1 week then decrease to daily . discharge disposition: extended care facility: watch manor discharge diagnosis: aortic stenosis - s/p lv apico-aortic valved conduit systolic congestive heart failure coronary artery disease - prior cabg , biventricular pacemaker hypertension hyperlipidemia atrial fibrillation discharge condition: good discharge instructions: 1)please shower daily. no baths. pat dry incisions, do not rub. 2)avoid creams and lotions to surgical incisions. 3)call cardiac surgeon if there is concern for wound infection. 4)no lifting more than 10 lbs for at least 10 weeks from surgical date. 5)no driving for at least one month 6)warfarin should be adjusted for goal inr between 2.0 - 2.5. please monitor inr every monday, wed, friday. please arrange warfarin follow up with pcp or cardiologist prior to discharge from rehab. followup instructions: dr. in weeks, call for appt dr. in weeks, call for appt dr. in weeks, call for appt procedure: extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft pericardiotomy transfusion of packed cells transfusion of platelets creation of conduit between left ventricle and aorta diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery unspecified essential hypertension coronary atherosclerosis of autologous vein bypass graft atrial fibrillation aortic valve disorders percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia other and unspecified angina pectoris acute on chronic systolic heart failure pleurisy without mention of effusion or current tuberculosis adhesive pericarditis acute bronchiolitis due to other infectious organisms fitting and adjustment of other cardiac device 

Answer: The patient is high likely exposed to