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: no known allergies / adverse drug reactions attending: chief complaint: unstable angina major surgical or invasive procedure: left & right heart catheterization, coronary angiogram insertion of intraaortic balloon urgent mitral valve repair (p2 triangular resection),ring annuloplasty(34mm physio ii annuloplasty ring, model number 5200,serial number )/ coronary artery bypass grafting times 3 lima-lad,svg-d1,svg-om1) history of present illness: this 45 year old white male began about one and a half months ago to notice chest discomfort "like indigestion", across the entire chest when exerting himself. he is avid walker and has noticed this discomfort when going up any type of incline and resolving with rest. he has not noticed this discomfort when walking on a level surface. it is easily reproducible. he underwent a stress echo which revealed mild lv enlargement with preserved lv function. the left atrium was moderately dilated. there was moderate mitral valve prolapse involving the posterior leaflet with severe mitral insuffiency and pulmonary vein flow reversal. mild tr and borderline aortic root dilation were seen. he exercised 6 minutes and developed chest pain at peak exercise along with lateral st depression. pvc's were noted. echo imaging showed anteroseptal ischemia. he was referred for cardiac catheterization to further evaluate. he was found to have coronary artery disease upon cardiac catheterization and referred to cardiac surgery. he continued to complain of chest pain on a nitro drip and morphine. he had an intraaortic balloon placed with stabilization and was taken the following day to the operating room for an urgent operation. enzymes were flat. past medical history: mitral prolapse/regurgitation mild hyperlipidemia, recently started on statin non sustained vt 13 years ago, on atenolol since hemorrhoids with occasional rectal bleeding bone spurs s/p surgery remote history of migraines social history: race:caucasian last dental exam: lives with:wife and three kids contact: (wife) # occupation:works at a bank as a temporary worker doing booking cigarettes: smoked no yes hx:occasional cigarette/cigar (none in 2 months) other tobacco use:denies etoh: 2 glasses of wine per day illicit drug use:denies family history: adopted. patient does not know his family history. physical exam: height:6'2" weight:228 lbs unable to assess patient due to emergent nature of case. no h&p in chart. pertinent results: 05:35am blood wbc-5.8 rbc-3.08* hgb-9.1* hct-27.0* mcv-88 mch-29.4 mchc-33.5 rdw-13.0 plt ct-138* 04:30am blood wbc-6.0 rbc-3.27* hgb-10.2* hct-28.9* mcv-88 mch-31.1 mchc-35.2* rdw-12.8 plt ct-133* 02:11am blood wbc-6.7 rbc-3.68* hgb-11.2* hct-32.0* mcv-87 mch-30.3 mchc-34.9 rdw-13.3 plt ct-148* 05:35am blood glucose-125* urean-14 creat-0.8 na-140 k-4.1 cl-107 hco3-27 angap-10 04:30am blood glucose-142* urean-10 creat-0.9 na-138 k-4.0 cl-105 hco3-25 angap-12 02:11am blood glucose-109* urean-9 creat-0.7 na-137 k-3.8 cl-110* hco3-23 angap-8 02:16pm blood urean-14 creat-1.0 na-138 k-4.1 cl-106 hco3-24 angap-12 tte results measurements normal range left ventricle - inferolateral thickness: 0.7 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *7.1 cm <= 5.6 cm left ventricle - systolic dimension: 3.9 cm left ventricle - fractional shortening: 0.45 >= 0.29 left ventricle - ejection fraction: 50% to 55% >= 55% left ventricle - stroke volume: 113 ml/beat left ventricle - cardiac output: 8.48 l/min left ventricle - cardiac index: 3.69 >= 2.0 l/min/m2 aorta - annulus: 2.7 cm <= 3.0 cm aorta - sinus level: *3.7 cm <= 3.6 cm aorta - sinotubular ridge: *3.2 cm <= 3.0 cm aorta - ascending: *3.6 cm <= 3.4 cm aorta - arch: 3.0 cm <= 3.0 cm aorta - descending thoracic: 2.4 cm <= 2.5 cm aortic valve - lvot vti: 25 aortic valve - lvot diam: 2.4 cm left atrium: dilated la. la not well visualized. no spontaneous echo contrast or thrombus in the body of the laa. right atrium/interatrial septum: no spontaneous echo contrast in the body of the ra or raa. no asd by 2d or color doppler. left ventricle: normal lv wall thickness. moderately dilated lv cavity. low normal lvef. right ventricle: normal rv systolic function. aorta: mildy dilated aortic root. mildly dilated ascending aorta. normal aortic arch diameter. no atheroma in descending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: moderately thickened mitral valve leaflets. moderate/severe mvp. partial mitral leaflet flail. moderate to severe (3+) mr. to the eccentric mr jet, its severity may be underestimated (coanda effect). tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: pulmonic valve not visualized. no ps. physiologic pr. pericardium: no pericardial effusion. conclusions pre-bypass: the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no spontaneous echo contrast is seen in the body of the right atrium or right atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is low normal (lvef 50-55%). the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the descending aorta appears free from atherosclerotic plaque with some limitation in the study due to the presence of an intraaortic balloon pump. the distal tip of the iabp appears end prior to the subclavian artery takeoff. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate/severe posterior leaflet mitral valve prolapse. there is partial posterior (p2) mitral leaflet flail. moderate to severe (3+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). there is no pericardial effusion. postbypass: the patient is in sinus tachycardia on low dose epinephrine & moderate dose phenylephrine infusions. the biventricular function is maintained. there is a well seated annuloplasty ring in the mitral position. there is trace mr. there are peak and mean gradients of 11 & 5mmhg, respectively. the remaining valves are unchanged. the aorta appears intact, though the descending aorta has suboptimal imaging due to the presence of an iabp. the iabp continues to remain with the distal tip in appropriate position. 04:40am blood wbc-6.0 rbc-3.00* hgb-9.0* hct-26.3* mcv-88 mch-30.2 mchc-34.4 rdw-12.9 plt ct-217# 04:40am blood na-141 k-4.0 cl-105 brief hospital course: this is a 45-year-old male referred from dr. for consideration of coronary artery bypass grafting as well as mitral valve repair. the patient developed severe angina after his diagnostic cardiac cath which revealed moderate left main disease and high-grade lad and diagonal stenoses. the patient was not responsive to nitroglycerin and therefore was brought to the operating room and an intra-aortic balloon pump inserted. this abated his chest pain. a stat echo in the operating room showed severe mitral regurgitation. it was felt that the patient should proceed with mitral valve repair or replacement and coronary artery bypass grafting the next morning. the patient had a stable night and did not rule in for a myocardial infarction by serial enzyme analysis. on he was taken to the operating room and underwent mitral repair and coronary artery bypass grafting times 3. cardiopulmonary bypass time: 155 minutes cross-clamp time: 126 minutes. see operative note for full details. the operation went without complication and the patient was transferred to the cvicu in stable condition. he was initially hypoxic which improved with recruitment maneuvers. the intraaortic balloon pump was removed on the night of surgery and he remained hemodynamically stable off all vasoactive medications. he was started on precedex and extubated on his post operative night. on pod1 beta blockers were started and he was gently diuresed with lasix. chest tubes were removed per cardiac surgery protocol and follow up cxr showed no pneumothorax. he was transferred to the step down unit in stable condition. pacing wires were removed on pod3 per cardiac surgery protocol without difficulty. he was changed from percocet to ultram due to confusion and lethargy. he worked with physical therapy for strength and mobility. he was kept an extra day due to unsteadiness with ambulation. on pod 5 he was ambulating with assistance, tolerating a full oral diet and his incisions were healing well. it was felt that he was safe for discharge home with visiting nurse services. there was a tiny amount of serosanguinous drainage on the sternal dressing the morning of discharge, however, the sternum was stable, no further drainage could be expressed and he was afebrile with a normal white blood cell count. all follow up appointments were arranged. medications on admission: atenolol 50 mg tablet - 2 tablets by mouth daily atorvastatin 40 mg tablet - 2 tablets by mouth every evening aspirin 81 mg daily discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever or pain. 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 6. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: severe mitral regurgitation unstable angina with left main stenosis s/p insertion of intra aortic balloon s/p urgent mitral valve repair and coronary artery bypass grafts s/p left & right heart catheterization, coronary angiogram hyperlipidemia hemorrhoids discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage leg right- healing well, no erythema or drainage. 1+ edema 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: dr () on at 1:45 pm cardiologist:dr. () at 1:30pm wound check at cardiac surgery office on / at 10:00am please call to schedule appointments with: 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 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 implant of pulsation balloon open heart valvuloplasty of mitral valve without replacement diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome tobacco use disorder mitral valve disorders congestive heart failure, unspecified other opiates and related narcotics causing adverse effects in therapeutic use other and unspecified hyperlipidemia family history of ischemic heart disease acute diastolic heart failure internal hemorrhoids with other complication migraine, unspecified, without mention of intractable migraine without mention of status migrainosus other premature beats reactive confusion 

Answer: The patient is high likely exposed to