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: demerol attending: chief complaint: increasing angina and sob major surgical or invasive procedure: s/p redo sternotomy, aortic valve replacement (21mm mechanical valve) history of present illness: 54 yo male with cad, s/p cabg x1 in . he has since had multiple stents placed in and . presents now with increasing angina and sob. admitted - for cardiac cath which revealed lad 30% in-stent restenosis, 80% cx stent restenosis amd an occluded rca. lima was patent to lad and collaterals. critical as present with 0.9 cm2. referred for reoperation. past medical history: 1) cad **intractable angina** - s/p cabg in (lima to lad with post op chronic stable angina resistant to ptca and other therapies - currently controlled with fenatnyl patch and ativan) - cath: 3vd, no intervention. - cath: lmca bifurcation dz. patent lima-lad, successful bifurcation stenting of distal lmca. ef 50%. - cath: patent lm bifurcation stents. lima not injected. - cath: patent lima-lad. severely elevated lvedp. - cath: severe native 3vd, 50-60% narrowing within his lmca to lcx stent, a patent lima-lad graft, mild as w/ a valve area of 1.7 cm2, with moderate diastolic dysfunction -no intervention performed. -: in-stent restenosis of kissing stents in left main into lad/lcx s/p pci of lm/lcx -: restenosis of proximal left circumflex stent. 1a) chronic, severe angina responsive to ntg 1b) tte : ef 50-55%, mildly dilated lv, 1+ar/tr 1c) vascular endothelial growth factor treatment in 2) hypertension 3) dyslipidemia 4) history of defibrillation 5) nephrolithiasis years ago 6) status post laparoscopic cholecystectomy in social history: quit tobacco in (25 pack-year history), no etoh, never ivda. the patient is married, with 1 child. family history: brother died of mi at age 51. father died of mi at age 72 physical exam: 5'" 88.5 kg hr 51 rr 18 right 96/43 left 107/47 skin/heent unremarkable neck supple with full rom, no bruits / ? murmur transmitted bilat. ctab rrr 3/6 sem soft, nt, nd, + bs warm, well-perfused, no edema or varicosities neuro grossly intact 2+ bil. fem/dp/pt/radials pertinent results: 03:35am blood wbc-6.6 rbc-3.61* hgb-11.0* hct-31.5* mcv-88 mch-30.5 mchc-34.8 rdw-14.6 plt ct-118* 03:35am blood pt-25.9* ptt-33.4 inr(pt)-2.6* 03:35am blood plt ct-118* 10:50am blood k-4.2 03:35am blood glucose-109* urean-26* creat-0.9 na-139 k-3.1* cl-103 hco3-26 angap-13 cardiology report echo study date of patient/test information: indication: abnormal ecg. aortic valve disease. chest pain. coronary artery disease. h/o cardiac surgery. hypertension. shortness of breath. status: inpatient date/time: at 09:36 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw2-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. r. measurements: left atrium - long axis dimension: *4.9 cm (nl <= 4.0 cm) right atrium - four chamber length: *5.9 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: *1.6 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.6 cm (nl <= 5.6 cm) left ventricle - ejection fraction: 40% to 45% (nl >=55%) aorta - valve level: 2.5 cm (nl <= 3.6 cm) aorta - ascending: 3.0 cm (nl <= 3.4 cm) aortic valve - peak velocity: *3.6 m/sec (nl <= 2.0 m/sec) aortic valve - peak gradient: 49 mm hg aortic valve - mean gradient: 29 mm hg aortic valve - valve area: *0.9 cm2 (nl >= 3.0 cm2) interpretation: findings: left atrium: mild la enlargement. no spontaneous echo contrast in the body of the la. no spontaneous echo contrast or thrombus in the body of the laa. depressed laa emptying velocity (<0.2m/s) right atrium/interatrial septum: mildly dilated ra. no spontaneous echo contrast in the body of the ra. a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. prominent eustachian valve (normal variant). left ventricle: wall thickness and cavity dimensions were obtained from 2d images. mild symmetric lvh with normal cavity size. moderate symmetric lvh. normal lv cavity size. mildly depressed lvef. transmitral doppler and tvi c/w grade ii (moderate) lv diastolic dysfunction. no resting lvot gradient. lv wall motion: regional lv wall motion abnormalities include: basal anterior - hypo; mid anterior - hypo; basal anteroseptal - hypo; mid anteroseptal - hypo; basal inferoseptal - hypo; mid inferoseptal - hypo; basal inferior - hypo; mid inferior - hypo; basal inferolateral - hypo; mid inferolateral - hypo; basal anterolateral - hypo; mid anterolateral - hypo; anterior apex - hypo; septal apex - hypo; inferior apex - hypo; lateral apex - hypo; apex - hypo; right ventricle: normal rv chamber size and free wall motion. normal rv wall thickness. mildly dilated rv cavity. normal rv systolic function. prominent moderator band/trabeculations are noted in the rv apex. aorta: normal aortic diameter at the sinus level. simple atheroma in aortic root. normal ascending aorta diameter. simple atheroma in ascending aorta. normal aortic arch diameter. simple atheroma in aortic arch. focal calcifications in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: bicuspid aortic valve. moderately thickened aortic valve leaflets. no masses or vegetations on aortic valve. moderate as (aova 0.8-1.19cm2). mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. moderate mitral annular calcification. no ms. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic 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 received antibiotic prophylaxis. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. the patient was under general anesthesia throughout the procedure. conclusions: pre-cpb: 1. the left atrium is mildly dilated. no spontaneous echo contrast is seen in the body of the left atrium. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no spontaneous echo contrast is seen in the body of the right atrium. no atrial septal defect is seen by 2d or color doppler. 2. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is mildly depressed. transmitral doppler and tissue velocity imaging are consistent with grade ii (moderate) lv diastolic dysfunction. 3. right ventricular chamber size and free wall motion are normal. the right ventricular cavity is mildly dilated. right ventricular systolic function is normal. 4. there are simple atheroma in the aortic root. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are focal calcifications in the aortic arch. there are simple atheroma in the descending thoracic aorta. 5. the aortic valve is a functional bicuspid valve, with fusion between the lcc and the rcc. the aortic valve leaflets are moderately thickened. no masses or vegetations are seen on the aortic valve. there is moderate aortic valve stenosis (area 0.8-1.19cm2) mild (1+) aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. 7. there is borderline pulmonary artery systolic hypertension. post-cpb: pt is on epinephrine infusion. there is a well-seated mechanical valve in the aortic position, no paravalvular leak. normal appearing washing jets of ai. lv function is globally hypokinetic, improved with the addition of milrinone. lvef now 40%. normal rv systolic function. trace mr as described. the aortic contour is normal post-decannulation. electronically signed by , md on 13:04. physician: () brief hospital course: admitted and underwent redo sternotomy / avr with dr. . transferred to the csru in stable condition on epinephrine, milrinone, neosynephrine and propofol drips. left ptx noted on postop cxr and chest tube placed. bronchoscopy also done for rul collapse/ secretions. transfused for postop bleeding. platelet count decreased to 79k, and hit panel sent, heparin held. extubated on pod #1.coumadin started for mechanical valve, and transferred to the floor to begin increasing his activity level on pod #2.chest tubes and pacing wires removed without incident. he made good progress and was cleared for discharge to home with services on pod #4. discharge inr 2.6. target inr 2.5 - 3.0. medications on admission: diltiazem 60 mg qid atenolol 50 mg qam, 25 mg qpm atorvastatin 80 mg daily lisinopril 10 mg daily plavix 75 mg daily asa 325 mg daily ativan fentanyl patch 150 mcg/ hs celexa 45 mg daily isosorbide 120 mg daily lasix 20 mg daily discharge medications: 1. warfarin 2 mg tablet sig: two (2) tablet po once a day for 2 days: please take 4mg and - have inr checked with results to dr fax # goal inr 2.5-3.0 . disp:*60 tablet(s)* refills:*0* 2. outpatient work pt/inr as needed for coumadin dosing first draw with results to dr fax # goal inr 2.5-3.0 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 5. atorvastatin 80 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 7. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 10. celexa 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 11. senna 8.6 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*0* 12. hydromorphone 2 mg tablet sig: 1-2 tablets po q3-4h (every 3 to 4 hours) as needed. disp:*50 tablet(s)* refills:*0* 13. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day): please take twice daily for 1 week then decrease to once daily for 1 week . disp:*21 tablet(s)* refills:*0* 14. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po twice a day for 14 days: please take 20meq twice a day for 7 days and then decrease to 20meq once daily for 7 days . disp:*42 capsule, sustained release(s)* refills:*0* discharge disposition: home with service facility: , discharge diagnosis: bicuspid aortic valve s/p redo sternotomy avr aortic stenosis coronary artery disease with stents / hypertension dyslipidemia anxiety discharge condition: good discharge instructions: shower, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr in 4 weeks () please call for appointment dr in 1 week () please call for appointment dr in weeks () please call for appointment wound check appointment 2 as instructed by nurse () pt/inr as needed for coumadin dosing first draw with results to dr fax # goal inr 2.5-3.0 procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve closed [endoscopic] biopsy of bronchus transfusion of packed cells diagnoses: pneumonia, organism unspecified intermediate coronary syndrome unspecified essential hypertension aortocoronary bypass status aortic valve disorders pulmonary collapse hemorrhage complicating a procedure iatrogenic pneumothorax 

Answer: The patient is high likely exposed to