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: novocain attending: chief complaint: chest pain/sob major surgical or invasive procedure: cardiac catheterization 1. coronary artery bypass grafting x4 with a left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to the right posterior left ventricular branch artery, ramus intermedius artery, diagonal artery. 2. mitral valve repair with a 34-mm cg future annuloplasty ring. 3. left-sided maze procedure with left atrial appendage resection. history of present illness: 71 yo russian speaking male with a known history of coronary artery disease s/p inderior st elevation mi in in the presents with several months of ongoing chest pain and atrial arrythmias. the patient had been in the when he suffered an inferior st elevation mi, developed atrial filbrillation/flutter and he was treated with one month of anticoagulation. he returned from after 2 months of hospitalization and rehab. presently, he has dyspnea on exertion, fatigue, paroxysmal nocturnal dyspnea and substernal chest pain. he denies lightheadedness, palpitations, or peripheral edema. he was transferred to for cabg/mvr evalution after catherization at osh which revealed cad and mitral valve disease. past medical history: coronary artery disease s/p st elevation myocardial infarction atrial fibrillation/flutter pnuemonia 10 years ago chronic bronchitis social history: race: caucasian last dental exam: edentulous - upper and lower dentures - last dental visit 9 years ago lives with: wife, speaks only russian occupation: retired economics professor - moved to america tobacco: former tobacco abuse (smoked 10 cigarettes/day x 40 years) quit in etoh: occasional family history: mother - "irregular heart beat" physical exam: pulse: resp:18 o2 sat: 98% ra b/p right:130/90 left: height: 67 inches weight:190 # general: aao x3 in nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur ii/vi sem murmur best heard at apex abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema - no varicosities: + left lower extremity varicosities neuro: grossly intact pulses: femoral right:2+ left:2+ no hematoma @ r groin cath site dp right:2+ left:2+ pt :2+ left:2+ radial right:2+ left:2+ carotid bruit right:no left:no pertinent results: carotid u/s and vein mapping: right ica no stenosis. left ica stenosis <40%. duplex and color doppler demonstrate patent bilateral lesser and greater saphenous veins, please see digitized images on pacs for formal sequential measurements. there are varicosities noted involving the left calf and the right lesser saphenous vein is somewhat diminutive in diameter. echo: pre-cpb: 1. the left atrium is moderately dilated. 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). a left atrial appendage thrombus cannot be excluded. 2. no atrial septal defect is seen by 2d or color doppler. 3. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. the remaining left ventricular segments are hypokinetic. lvef = 30%. 4. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. there is abnormal septal motion/position. 5. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 6. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. 7. moderate (2+) mitral regurgitation is seen with a central jet. the vena contracta is consistent with moderate (2+) mitral regurgitation. there is bilateral leaflet restriction. the leaflets appear structurally normal. there is dilation of the annulus in the commisural plane.. the left ventricular inflow pattern suggests impaired relaxation. dr. was notified in person of the results. post-cpb: on infusions of norepinephrine, milrinone. av pacing for slow sr with first degree avb. well-seated annuloplasty ring in the mitral position. trace mr. function is improved on inotropic support. lvef is now 35%. aortic contour is normal post decannulation 06:01am blood wbc-7.3 rbc-3.24* hgb-10.0* hct-30.5* mcv-94 mch-30.8 mchc-32.7 rdw-14.5 plt ct-316# 06:01am blood glucose-107* urean-21* creat-1.0 na-137 k-4.3 cl-102 hco3-27 angap-12 06:01am blood pt-23.9* ptt-97.8* inr(pt)-2.3* , m 71 radiology report chest (pa & lat) study date of 11:03 am , fa6a 11:03 am chest (pa & lat) clip # reason: evaluate for effusion final report pa and lateral views of the chest reason for exam: status post cabg and mvr repair. comparison is made with prior study . small right pneumothorax is stable. mild cardiomegaly is unchanged. postoperative mediastinal widening is stable. right lower lobe atelectasis has improved. aeration in the left lower lobe has also improved. sternal wires are aligned. there is atelectasis adjacent to the right minor fissure. there are no enlarging pleural effusions. there is mild fluid overload. dr. approved: tue 11:27 am brief hospital course: mr. was transferred from mwmc after cardiac cath revealed severe three vessel disease and moderate mitral regurgitation. upon admission he was completely worked-up for surgical intervention. on he was brought to the operating room where he underwent a coronary artery bypass, mitral valve repair and maze procedure. please see operative report for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. pod 1 found the patient extubated, alert and oriented and breathing comfortably. he was neurologically intact and hemodynamics were maintained with milrinone and levophed which were weaned subsequently. coumadin was started for atrial flutter, as well as evidence of a right atrial clot that was seen in the operating room. chest tubes and pacing wires were discontinued without complication. the patient was transferred to the telemetry floor on pod 4. he made further progress with physical therapy, demonstrating good strength and balance prior to discharge. the patient remained in atrial flutter throughout the hospital course. his rate was controlled with beta blockers. anticoagulation was achieved with a heparin bridge to coumadin. by the time of discharge on pod 7, the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. he was discharged home in good condition with vna services. his anticoagulation will be followed by the mwmc coumadin clinic. his first inr will be drawn by the vna on sat. and will be called into the mw heart center attending on call. a list of inpatient inrs and coumadin doses has been faxed to the mw heart center clinic and will be sent home with the patient for the vna. this plan was discussed with from the coumadin clinic. medications on admission: amiodarone 100 mg , coumadin 2.5 mg daily, trimetazidine 35 mg daily. last dose of coumadin discharge medications: 1. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. 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:*2* 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 7. warfarin 2.5 mg tablet sig: three (3) tablet po at bedtime for 2 days: take as directed by the coumadin clinic for inr goal of .5. disp:*90 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:*2* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease, mitral regurgitation, atrial fibrillation/flutter s/p coronary artery bypass graft x 4, mitral valve repair, maze procedure past medical history: s/p st elevation myocardial infarction pnuemonia 10 years ago chronic bronchitis discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with percocet prn discharge instructions: please wash daily (no shower due to tunnel line per renal) including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 followup instructions: please call to schedule appointments surgeon dr. (for dr. in weeks primary care dr. in weeks cardiologist dr. in 4 weeks procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery annuloplasty excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified atrial fibrillation personal history of tobacco use atrial flutter old myocardial infarction long-term (current) use of anticoagulants acute systolic heart failure chronic total occlusion of coronary artery other acute postoperative pain 

Answer: The patient is high likely exposed to