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: sulfa (sulfonamide antibiotics) attending: chief complaint: left sided chest pain/back pain major surgical or invasive procedure: 1. replacement of ascending aorta and hemiarch with a 32-mm dacron vascutek gelweave graft using deep hypothermic circulatory arrest. 2. coronary artery bypass grafting x1 with left internal mammary artery to left anterior descending coronary artery. history of present illness: 62 year old gentleman with a history of a type b aortic dissection in and ascending aortic aneurysm discovered at that time which has been managed medically with blood pressure control. given the significance of his aneurysm along with possiblity of a connective tissue disorder, it was planned to proceed with surgery. he underwent a cardiac catheterization which revealed left anterior descending artery disease past medical history: hypertension type b aortic dissection abdominal aortic aneurysm ascending aortic aneurysm chronic obstructive pulmonary disease depression gastroesophageal reflux disease osteoarthritis anemia chronic kidney disease stage 4 - due to dissection of the renal artery past surgical history: teeth extraction tonsillectomy social history: occupation: retired last dental exam: many yrs ago, edentulous lives with: roommate race: caucasian tobacco: quit 1 yr ago after 2ppd x 40 yrs etoh: rare family history: family history: non-contributory, father died of cirrhosis occupation: retired lives with: roommate race: caucasian tobacco: quit 1 yr ago after 2ppd x 40 yrs etoh: rare physical exam: pulse: 57 resp: 20 o2 sat: 98% b/p left: 137/88 height: 6'2" weight: 215 lb general: well-developed male in no acute distress skin: dry intact lipoma on upper back heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally expiratory wheezes throughout heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: none varicosities: none neuro: alert and oriented to person and place, non focal pulses: femoral right: +2 left: +2 dp right: +2 left: +2 pt : +2 left: +2 radial right: +2 left: +2 carotid bruit right: no bruit left: no bruit pertinent results: 10:05am blood wbc-10.9 rbc-3.26* hgb-9.6* hct-28.5* mcv-88 mch-29.4 mchc-33.6 rdw-15.3 plt ct-291 02:01am blood wbc-10.9 rbc-3.31* hgb-9.7* hct-28.8* mcv-87 mch-29.3 mchc-33.7 rdw-15.5 plt ct-254 10:05am blood glucose-112* urean-58* creat-3.0* na-134 k-5.1 cl-100 hco3-24 angap-15 02:01am blood glucose-103* urean-53* creat-3.0* na-134 k-4.8 cl-99 hco3-25 angap-15 tte : pre-bypass: the left atrium and right atrium are normal in cavity size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic root is moderately dilated at the sinus level. the ascending aorta is moderately dilated. the aortic arch is mildly dilated. there are simple atheroma in the aortic arch. the descending thoracic aorta is markedly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. the abdominal aorta is moderately dilated. a mobile density is seen in the descending aorta consistent with an intimal flap/aortic dissection. the aortic wall is thickened consistent with an intramural hematoma. there is flow in the false lumen. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. post-bypass: there is a well-seated aortic graft above the level of the aortic annulus that measures 32 mm in diameter. biventricular systolic function is unchanged. the aortic contour is unchanged post decannulation. 05:58am blood wbc-11.8* rbc-3.16* hgb-9.0* hct-27.5* mcv-87 mch-28.6 mchc-32.8 rdw-15.5 plt ct-293 05:58am blood pt-21.9* ptt-31.8 inr(pt)-2.0* 05:58am blood glucose-87 urean-61* creat-3.1* na-131* k-5.0 cl-97 hco3-25 angap-14 brief hospital course: the patient was admitted to the hospital and brought to the operating room on where he underwent replacement of ascending aorta and hemiarch with a 32-mm dacron vascutek gelweave graft using deep hypothermic circulatory arrest and coronary artery bypass grafting x1 with left internal mammary artery to left anterior descending coronary artery. see operative note for full details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and some breathing difficulty requiring bipap. the patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. he was started on vancomycin and cefepime for a presumed left sided pneumonia for a 10 day course. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. he was in and out of rate controlled atrial fibrillation throughout his hospital course and started on amiodarone and coumadin with an inr goal 2-2.5. he will be followed by dr. and the for his coumadin dosing. the patient was transferred to the telemetry floor for further recovery on post operative day 5. on post operative day 6 the patient was swallowing a medication, started choking and had a vagal episode losing consciousness for a few seconds. the patient was hemodynamically stable after the episode with no events on the monitor throughout the episode. he was transferred to the cvicu for further monitoring. he remained hemodynamically stable and was transferred back to the telemetry floor in stable condition. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. the patient was ambulating with oxygenation desaturation. reassessment of his pulmonary status proved further pulmonary rehabilitation was required prior to discharge home. the wound was healing and pain was controlled with oral analgesics. he was transfused 2units of prbc for a hematocrit of 25.6% on . hematocrit rose appropriately. the patient was discharged to rehab in good condition with appropriate follow up instructions. medications on admission: albuterol inh prn norvasc 10 mg daily famotidine 20 mg daily lisinopril 5 mg daily metoprolol 12.5 mg omeprazole 20 mg daily zoloft 100 mg daily simvastatin 40 mg daily aspirin 325mg daily allergies: sulfa drugs discharge medications: 1. outpatient lab work labs chem 7 on with results to dr fax ( 2. outpatient lab work labs: pt/inr for coumadin ?????? indication atrial fibrilation goal inr 2.0-2.5 first draw for further dosing 3. vancomycin in d5w 1 gram/200 ml piggyback sig: one (1) gram intravenous q 24h (every 24 hours) for 3 days: for treatment of pneumonia . 4. cefepime 2 gram recon soln sig: two (2) gram injection q24h (every 24 hours) for 3 days: for treatment of pneumonia . 5. chest pt chest pt q6h to lll 6. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 7. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 8. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 9. picc line per picc line protocol 10. warfarin 3 mg tablet sig: one (1) tablet po once (once) for 2 days: please give sat and sun - lab draw monday for further dosing . 11. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours). 12. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q4h (every 4 hours) as needed for prior to walking . 13. famotidine 20 mg tablet sig: one (1) tablet po daily (daily). 14. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. 15. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 16. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 17. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 18. acetaminophen 500 mg tablet sig: two (2) tablet po every eight (8) hours. 19. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 20. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 21. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: three (3) ml inhalation q6h (every 6 hours) as needed for dyspnea. 22. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 23. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 24. sertraline 50 mg tablet sig: two (2) tablet po daily (daily). discharge disposition: extended care facility: center for rehab & sub-acute care - discharge diagnosis: 1. ascending aortic aneurysm. 2. chronic type b aortic dissection involving the descending thoracic aorta and abdominal aorta. 3. single-vessel coronary disease.s/p replacement of ascending aorta and hemiarch with a 32-mm dacron vascutek gelweave graft using deep hypothermic circulatory arrest/coronary artery bypass grafting x1 with left internal mammary artery to left anterior descending coronary artery 4. chronic obstructive pulmonary disease. 5. chronic renal failure. discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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 2:15 pm nephrology: , m.d. phone: date/time: 2:00 , : date/time: 9:00 labs chem 7 on with results to dr ( please call to schedule appointments with your primary care dr. in weeks cardiologist dr. in weeks ( **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication atrial fibrilation goal inr 2.0-2.5 first draw for further dosing procedure: venous catheterization, not elsewhere classified single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery resection of vessel with replacement, thoracic vessels diagnoses: pneumonia, organism unspecified anemia in chronic kidney disease coronary atherosclerosis of native coronary artery esophageal reflux hyposmolality and/or hyponatremia thoracic aneurysm without mention of rupture chronic airway obstruction, not elsewhere classified chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation depressive disorder, not elsewhere classified surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation retention of urine, unspecified other symptoms involving head and neck 

Answer: The patient is high likely exposed to