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: tape / integrilin attending: chief complaint: sob major surgical or invasive procedure: cardiac catheterization aortic valvuloplasty history of present illness: 80 m with h/o cad s/p cabg and pci, severe as, chf and interstitial lung dz presumed from methyltrexate for polymycitis who presents upon transfer from mvh with decompensated congestive heart failure. as per outside records and report; patient came to ed after one day history of difficulty breathing requiring him to sleep bolt upright. he was found to be in pulmonary edema by x-ray and with a corresponding bnp 2280. he was given a total of 80mg of lasix and sent to icu for closer management. diuresed aggresively but overnight he became hypotensive requiring fluids and started on dopamine but was unable to tolerate due to ventricular irritability so he was placed on a neo gtt. transferred to for further care. upon transfer: pt initially sob now in ccu feels more comfortable. denies chest pain. as per osh note, pt endorses several weeks most pronounced the last few days of worsening sob and orthopnea. describes slightly worsened pedal edema. on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. cardiac review of systems is notable for absence of chest pain. dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea as per hpi. denies any palpitations, syncope or presyncope past medical history: cad s/p cabg/pci anatomy as follows: (lima to lad, svg to rca, svg to om) aortic stenosis 0.8 () ra/osteoarthritis hiatal hernia social history: lives with wife and daughter on mvi. quit smoking 40 years ago. no alcohol abuse. family history: father had an mi at 70 y/o. physical exam: vs: 97.8, 98/54, 88, 96% 4lnc at rr 24 general: moderate distress. oriented to person, place and time. the patient's mood and affect were not inappropriate. heent: perrla, conjunctiva were pink with no pallor. oral mucosa wnl. dry mm neck: supple with ~ jvp of 8 cm. no obvious cb. chest: no wall deformities, scoliosis or kyphosis. the respirations were labored with use of accessory muscles. diffuse bibasilar rales and decreased bs at bases. no wheezes cvs: tachycardic but regular. sm best lusb. no r/g. abd: the abdominal aorta was not palpated. there was no hepatosplenomegaly or tenderness. the abdomen was soft nontender and nondistended. ext: cool. delayed cap refill. 1+ le edema. inspection of skin and subcutaneous tissue showed no rash, ulcers, scars, or other lesions. neuro: ao3, appropriate , answering questions appropriate, following commands, sensation to light touch intact, strength grossly symmetric pulses: right: carotid 2+ femoral trace dp dopp pt dopp left: carotid 2+ femoral trace dp dopp pt dopp pertinent results: osh: his wbc is 15.8 and his bun/ct was 50/1.9 his bnp is 2600 today. he was said to have some st depressions last evening and his troponin was 1.01. his 2nd and 3rd troponins were 0.77 and 0.79 respectively. . 04:55pm pt-13.2* ptt-26.1 inr(pt)-1.1 04:55pm plt count-394# 04:55pm wbc-16.1*# rbc-4.15* hgb-11.7* hct-33.8* mcv-82# mch-28.3 mchc-34.7 rdw-18.6* 04:55pm calcium-8.0* phosphate-4.9*# magnesium-2.1 04:55pm ck-mb-notdone ctropnt-0.41* 04:55pm ck(cpk)-71 04:55pm glucose-137* urea n-48* creat-2.0* sodium-140 potassium-3.2* chloride-103 total co2-23 anion gap-17 . echocardiogram : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is severely depressed (ef 15-30%) with global hypokinesis. left ventricular thrombus cannot be excluded. right ventricular systolic function is normal. right ventricular systolic function appears depressed. the aortic valve leaflets are severely thickened/deformed. there is probably moderate to severe aortic stenosis (although data for valve area calculation is technically suboptimal). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate to severe (3+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. . cardiac cath performed on demonstrated: 1. selective coronary angiography in this right dominant system revealed three vessel coronary artery disease. the lmca was a short vessel without significiant disease. the lad had an ostial 60% lesion that was unchanged from . the distal vessel fills via the and via the native circulation. the lcx was a nondominant vessel without critical lesions. the previously placed lcx stents were widely patent. the rc was a dominant vessel with widely patent stents. 2. arterial conduit angiography revealed a small but patent lima that filled the lad. the svg-rca was totally occluded; the previously placed amplatz device was seen in the graft. the svg-om was occluded in the mid segment. 3. left ventriculography was not performed. 4. limited hemodynamics were performed. the previously placed pulmonary artery catheter in the right internal jugular vein was used to measure right sided pressures (only pcw and pa). the pulmonary artery pressure was elevated at 40/20 mmhg. the pulmonary capilary wedge pressure was elevated at 30mmhg. left ventricular end diastolic pressure was 33 mmhg. central aortic pressure was 90/60 mmhg with a mean of 77 mmhg. there was a mean gradient of 28 mmhg across the aortic valve. cardiac output was 3.53 l/min/m2. the aortic valve area was calculated to be 0.6 cm2 . cardiac cath w aortic valvuloplasty : initial hemodynamics revealed a peak aortic gradient of 19mmhg, with a valve area of 0.62cm2 and cardiac index of 1.7l/min/m2. after several inflations with a 20mm balloon, the gradient decreased to 13mmhg and the valve area increased to 0.8cm2. the cardiac index was relatively unchanged at 1.8l/min/m2. there was a 10-15mmhg increase in the systolic arterial pressure after the procedure. final diagnosis: 1. severe aortic stenosis. 3. successful aortic valvuloplasty. . brief hospital course: assessment and plan, 80 yo m with significant cad, chf and as presented with shortness of breath and decompensated heart failure complicated by hypotension. on initial presentation, plan was for him to go for avr but he was persistently hypotensive in cardiogenic shock, complicated by sepsis. after a prolonged course, his family decided to make him cmo and he passed away quickly after we stopped pressors. . hospital course complicated by: . # hypotension: initially cardiogenic, but also likley in septic shock by the end - used neosyn, dobutamine, and vasopressin . # respiratory: sob likely to both volume overload and pneumonia. - cont vanco/zosyn, added flagyl - lasix gtt; goal to improve respiratory status - supplemental o2 - nebs prn . # renal: decreasing urine op, increasing cr; likely secondary to ischemia/atn. - continue to diurese as tol by bp - monitor renal function - renally dose meds . # ischemia: documented cad and nstemi in setting of demand ischemia and worsening systolic function (ef 15-20%). - cath revealed coronaries unchanged from prior cath - asa - currently on pressers, so no bb - statin . # pump: previous with ef50% now with significant worsening of systolic function of unclear etiology probable worsening ischemic disease / as. now with decompensated heart failure and episodes of flash pulm edema - with severe as, mod-sev mr, and ef 15-20% - cont lasix gtt as tol; titrate to improvement in respiratory status - cont pressers as above . # as: contributing to overall cardiac dysfunction but degree of which is unclear - shows ef 15-20% - supportive care . # fen: npo (resp distress) . # access: a-line, central line/swan . # code: dnr/dni, no escalation of care then cmo . # contact: (wife) ; (daughter) . medications on admission: simvastatin 40 asa 81 h2ra prednisone 10mg qod carafate dyazide discharge medications: n/a discharge disposition: expired discharge diagnosis: n/a discharge condition: n/a discharge instructions: n/a followup instructions: n/a procedure: venous catheterization, not elsewhere classified coronary arteriography using two catheters left heart cardiac catheterization enteral infusion of concentrated nutritional substances percutaneous balloon valvuloplasty diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified septicemia severe sepsis coronary atherosclerosis of autologous vein bypass graft aortic valve disorders cardiogenic shock septic shock 

Answer: The patient is high likely exposed to