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: history of present illness: this is a 59-year-old male who presented for replacement of his aortic valve with a known heart murmur for 40 years with increasing degree of aortic stenosis. he has been generally asymptomatic but now has critical stenosis and he presents for elective replacement. he was referred to dr. , for aortic valve replacement. preoperatively cardiac catheterization showed normal coronaries with anomalous left circumflex coming from the rca take off and severe aortic stenosis with a peak gradient of 56 mm and in the aortic valve area of 0.8 cm2. past medical history: 1. hypertension. 2. hyperlipidemia. 3. aortic stenosis. 4. obesity. 5. prior prostate biopsy. medications: 1. altace 20 mg po once daily. 2. toprol 25 mg po once daily. 3. lipitor 10 mg po once daily. 4. centrum silver vitamin daily. family history: contributory as his mother passed away at 79 of myocardial infarction. social history: he is married and works. he is a nonsmoker. he quit smoking cigars 12 years ago with no history of alcohol abuse. review of symptoms: he has no chills, no chest pain, no fever, no claudication. no diarrhea or dyspnea. no orthopnea, or palpitations. he denied any allergies. penicillin was ok but he got a rash with augmentin in the past. preoperative laboratory data: white blood cell count 7.0, hematocrit 42.4, pt 13.0, ptt 27.8, inr 1.1, platelet count 265,000. urinalysis was negative preoperatively. sodium 140, potassium 4.1, chloride 103, bicarb 24, bun 23, creatinine 0.8 with a blood sugar of 87. alt 35, ast 32, alkaline phosphatase 71, total bilirubin 1.0. total protein 7.3, albumin 4.5, globulin 2.8, hb a1c 5.6%. preoperative chest x-ray showed no acute cardiopulmonary process. preoperative ekg showed sinus rhythm at 67 with no acute ischemia. please refer to the official report dated . physical examination: the patient is 5 feet 9 inches tall, 230 pounds, heart rate 80, blood pressure 168/palp. in no apparent distress. no serious dental issues. pupils are equal, round and reactive to light. no jaundice. heart with regular rate and rhythm with a systolic ejection murmur. chest was clear without any fremitus. abdomen soft and benign and obese. extremities - 5/5 strength in all four extremities, 2+ radial, 2+ dps bilaterally. the patient came in as a same day admission on , and underwent aortic valve replacement with dr. , with a 25 mm - pericardial aortic valve. he was transferred to the cardiothoracic intensive care unit in stable condition on an amiodarone drip at 1 mg per minute and i have titrated his propofol drip, a paste. on postoperative day 1, he had been extubated overnight and was hemodynamically stable saturating 96% on 4 liters nasal cannula on an amiodarone drip at 0.5 mg per minute and nipride drip at 1.5. he was neurologically intact. he began a beta blocker and ace inhibitor as well as diuresis. chest tubes remained in place. postoperative white blood cell count was 16.0, hematocrit 31.0, inr 1.1. on postoperative day 2, he was transferred out to the floor, was seen and evaluated by physical therapy and case management using percocet for pain control. his creatinine remained stable at 0.8. on postoperative day 3, he also began his aspirin and went back onto captopril, continued with lasix diuresis. his lopressor was increased to 50 twice a day and on postoperative day 3, increased to 75 mg po twice a daily. he was already doing level 4 activity and was very motivated. on postoperative 3, he remained hemodynamically stable in sinus rhythm. his creatinine dropped slightly to 0.7, and it was planned to discharge him on , however he went into atrial fibrillation on , and needed to remain in hospital for treatment and resolution of that dysrhythmia. on postoperative day 4, he did have short verse of atrial fibrillation in the evening prior. he was also restarted on his ace inhibitor. her epicardial pacing wires had been removed at that instance. his chest tubes had been removed. he remained in sinus rhythm again with blood pressure of 160/80, and he remained in the hospital for additional monitoring. he had little bit of disorientation on postoperative 5 which resolved. on postoperative day 5, he was hemodynamically stable in no apparent distress. his incisions were clean, dry and intact. his extremities were warm and well perfused. he went back into atrial fibrillation and was started on coumadin with heparin bridge on . on postoperative day 6, he went back into sinus rhythm. he had already been started on heparin and coumadin with a plan to discharge him from the hospital when his inr was greater than 1.4. he received an additional dose of 5 mg of coumadin that second night after briefly going into atrial fibrillation and back to sinus rhythm. on postoperative day 7, his lasix was increased to help with diuresis. he was encouraged to ambulate. he received 7.5 mg of coumadin that evening. his inr was only 1.2. on postoperative day 8, his inr rose to 1.3. he received another 7.5 mg of coumadin that evening as he remained on his heparin drip. he had slight erythema on the left side of his incision but no click or drainage. he was otherwise hemodynamically stable with a blood pressure of 120/63, in sinus rhythm. he was also started on amlodipine 10 mg po once a day. on , he also complained of some right shoulder blade pain and stated that he thought he pulled a muscle when he was getting out of bed. warm packs were applied with good effect. his heparin was off briefly for 2 hours that evening secondary to no iv access. on , his inr rose to 2.4. repeat urinalysis was negative. discharge disposition: he was discharged to home with vna services in stable condition with the following discharge medications. discharge medications: 1. lasix 20 mg po twice a day for 7 days. 2. potassium chloride 20 meq po twice a day for 7 days. 3. colace 100 mg po twice a day. 4. enteric coated aspirin 81 mg once a day. 5. percocet 5/325 one to two tablets po p.r.n. q4 to 6 hours p.r.n. pain. 6. lipitor 10 mg po once a day. 7. ramipril 20 mg po once a day. 8. metoprolol 100 mg po twice a day. 9. zantac 150 mg po twice a day. 10. amlodipine 5 mg po once a day. 11. keflex 500 mg po 4 times a day for 7 days. 12. coumadin with the instructions for a 5 mg dose once a day for 4 days and then inr check at dr. s. office on , and dr. to follow up with additional inr testing and coumadin dosing for a target inr of 2.0. dr. number is . discharge diagnoses: 1. status post aortic valve replacement with pericardial tissue valve. 2. hypertension. 3. hyperlipidemia. 4. aortic stenosis. 5. obesity. the patient was also given instructions to follow up in our wound clinic postoperatively in 2 weeks to see dr. , in the office for postoperative visit in 3 to 4 weeks and to visit dr. , for his postoperative surgical visit, 4 weeks post discharge. the patient was discharged on . , m.d. procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: unspecified essential hypertension atrial fibrillation other and unspecified hyperlipidemia multiple involvement of mitral and aortic valves 

Answer: The patient is high likely exposed to