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: niacin / hayfever attending: chief complaint: fatigue major surgical or invasive procedure: redo sternotomy/avr history of present illness: 84 year old male with extensive pmm complaint of progressively worsening fatigue. most recent cardiac catherization revealed 1 and echocardiogram with decreased left ventricular function. past medical history: hoh : prostate ca with radiation radiation proctitis with multiple colon cauterizations gerd anemia gall bladder surgery hand surgery ? hernia repair as a child history of gout cabg disease : s/p tia/mild cva- no residual elevated homocysteine niddm social history: retired lives with spouse denies etoh social family history: brother and sisters with cad < 55 years old physical exam: admission general: well appearing and no acute distress skin: unremarkable heent eomi perrla ncat neck supple full rom chest cta bilat heart rrr 4/6 sem abd soft nd nt +bs ext warm well perfused no edema neuro a/o x3 mae nonfocal pertinent results: 06:10am blood wbc-8.2 rbc-2.89* hgb-8.8* hct-25.2* mcv-87 mch-30.5 mchc-34.9 rdw-16.0* plt ct-121* 11:39am blood wbc-9.7 rbc-2.12*# hgb-6.8*# hct-19.7*# mcv-93 mch-31.9 mchc-34.4 rdw-15.0 plt ct-143* 08:25am blood pt-18.3* inr(pt)-1.7* 06:10am blood plt ct-121* 06:10am blood pt-17.2* inr(pt)-1.6* 07:00am blood pt-15.0* inr(pt)-1.3* 11:39am blood plt ct-143* 11:39am blood pt-15.0* ptt-40.8* inr(pt)-1.3* 06:14pm blood fibrino-291 06:10am blood glucose-96 urean-30* creat-1.1 na-143 k-3.8 cl-105 hco3-29 angap-13 01:30pm blood urean-17 creat-0.8 cl-110* hco3-24 06:10am blood mg-1.6 06:14pm blood calcium-8.9 phos-4.1 mg-2.0 chest (portable ap) 9:13 pm chest (portable ap) reason: eval for pneumothorax s/p chest tube removal medical condition: 84 year old man s/p avr reason for this examination: eval for pneumothorax s/p chest tube removal chest radiograph comparison with . left-sided chest tube has been removed. the left hemidiaphragm has returned to its normal position. no pneumothorax. small atelectasis right. no pulmonary opacities, no signs of cardiac failure. dr. dr. approved: sun 11:07 am technically difficult study atrial fibrillation intraventricular conduction defect - left bundle branch block type late r wave progression consider anteroseptal infarct - age undetermined since previous tracing of , now irregular rhythm, qrs wider clinical correlation is suggested read by: , a. intervals axes rate pr qrs qt/qtc p qrs t 90 0 148 400/452 0 -25 139 , portable tte (focused views) done at 12:38:16 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 84 m hgt (in): 66 bp (mm hg): 90/50 wgt (lb): 175 hr (bpm): 80 bsa (m2): 1.89 m2 indication: hypotensive s/p 25 mm mosaic porcine avr. evaluate for tamponade. icd-9 codes: v42.2, 424.1 test information date/time: at 12:38 interpret md: , md test type: portable tte (focused views) son: , rdcs doppler: limited doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2007w077-0:23 machine: vivid echocardiographic measurements results measurements normal range left ventricle - ejection fraction: 40% >= 55% aorta - ascending: *4.1 cm <= 3.4 cm aortic valve - peak velocity: *2.2 m/sec <= 2.0 m/sec aortic valve - peak gradient: *20 mm hg < 20 mm hg aortic valve - mean gradient: 10 mm hg tr gradient (+ ra = pasp): *30 mm hg <= 25 mm hg findings this study was compared to the report of the prior study (images not available) of . right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left ventricle: suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. mildly depressed lvef. no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. paradoxic septal motion consistent with prior cardiac surgery. aorta: moderately dilated ascending aorta. aortic valve: bioprosthetic aortic valve prosthesis (avr). normal avr gradient. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. mild thickening of mitral valve chordae. no mr. tricuspid valve: tricuspid valve not well visualized. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: pulmonic valve not well seen. physiologic (normal) pr. pericardium: trivial/physiologic pericardial effusion. conclusions due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is difficult to assess but appears mildly depressed (lvef= 40 %). right ventricular chamber size and free wall motion are normal. the ascending aorta is moderately dilated. a bioprosthetic aortic valve prosthesis is present. the transaortic gradient is normal for this prosthesis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. compared with the report of the prior study (images unavailable for review) of , a bioprosthetic avr is now present. the severity of mitral and tricuspid regurgitation has decreased, although image quality is technically suboptimal. overall left ventricular function appears at least mild to moderately depressed. electronically signed by , md, interpreting physician 14:14 brief hospital course: mr was admitted the evening before surgery. the next am he was brought to the operating room and underwent a redo sternotomy and aortic valve replacement. please see operative report for further details. he tolerated the procedure well except for complete heart block with swan ganz insertion, and was transferred to the csru for invasive monitoring. he required pressors and fluid for blood pressure management and returned to the operating room on post operative day one for bleeding and removal of clot. om post operative day 2 he was weaned from sedation, awoke neurologically intact, and was extubated. his platlet count had decreased to 58 and hit was sent that was negative. he also went into atrial fibrillation and was started on beta blockers for rate control, no amiodarone was given due to heart block intra and post op day 1. diuretics were started and he was gently diuresised towards his preoperative weight. on post operative day three chest tubes were removed and he was transferred to the post operative floor. he continued to remain in atrial fibrillation and coumadin was started for anticoagulation. physical followed him during entire post-op course for strength and mobility. his beta blockers continued to be adjusted for rate control and he was ready for discharge to rehab on post operative day five. medications on admission: fish oil 1 gm asa 81 daily metformin 500 prilosec 20 glipizide 10 lipitor 40 hs zetia 10 hs atenolol 12.5 hs lisinopril 20 hs discharge medications: 1. plavix 75 mg tablet sig: one (1) tablet po once a day: restart at d/c per rdt. 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 6. glipizide 5 mg tablet sig: two (2) tablet po bid (2 times a day). 7. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 8. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 9. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 10. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 11. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. 12. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 13. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 14. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 15. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po bid (2 times a day). 16. warfarin 1 mg tablet sig: as directed tablet po daily (daily): adjust dose to target inr of .5 please give 2.5mg on and and check inr . discharge disposition: extended care facility: for the aged - macu discharge diagnosis: aortic stenosis s/p redo sternotomy/avr(tissue) complete heart block post operative atrial fibrillation pmh: prostate ca s/p radiation/radiation proctitis, gerd, anemia, gout, gilberts dz, cva/tia, dm2, homocysteinuria, psh: cabgx6, ccy, rih repir, lft rad aneurysm repair discharge condition: good discharge instructions: please shower daily including washing incisions, 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 after discharge from rehab dr in 4 weeks please call to schedule dr after discharge from rehab procedure: insertion of intercostal catheter for drainage arterial catheterization reopening of recent thoracotomy site open and other replacement of aortic valve with tissue graft pulmonary artery wedge monitoring transfusion of packed cells transfusion of packed cells transfusion of packed cells transfusion of other serum diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified gout, unspecified atrial fibrillation personal history of malignant neoplasm of prostate aortocoronary bypass status aortic valve disorders hemorrhage complicating a procedure old myocardial infarction chronic systolic heart failure disorders of bilirubin excretion other heart block 

Answer: The patient is high likely exposed to