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: accupril / iodine-iodine containing attending: chief complaint: aortic stenosis major surgical or invasive procedure: redo-sternotomy, aortic valve replacement (23mm porcine) history of present illness: 76 year old male with prior coronary artery grafts in at the hospital, who has known severe aortic stenosis which was being followed by serial echocardiograms. given worsening dyspnea on exertion and exertional angina, he has been referred for a redo sternotomy and aortic valve replacement. past medical history: aortic stenosis coronary artery disease s/p coronary artery bypass graft x3 dr. at a bilateral lower extremity claudication peripheral vascular disease diabetes mellitus inflammatory arthritis glaucoma cabg x 3 ( lima to lad, svg to om1, svg to om2) bilateral femoral endarterectomies tonsillectomy left vitrectomy 's social history: occupation: retired teacher last dental exam: 6 months ago lives with wife in , ma tobacco: brief use while in college etoh: denies family history: no premature coronary artery disease physical exam: bp: 133/63 pulse:77 resp: 20 o2 sat: 98% ra height: 65" weight: 135 lb general: wdwn elderly gentleman in nad skin: warm, dry and intact. no c/c. well healed bilateral groin incisions. well healed sternotomy. well healed r leg saphenectomy incision. heent: ncat, perrla, eomi, anicteric sclera, op benign neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr, nl s1-s2 +s4, iii/vi sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused trace edema mildly thickened digits. varicosities: right gsv surgically absent. left appears suitable if needed. neuro: grossly intact pulses: femoral right: 2 left: 2 no bruit bilaterally dp right: 1 left: 1 pt : 1 left: 1 radial right: 2 left: 2 carotid bruit transmitted murmur to (b) carotids pertinent results: 02:52am blood wbc-10.7 rbc-3.79* hgb-11.5* hct-34.4* mcv-91 mch-30.4 mchc-33.5 rdw-14.0 plt ct-116* 01:37pm blood wbc-20.0*# rbc-3.13* hgb-9.8* hct-29.3* mcv-94 mch-31.5 mchc-33.6 rdw-13.4 plt ct-165 02:52am blood plt ct-116* 12:39pm blood pt-16.1* ptt-48.6* inr(pt)-1.4* 12:39pm blood plt ct-131* 07:55am blood urean-27* creat-1.3* na-138 k-4.8 cl-99 hco3-32 angap-12 01:37pm blood urean-21* creat-0.9 cl-113* hco3-24 02:52am blood mg-2.5 , f m 77 cardiology report ecg study date of 8:13:48 am sinus rhythm with sinus arrhythmia. possible left atrial enlargement. possible inferior myocardial infarction of indeterminate age. non-specific st-t wave abnormalities. compared to tracing #1 sinus rhythm has replaced atrial flutter. st-t wave abnormalities are less marked. clinical correlation is suggested. tracing #2 read by: , intervals axes rate pr qrs qt/qtc p qrs t 84 180 94 364/406 47 73 31 , f m 77 radiology report chest (pa & lat) study date of 3:01 pm , r. csurg fa6a 3:01 pm chest (pa & lat) clip # reason: ? effusions medical condition: 77 year old man with avr reason for this examination: ? effusions final report pa and lateral chest, history: avr, question effusions. impression: pa and lateral chest compared to : small right pleural effusion and mild left lower lobe atelectasis is unchanged. more severe right lower lobe atelectasis has worsened. no pneumothorax. stable postoperative appearance to cardiomediastinal silhouette. dr. approved: mon 8:43 pm echocardiography report , (complete) done at 11:29:12 am preliminary referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 77 m hgt (in): 65 bp (mm hg): 124/73 wgt (lb): 133 hr (bpm): 63 bsa (m2): 1.66 m2 indication: aortic valve disease. shortness of breath. icd-9 codes: 786.05, 424.1, 424.2 test information date/time: at 11:29 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2010aw001-0:00 machine: ie33 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.0 cm <= 4.0 cm left atrium - four chamber length: *5.5 cm <= 5.2 cm right atrium - four chamber length: *5.9 cm <= 5.0 cm aorta - annulus: 2.5 cm <= 3.0 cm aorta - ascending: 3.2 cm <= 3.4 cm aorta - arch: 2.1 cm <= 3.0 cm aorta - descending thoracic: 2.0 cm <= 2.5 cm aortic valve - peak velocity: *5.0 m/sec <= 2.0 m/sec aortic valve - peak gradient: *101 mm hg < 20 mm hg aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 aortic valve - pressure half time: 334 ms findings left atrium: moderate la enlargement. elongated la. no spontaneous echo contrast or thrombus in the body of the laa. right atrium/interatrial septum: mildly dilated ra. normal interatrial septum. no asd by 2d or color doppler. left ventricle: normal lv wall thickness, cavity size, and global systolic function (lvef>55%). right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). moderate (2+) ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets. moderate to severe tr. normal pa systolic pressure. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. conclusions pre-bypass: the left atrium is normal in 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%). the right ventricular cavity is mildly dilated with normal free wall contractility. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. post-bypass: i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician pathology examination name birthdate age sex pathology # , f 77 male report to: dr. . gross description by: dr. /mtd specimen submitted: aortic valve. procedure date tissue received report date diagnosed by dr. /vf diagnosis: aortic valve: valvular tissue with calcification, fibrosis and myxoid degeneration. clinical: aortic stenosis. gross: the specimen is received in saline in a container labeled with the patient's name, ", ", the medical record number and additionally labeled "aortic valve tissue". it consists of three separate heavily calcified valve leaflets which measure 1.6 x 1 cm, 1.8 x 1 cm, 1.6 x 1.1 cm. representative sections are submitted in cassette a for decalcification. brief hospital course: he was admitted and brought to preoperative holding area, and brought to the operating room where he underwent a redo-sternotomy and aortic valve replacement. please see operative report for surgical details. following surgery he was transferred to the cvicu for invasive monitoring. within 24 hours he was weaned from sedation, awoke neurologically intact and extubated. chest tubes and epicardial pacing wires were removed per protocol. he was diuresed towards his preoperative weight and beta blockers were begun. physical therapy worked with him for mobility and strength. he had a brief episode of atrial fibrillation after transfer and the beta blocker dose was increased. arrangements were made for outpatient follow up. medications, restrictions and precautions were discussed prior to discharge. he was readyu for discharge home on post operative day five with plan for lab drawn . medications on admission: prednisone 10 qd plaquenil 200 qd asa 81 mg daily avapro 150 mg daily fish oil simvastatin 40 mg daily timolol ophthalmic 0.5% one gtt daily lantus insulin 20 units qam humalog ssi insulin mvi/minerals daily trazodone 100 qhs ambien 10 qhs prn discharge medications: 1. 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:*0* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 3. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 7 days. disp:*7 tab sust.rel. particle/crystal(s)* refills:*0* 4. lasix 40 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po every eight (8) hours. disp:*90 tablet(s)* refills:*0* 7. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic daily (daily). disp:*qs qs* refills:*0* 9. prednisone 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 10. insulin glargine 100 unit/ml solution sig: twenty (20) units subcutaneous once a day. 11. insulin lispro 100 unit/ml solution sig: sliding scale subcutaneous four times a day: sliding scale as prior to admission . disp:*qs qs* refills:*0* 12. plaquenil 200 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 13. zaroxolyn 2.5 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 14. outpatient lab work please check potassium, cr on friday with results to dr office phone # discharge disposition: home with service facility: discharge diagnosis: aortic stenosis s/p avr coronary artery disease s/p coronary artery bypass graft rheumatoid arthritis peripheral vascular disease s/p bilateral femoral endarterectomies diabetes mellitus type 2 hyperlipidemia bilateral lower extremity claudication peripheral vascular disease diabetes mellitus djd/inflammatory arthritis, currently on steroids and plaquenil glaucoma cabg x 3 ( lima to lad, svg to om1, svg to om2) bilateral femoral endarterectomies tonsillectomy left vitrectomy meei 's od laser surgery discharge condition: alert and oriented x3, nonfocal ambulating, gait steady sternal pain managed with percocet prn discharge instructions: please shower daily 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: , md phone: date/time: 1:30 please call to schedule appointments primary care: dr. (in weeks cardiologist: dr. in weeks wound check appointment - 6 () - your nurse will schedule outpatient lab work please check potassium, cr on friday with results to dr office phone # procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: long-term (current) use of steroids atrial fibrillation aortocoronary bypass status aortic valve disorders other and unspecified hyperlipidemia long-term (current) use of insulin rheumatoid arthritis diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled edema 

Answer: The patient is high likely exposed to