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: doxycycline attending: chief complaint: chest pain major surgical or invasive procedure: - 1. mitral valve replacement 27-mm biocor tissue heart valve. 2. coronary artery bypass grafting x3 with reverse saphenous vein graft to the marginal branch, diagonal branch, left anterior descending. history of present illness: this 88 year old male with known mitral regurgitation recently developed new onset of exertional chest discomfort. he underwent elective catheterization at which revealed severe coronary disease. he is transferred for surgical evaluation. he is without pain on transfer. past medical history: mitral regurgitation hypertension peripheral vascular disease pancytopenia blepharitis left rib resection social history: occupation: retired fire-fighter cigarettes: smoked no yes last cigarette _____ hx: other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use family history: no premature heart disease physical exam: pulse:79 resp:18 o2 sat: 98% b/p right: left: height: 5ft 3" weight: 150lb five meter walk test #1_______ #2 _________ #3_________ general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade _3/6_____ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right: +2 left:+2 dp right: +1 left:+1 pt : +1 left:+1 radial right: +2 left:+2 carotid bruit right: +2 left:+2 pertinent results: carotid u/s: right ica <40% stenosis. left ica 60-69% stenosis. . echo: pre bypass the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the right atrium is dilated. no atrial septal defect is seen by 2d or color doppler. there is mild regional left ventricular systolic dysfunction with mild hypokinesis of the distal anterior, anterolateral, and apical walls. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is dilated with normal free wall contractility. there are simple atheroma in the ascending aorta. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is partial mitral leaflet flail involving the p1 and p2 scallop interface. there is also a very small area of a! that prolapses. there is also centrally directed mitral regurgitation. there is moderate to severe mitral annular calcification. an eccentric, anteriorly directed jet of severe (4+) mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen. there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results in the operating room at the time of the study. post bypass the patient is av paced. there is normal right ventricular systolic function. there is some suggestion of left ventricular septal dyskinesis/dyssynchrony that may be reated to ventricular pacing. the apical and distal anterior, anterolateral hypokinesis noted in the prebypass study remains. overall ejection fraction is about 45 to 50%. there is a bioprosthesis located in the mitral position. it appears well seated and the leaflets appear to be moving normally. there is a trace perivalvular jet of mitral regurgitation on the anterior side of the prosthesis and a trace jet of valvular regurgitation. the maximum gradient across the valve was 16 mmhg with a mean of 7 mmhg at a cardiac output of about 4.5 liters/minute. this may indicate some element of functional mitral stenosis. the rest of valvualr function is unchanged from the prebypass period. the thoracic aorta is intact after decannulation. . 05:34am blood wbc-7.5 rbc-3.46* hgb-10.5* hct-33.8* mcv-98 mch-30.5 mchc-31.2 rdw-15.2 plt ct-164 05:34am blood pt-15.3* inr(pt)-1.4* 02:00am blood pt-13.4* ptt-25.0 inr(pt)-1.2* 06:53pm blood pt-13.6* ptt-35.5 inr(pt)-1.3* 05:34am blood glucose-114* urean-42* creat-1.5* na-143 k-3.8 cl-102 hco3-33* angap-12 02:00am blood glucose-136* urean-44* creat-1.6* na-138 k-3.8 cl-100 hco3-32 angap-10 02:02am blood glucose-156* urean-41* creat-1.8* na-137 k-4.1 cl-99 hco3-33* angap-9 03:13am blood glucose-135* urean-32* creat-1.9* na-136 k-4.0 cl-98 hco3-28 angap-14 03:03am blood glucose-92 urean-20 creat-1.2 na-139 k-4.7 cl-108 hco3-26 angap-10 brief hospital course: mr. was transferred from an outside hospital after catheterization and echo showed severe coronary artery disease and mitral regurgitation. upon admission he underwent the usual surgical work-up and was medically managed. he remained stable and on was brought to the operating room where he underwent mitral valve replacement and coronary artery bypass graft x 3. he suffered a ventricular fibrillatory arrest in the holding area preoperatively. please see operative report for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition on milrinone and neosynephrine.. he awoke intact, weaned from all vasoactive medications and was weaned from the ventilator and extubated. he developed an ileus that resolved over a couple of days and he was then able to eat, although a modified soft solids and nectar thick liquids. he had urinary retention and the foley was replaced on two occassions and was therefor, left in at discharge. coumadin was started for persisitent atrial dysrhythmia and amiodarone was given with rate control. on pod 6 he was intact and ready for discharge. rehab was recommended and he consented. he was transferred to reahb in . medications on admission: lisinopril 40mg daily toprol xl 25mg daily amlodipine 2.5mg daily aspirin 81mg daily avodart 0.5mg daily tamsulosin 0.4mg daily sertraline 50mg daily discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). 4. sertraline 50 mg tablet sig: one (1) tablet po once a day. 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 6. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 8. coumadin 2.5 mg tablet sig: as directed tablet po once a day: as ordered for goal inr 2-2.5 for atrial fibrillation. 9. outpatient lab work inr on ***** 10. amiodarone 200 mg tablet sig: as directed tablet po bid (2 times a day): 400mg (two tablets) twicew daily for two weeks, then 200mg (one tablet) twice daily for two weeks, then 200mg (one tablet) daily until instructed to stop. 11. avodart 0.5 mg capsule sig: one (1) capsule po daily (daily). 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. combivent 18-103 mcg/actuation aerosol sig: two (2) puffs inhalation four times a day as needed for shortness of breath or wheezing for 2 weeks. 15. furosemide 40 mg tablet sig: one (1) tablet po once a day for 10 days. 16. potassium chloride 20 meq tablet, er particles/crystals sig: two (2) tablet, er particles/crystals po once a day for 10 days. discharge disposition: extended care facility: northeast - discharge diagnosis: mitral regurgitation and coronary artery disease s/p mitral valve replacement and coronary artery bypass graft x 3 hypertension peripheral vascular disease pancytopenia h/o blepharitis discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema trace alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema trace alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema trace discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) 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 3:15 pm cardiologist: dr. on at 11:20am in 7 wound check in 2a on at 10:15 am please call to schedule appointments with your primary care 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 fibrillation goal inr 2-2.5 first draw will need coumadin follow up arranged after rehab discharge procedure: (aorto)coronary bypass of three coronary arteries extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft cardiopulmonary resuscitation, not otherwise specified diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation cardiac arrest 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 paralytic ileus retention of urine, unspecified ventricular fibrillation family history of ischemic heart disease atherosclerosis of native arteries of the extremities, unspecified dysphagia, oropharyngeal phase blepharitis, unspecified other pancytopenia 

Answer: The patient is high likely exposed to