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: morphine / bee venom (honey bee) / wasp venom attending: chief complaint: shortness of breath major surgical or invasive procedure: coronary artery bypass grafting times four (lima>lad, svg>om, svg>diag, svg>pda), mv repair (#28 ring) history of present illness: mr. is a 65 year old male with a past medical history significant for rheumatic fever, tobacco use and asthma who presented with shortness of breath which began on sun . he reported no associated chest pain. he initially thought it to be an asthma exacerbation but the following day presented to an outside hospital with persistent shortness of breath. he was given oxygen and ativan, with resolution of symptoms. he was found to have a troponin of 11. elevations. he was treated with lopressor, asa, heparin drip and cardiology was consulted for cardiac catherization. he was also noted to have diffuse infiltrates on chest radiograph with a leukocytosis of 13.4. he was treated with levaquin for presumed pneumonia. a cardiac catheterization today revealed three vessel coronary artery disease. he was given plavix. he was tranferred to for surgical evaluation and plavix washout. past medical history: asthma rheumatic fever with possible mitral stenosis tobacco use s/p t+a s/p shrapnel removal social history: mrl who lives with his wife. mr. is a retired fence builder. he has been smoking since age 12, 50 pack years, but recently cut down. he drinks 3 beers per day. family history: mother and father without premature coronary artery disease physical exam: general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ 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: 2+ left: 2+ pt : 1+ left: 1+ radial right: cath site left: 2+ carotid bruit right: no left: no pertinent results: echocardiography report , (complete) done at 3:52:26 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 65 m hgt (in): 71 bp (mm hg): 106/70 wgt (lb): 244 hr (bpm): 83 bsa (m2): 2.30 m2 indication: coronary artery disease. left ventricular function. mitral valve disease. icd-9 codes: 424.0, 424.2 test information date/time: at 15:52 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 #: 2012aw000-0:00 machine: u/s 6 echocardiographic measurements results measurements normal range left atrium - four chamber length: *6.4 cm <= 5.2 cm left ventricle - septal wall thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *5.7 cm <= 5.6 cm left ventricle - ejection fraction: 30% to 35% >= 55% left ventricle - stroke volume: 80 ml/beat left ventricle - cardiac output: 6.61 l/min left ventricle - cardiac index: 2.87 >= 2.0 l/min/m2 aorta - annulus: 2.3 cm <= 3.0 cm aorta - ascending: *3.8 cm <= 3.4 cm aortic valve - lvot vti: 15 aortic valve - lvot diam: 2.6 cm mitral valve - e wave: 0.9 m/sec mitral valve - a wave: 0.3 m/sec mitral valve - e/a ratio: 3.00 tr gradient (+ ra = pasp): *41 mm hg <= 25 mm hg findings left atrium: dilated la. all four pulmonary veins identified and enter the left atrium. right atrium/interatrial septum: normal ra size. no asd by 2d or color doppler. left ventricle: moderate-severe regional left ventricular systolic dysfunction. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. mildly dilated ascending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: no ms. eccentric mr jet. moderate to severe (3+) mr. tricuspid valve: mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. pericardium: no pericardial effusion. general comments: written informed consent was obtained from the patient. 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. the patient appears to be in sinus rhythm. patient. conclusions the left atrium is dilated. no atrial septal defect is seen by 2d or color doppler. there is moderate to severe regional left ventricular systolic dysfunction with apical akinesis, severe hypokinesis in the inferolateral, inferior, and inferoseptal walls. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. an eccentric, posteriorly directed jet of moderate to severe (3+) mitral regurgitation is seen. there is no pericardial effusion. post bypass the patient is s/p cabgx3 with mitral annuloplasty ring. the patient is on a norepinephrine drip at 0.2 mcg/kg/min ,milrinone drip at 0.125 mcg/kg/min the cardiac index is 3.3 there is a well seated mitral annuloplasty ring with no paravalvular leaks present.there is mild valvular mitral regurgitation present. the mean gradient across the mitral valve is 9 mmhg with a peak gradient of 29 mmhg across the mitral valve the ejection fraction is 35% electronically signed by , md, interpreting physician 06:20 05:05am blood wbc-11.2* rbc-2.92* hgb-9.6* hct-28.1* mcv-96 mch-32.8* mchc-34.1 rdw-13.7 plt ct-163 02:20am blood pt-11.8 ptt-37.3* inr(pt)-1.1 05:05am blood glucose-109* urean-11 creat-0.7 na-127* k-3.7 cl-90* hco3-29 angap-12 brief hospital course: the patient was brought to the operating room on where the patient underwent a coronary artery bypass grafting times four (lima to lad, svg>om, svg>diag, svg>pda), mitral valve repair. please see the operative note for details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod four the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to home in good condition with appropriate follow up instructions. medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. acetaminophen 325-650 mg po q6h:prn pain/fever 2. aspirin 81 mg po daily 3. docusate sodium 100 mg po bid 4. heparin iv no initial bolus initial infusion rate: 1500 units/hr check ptt q 6 hours 5. lisinopril 2.5 mg po daily 6. metoprolol tartrate 25 mg po bid 7. simvastatin 10 mg po daily 8. albuterol-ipratropium 2 puff ih q6h:prn wheezing discharge medications: 1. aspirin ec 81 mg po daily 2. metoprolol tartrate 25 mg po bid rx *metoprolol tartrate 25 mg one tablet(s) by mouth two times daily disp #*60 tablet refills:*2 3. simvastatin 10 mg po daily rx *simvastatin 10 mg one tablet(s) by mouth daily disp #*30 tablet refills:*2 4. docusate sodium 100 mg po bid:prn constipation rx *colace 100 mg 1 capsule(s) by mouth two times daily disp #*30 capsule refills:*2 5. furosemide 40 mg po daily duration: 10 days rx *furosemide 40 mg 1 tablet(s) by mouth daily disp #*10 tablet refills:*2 6. potassium chloride 20 meq po daily duration: 10 days rx *klor-con 20 meq one packet by mouth daily disp #*10 packet refills:*2 7. oxycodone-acetaminophen (5mg-325mg) tab po q4h:prn pain rx *percocet 5 mg-325 mg tablet(s) by mouth every four hours disp #*40 tablet refills:*0 8. acetaminophen 325-650 mg po q6h:prn pain/fever discharge disposition: home with service facility: discharge diagnosis: coronary artery disease discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage 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 and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments: wound check at cardiac surgery office at 10:00am surgeon dr. at 1:45pm cardiologist dr. at 12:00pm please call to schedule the following: primary care in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** md procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery open heart valvuloplasty of mitral valve without replacement diagnoses: thrombocytopenia, unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery tobacco use disorder acute posthemorrhagic anemia hyposmolality and/or hyponatremia asthma, unspecified type, unspecified hypotension, unspecified obesity, unspecified hypovolemia rheumatic mitral insufficiency physical restraints status 

Answer: The patient is high likely exposed to