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: lasix / ciprofloxacin / optiray 300 / cefepime attending: chief complaint: transfer from osh for chest pain major surgical or invasive procedure: none history of present illness: 79 year old man with history of afib, cad s/p cabg x 2, thoracic aortic aneurysm repair x 2 who is transfered from osh for acute chest pain. he initially present to osh on for complains of cp associated with rapid afib. at osh he was ruled out for mi and had a negative vq scan and non-contrast ct to eval for pulmonary embolism. his thoracic aortic aneurysm was also noted to be stable on the ct. patient was rate controlled with iv diltiazem and given increased doses of bb. . on the morning of transfer, he noted acute onset of pounding chest pain that was sharp, located in the center of his chest. he denies radiation to his arm, jaw or back. was associated with some nausea but denies vomiting of diaphoresis. pain last for 10min to 1hr and was relieved with morphine. he is currently chest pain free. patient has shortness of breath at baseline which limits his exercise tolerance. denies abd pain or change in bowel movements. has a dry cough at baseline. also notes increased urinary frequency. he has known prostate enlargement and is followed by urology. past medical history: s/p repair of pseudoaneurysm from leaking graft from previous bentyl operation, coronary artery bypass graft times 3, saphenous vein grafts to left anterior descending artery, obtuse marginal, and posterior descending artery in s/p bentall w/ modification/mech st. /cabgx2 (') trach afib cad hyperlipidemia htn hypothyroidism social history: married, lives with wife, denies current tob use but does have remote history, no etoh use, denies ivda family history: extensive cad history, father with mi in 60s, brother with mi in 40s and mother with mi and cva physical exam: vitals: t 99.5, bp in rt 128/80 in lt 138/78, p 69, rr 24, 97% on 3l => 95% on 50% trach mask gen: mild distress, difficulty getting comfortable heent: perrla, eomi, op clear w/ mmm, ecchymosis under left eye, no tenderness to palpation. neck: jvd to ear, no lad, well healed trachiostomy cv: mechanical click, rrr no m/r/g lungs: diffuse crackles halfway up lung fields abd: +bs nt/nd soft ext: 2+ doralis pedis pulses, no peripheral edema pertinent results: ekg: atrial flutter with 4:1 block, no acute st changes . chest xray worsening bibasilar densities, may be related to pneumonia or chf . echo normal systolic function, mild septal wall abnormality, biatrial enlargement, mild aortic incompetence, moderate pulmonary hypertension. . labs from osh: glucose 103, bun 26, cr 1.6, na 137, k 5, cl 103, hco3 26, ca 9.3 ck 47, trop 0.02 wbc 7.3, hct 35.9, plt 101 inr 4.2 brief hospital course: 79 year old man with extensive cardiac and surgical history who is transfered from osh for chest pain . #aortic dissection with rupture- patient initially transfered from osh with new chest pain. he was ruled out for a pe before transfer. he was initially ruled out for an mi and mr imaging was obtained to eval for dissection. mri showed descending aortic dissection. surgery was consulted and recommended medical management with good heart rate and blood pressure control. while on the floor, he had tearing chest pain to his back. cta performed which revelaed an aortic dissection with rupture. he was transfered to the ccu and he required 2 units of prbc. ffp was given to reverse his inr. he was hemodynamically stable while in the unit. a labetalol drip was started to keep sbp from 90 to 100 and hr from 50-60. hr and bp were well controlled in initial 72 hours and hct was stable. patient did not require any more blood transfusions after the initial 2 units. he was eventually switched to a po regimen for hr and bp control. vascular surgery consulted, and the patient was not a candidate for surgery given the rupture was of the descending aorta. after he was stablized on oral meds, he was transfered to the floor. his blood pressure and heart rate were tightly controlled. per vascular surgery, he will need repeat imaging in the future. . #cad: known disease, s/p cabg x 2. he was initially ruled out for an mi. . #rhythm: in atrial fibrillation/flutter while in house. initially was difficult to control. digoxin was stopped and he was tried with amiodarone. amiodarone was stopped on transfer to the unit. his heart rate was controlled with metoprolol and diliazem. . #pump: normal systolic function on recent echo. throughout hospitalization he was at times noted to be volume overloaded. his home bumex was continued. . #anticoagulation - he is anticoagulated for his valve and afib. on transfer to the unit, he was initially reversed with ffp. after his hct was stable, he was bridged with heparin back to coumadin. patient's anticoagulation goal was decreased to 2.0-2.5 from 2.5 to 3.5. his anticoagulation should be monitored very closely given his comorbidities. . #renal failure - patient has chronic renal failure. acute renal failure noted in setting of contrast. returned to baseline before discharge. . #possible aspiration/tracheoesophogeal fistula - while in the ccu, there was a concern that the patient was aspirating whlie eating and a concern for a tracheoesophogeal fistula. there did not appear to be a communication on imaging studies. ent consulted and said that he may benefit from covering stoma while eating. he was maintained on a soft diet with thin liquids. he will need to swallow with his head turned over right shoulder and chin tucked to chest and alternate between bites of food & sips of thin liquid. also needs to swallow with right head turned + chin tuck. . #hypothryoid - continued synthroid . #hld - continued statin medications on admission: home meds: lopressor 75mg digoxin 0.125 every other day synthroid 75mcg daily bumex uroxatral every other day lovastatin 10mg daily coumadin 7.5mg 4 days, 5 mg 3 days multivitamin . meds on transfer: aspirin 81mg daily colchicine 0.6mg daily digoxin 0.125mg every other day diltiazem er 120mg daily colcae 100mg ibuprofen 400mg synthroid 75mcg daily metoprolol 50mg multivitamin nitropaste 1" q 6 hours omeprazole 20mg once daily simvastatin 5mg daily coumadin 5mg daily discharge medications: 1. lovastatin 10 mg tablet : one (1) tablet po once a day. 2. metoprolol tartrate 50 mg tablet : three (3) tablet po tid (3 times a day). disp:*270 tablet(s)* refills:*2* 3. levothyroxine 75 mcg tablet : one (1) tablet po daily (daily). 4. bumetanide 0.5 mg tablet : one (1) tablet po daily (daily). 5. uroxatral 10 mg tablet sustained release 24 hr : one (1) tablet sustained release 24 hr po every other day. 6. amlodipine 2.5 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. diltiazem hcl 60 mg tablet : one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 8. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 9. warfarin 2 mg tablet : one (1) tablet po daily16 (once daily at 16). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: health vna discharge diagnosis: ruptured aortic aneurysm atrial fibrillation coronary artery disease hypertension discharge condition: stable, blood press and heart rate well controlled. able to ambulate. discharge instructions: you were transfered to the hospital for further evaluation of chest pain. while in the hospital you had imaging studies which showed an aortic dissection. you also had rupture of this aortic dissection. you were followed in the icu where your blood pressure was tightly controlled. you were also seen by the surgeons who said that you were currently not a surgical candidate. you were medically managed with tight blood pressure and heart rate control. . we changed some of your medications while in the hospital. -we increased the dose of your lopressor, now at 150mg three times daily -we stopped your digoxin -we added amlodipine for better blood pressure control -we added diltiazem for better heart rate control -your coumadin dosage is now 2mg . either call your primary care physician or return to the emergency room if you have chest pain, shortenss of breath, dizziness, confusion, abdominal pain, or other symptoms of concern to you. followup instructions: please call dr. at to schedule a follow up appointment for monday to get your inr checked. . please call dr. at to schedule a follow up appointment in weeks. procedure: transfusion of packed cells transfusion of other serum diagnoses: acute kidney failure with lesion of tubular necrosis unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortocoronary bypass status atrial flutter chronic kidney disease, unspecified other and unspecified hyperlipidemia heart valve replaced by other means drug-induced delirium dissection of aorta, thoracic parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to