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: paregoric / heparin agents attending: chief complaint: dizziness w/without activity major surgical or invasive procedure: aortic valve replacement(23 st. epic), cabgx2 (lima-lad, svg-om) on with dr. history of present illness: 62 yo m found to have on routine pe with his pcp, new murmur. on further work up echo revealed as with 0.7cm'2. pt having symptoms of dizziness, fatigue, and sob for nearly 1 year. dr. consulted for avr. past medical history: s/p avr (#23mm st. epic porcine)/cabg x2(lima->lad/svg->om) c/w hit + as atn raynaud's syndrome lumbar stenosis nasal polyps ulnar nerve release l5-s1 fusion' l4-l5 fusion ' (l)knee surgery torn bicep tendon open appy social history: married with 5 children current 1ppd (20py hx) lives with wife drinks etoh daily family history: nc physical exam: a/o x 3 nad cta rrr abd beingn eschar on fingertips palp radial and ulanar pulses sternal incision min. serous drainage and lle mild erythema pertinent results: echocardiography report , portable tee (complete) done at 9:16:58 am final referring physician information , w. , status: inpatient dob: age (years): 62 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: s/p avr/cabg with poor hemodynamics in icu. icd-9 codes: 799.02, 440.0, v43.3 test information date/time: at 09:16 interpret md: , md test type: portable tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2008aw1-: machine: aw2 echocardiographic measurements results measurements normal range findings conclusions this was a directed, limited study to investigate this patient with poor hemodynamics in icu. the patient had just begun a dobutamine infusion. hr is sinus at 110. the rv is large and hypokinetic. tr is mild-moderate. the lv is dynamic and underfilled. there is no mr. aortic valve is well-seated with no leak and no ai. there is no pericardial collection. there is no laa contrast. there is no clot or dissection of the aorta. there is no clot seen in the pa. the tip of the sgc is in the proximal right pa. 05:30am blood wbc-8.5 rbc-3.09* hgb-10.5* hct-32.0* mcv-104* mch-33.9* mchc-32.7 rdw-14.6 plt ct-217 05:05pm blood neuts-75.4* lymphs-16.2* monos-6.4 eos-1.3 baso-0.7 06:35am blood urean-14 creat-0.9 k-4.3 06:15am blood mg-1.9 06:30am blood alt-340* ast-118* ld(ldh)-302* alkphos-176* totbili-2.2* 05:43am blood wbc-8.4 rbc-3.37* hgb-11.3* hct-34.9* mcv-104* mch-33.5* mchc-32.4 rdw-14.7 plt ct-260 12:30pm blood wbc-5.0# rbc-3.43* hgb-12.6* hct-35.9* mcv-105* mch-36.6*# mchc-35.1* rdw-13.6 plt ct-214 08:55am blood pt-36.0* ptt-49.4* inr(pt)-3.8* 12:30pm blood pt-12.8 ptt-29.8 inr(pt)-1.1 05:43am blood glucose-95 urean-14 creat-1.0 na-137 k-4.5 cl-105 hco3-24 angap-13 05:43am blood alt-154* ast-109* ld(ldh)-236 alkphos-185* amylase-136* totbili-0.8 03:02am blood alt-2815* ast-4685* ld(ldh)-3502* alkphos-68 amylase-23 totbili-1.6* , m 62 radiology report chest (pa & lat) study date of 9:57 am , fa6a sched chest (pa & lat) clip # reason: ? pneumothorax, assess sternum s/p avr and cabg medical condition: 62 year old man s/p avr and cabg reason for this examination: ? pneumothorax, assess sternum s/p avr and cabg final report chest pa and lateral reason for exam: 62-year-old man status post avr and cabg. assess sternum pneumothorax, status post avr and cabg. since , bilateral pleural effusion decreased. tiny residual left pleural effusion persists. there is no overload. lungs are otherwise clear. the cardiomediastinal silhouette and hilar contours are normal. there is no pneumothorax. wires of prior sternotomy are intact. right picc ends in the subclavian. right internal jugular catheter sheath was removed. old right rib fractures are unchanged. the study and the report were reviewed by the staff radiologist. dr. dr. approved: sat 1:08 pm imaging lab brief hospital course: mr. avr(#23mm st. epic supra porcine valve)/cabg x2 (lima->lad/svg->om). please refer to dr operative note for further details. xct:84min,cpb:107minutes. he was intubated, sedated, requiring epi and neo to optimize his bp and co. upon arrival to the cvicu, his svo2 dropped with associated hypotension and elevated pa pressures. cxr revealed a right upperlobe collapse. he was bronched at the bedside to assist reexpansion. during the postoperative night precedex was initiated due to mr. severe agitation and hemodynamic instability with waking. epi and neo were weaned to off with the initiation of dobutamine. folate, thiamine, and ativan were used to treat his current etoh abuse hx. he remained in the icu for 6 days postop to recover from hemodynamic instability, weaning from the ventilator, and shock liver with recovering lfts. all lines and drains were discontinued while in the cvicu. on pod#7 after picc line insertion for access was completed, mr. was doing well and transferred to the sdu for further telemetry monitoring and increased activity/ambulation with pt. mr. was noted to be thrombocytopenic and the hematology service was consulted. an initial hit assay was negative from . a pf4 antibody was obtained and was strongly positive. argatroban was started and all heparin products and aspirin were discontinued. coumadin was started when his platelets were greater then 100,000. argatroban was overlapped with coumadin until his inr had been therapeutic for three days. he did have some purpura and discomfort in his fingertips, wound care rn was consulted for reccommendations. ntg topical was started, placed on necrotic fingertips. some recovery noted and vascular was consulted.mr. continued to progress while waiting for his inr to become therapeutic. on pod# 20 he was ready for discharge to home with vna. his pcp, . has agreed to follow his inr and coumadin dosing. an appointment for follow up was scheduled for . as discussed with hematology, coumadin is to be continued for 3 months with an inr goal . a course of keflex was initiated for an erythematous left lower leg evh site,which is not draining, and approximately 1cm opening on the mid sternotomy incision, with minimal serous drainage. . per dr., discharge today with vna. all follow-up appointments were advised. medications on admission: ibuprofen 600(2) lisinopril 10(1) discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. atorvastatin 40 mg sig: one (1) po daily (daily). 3. pantoprazole 40 mg , delayed release (e.c.) sig: one (1) , delayed release (e.c.) po q24h (every 24 hours). 4. thiamine hcl 100 mg sig: one (1) po daily (daily). 5. multivitamin sig: one (1) po daily (daily). 6. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours). 7. folic acid 1 mg sig: one (1) po daily (daily). 8. ibuprofen 400 mg sig: one (1) po q6h (every 6 hours) as needed. 9. metoprolol tartrate 50 mg sig: 1.5 tablets po bid (2 times a day). disp:*90 (s)* refills:*0* 10. furosemide 20 mg sig: one (1) po daily (daily) for 7 days. disp:*7 (s)* refills:*0* 11. potassium chloride 10 meq sustained release sig: two (2) sustained release po once a day for 7 days. disp:*14 sustained release(s)* refills:*0* 12. warfarin 1 mg sig: md once daily at 4 pm: x 3 months, inr goal . disp:*90 (s)* refills:*2* 13. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 7 days. disp:*28 capsule(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: s/p avr/cabg x2 aortic stenosis hypertension lumbar stenosis raynaud's disease s/p lt knee surgery s/p l5 fusion pulmonary hypertension heparin induced thrombocytopenia discharge condition: good discharge instructions: no lifting more than 10 pounds for 10 weeks no baths, swimming shower daily no lotions, creams or powders to incisions take all medications as prescribed no driving weigh daily and report any weight gain greater than 3 pounds report any fever greater than 101.5 or wound drainage followup instructions: -followup with dr. in 4 weeks () -followup with dr. ***.appointment at 12:30 for inr draw/coumadin dosing. -followup with dr. in 2 weeks -follow-up with dr. (hematology)4-6 weeks (. -will need coumadin for 3 months, inr goal . procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization coronary arteriography using a single catheter (aorto)coronary bypass of one coronary artery arterial catheterization open and other replacement of aortic valve with tissue graft closed [endoscopic] biopsy of bronchus angiocardiography of right heart structures diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute and subacute necrosis of liver chronic airway obstruction, not elsewhere classified aortic valve disorders other chronic pulmonary heart diseases pulmonary collapse 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 anticoagulants causing adverse effects in therapeutic use raynaud's syndrome alcohol withdrawal other specified disorders of skin spinal stenosis, lumbar region, without neurogenic claudication 

Answer: The patient is high likely exposed to