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: bactrim / daypro attending: chief complaint: incidental finding of thoracic aortic anuerysm major surgical or invasive procedure: total aortic arch replacement, reimplantation of cephalic vessels history of present illness: incidental finding of ascending aortic aneurysm on ct scan obtained s/p fall. past medical history: familial thrombocytopenia hiatal hernia gerd htn osteoporosis r shoulder replacement colonic polyps removal cataract surgery social history: lives with husband. retired. denies tobacco use, rare etoh. family history: cousin died of anuerysm at age 65. mother with chf physical exam: 81yo in chair nad, hoarse neuro aa&ox3, nonfocal chest ctab resp unlab median sternotomy stable, c/d/i no d/c, rrr no m/r/g chest tubes and epicardial wires removed. abd s/nt/nd/bs+ ext warm with trace edema pertinent results: 06:10am blood wbc-9.8 rbc-4.55 hgb-13.2 hct-38.6 mcv-85 mch-29.0 mchc-34.2 rdw-14.9 plt ct-169 06:10am blood pt-23.4* ptt-24.8 inr(pt)-2.3* 07:00am blood glucose-93 urean-26* creat-0.7 na-143 k-3.9 cl-105 hco3-25 angap-17 radiology final report chest (portable ap) 10:31 am chest (portable ap) reason: assess for ptx or effusion medical condition: 81 year old woman with s/p replacement of asc aorta and arch and ct removal reason for this examination: assess for ptx or effusion portable chest comparison: . indication: chest tube removal. evaluate for pneumothorax. there has been interval slight decrease in size of a loculated left apical hydropneumothorax. small small-to-moderate left pleural effusion is probably unchanged allowing for positional differences. cardiac and mediastinal contours are stable. poorly defined right mid lung zone opacity and focal linear right basilar opacity are without change. there is a questionable small right pleural effusion. impression: slight decrease in size of loculated left apical hydropneumothorax. dr. approved: mon 2:17 pm cardiology report echo study date of patient/test information: indication: intra op tee for resection of ascending aortic aneurysm height: (in) 60 weight (lb): 130 bsa (m2): 1.56 m2 bp (mm hg): 167/56 hr (bpm): 57 status: inpatient date/time: at 11:31 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2006aw590-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. measurements: aorta - ascending: *5.3 cm (nl <= 3.4 cm) aortic valve - peak velocity: 1.2 m/sec (nl <= 2.0 m/sec) interpretation: findings: left atrium: normal la size. right atrium/interatrial septum: normal ra size. no asd by 2d or color doppler. left ventricle: normal lv wall thickness. suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. mild regional lv systolic dysfunction. mildly depressed lvef. no resting lvot gradient. lv wall motion: regional lv wall motion abnormalities include: mid inferior - hypo; right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated aortic root. markedly dilated ascending aorta. moderately dilated descending aorta aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets. no as. mild to moderate (+) ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: mild tr. 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. no tee related complications. the patient was under general anesthesia throughout the procedure. the patient appears to be in sinus rhythm. results were personally conclusions: pre bypass limited view of the heart from upper esophageal views. lv function assessed from transgastric views. the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. there is mild regional left ventricular systolic dysfunction. the inferior wall of the lv is mildly hypokinetic. overall left ventricular systolic function is mildly depressed. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated. the ascending aorta is markedly dilated the descending thoracic aorta is moderately dilated. there is a thrombus seen in the descending aorta at the level of the left subclavian take off. the aorta at this level measures 4.3 cm. there is a well formed sinotubular junction and it measures 2.8 cm. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the views of the mitral valve was very limited because the aortic aneurysm was distorting the anatomy. there is no pericardial effusion. post bypass lv function much the same. however rv function is moderately depressed globally. somewhat better with a bolus of milrinone and epinephrine. graft seen in the ascending aorta, arch and descending aorta. 1+ aortic insuffciency present at the end of the procedure. electronically signed by , md on 15:35. physician: brief hospital course: mrs. was admitted to the on for further management of her ascending aortic anuerysm. she was taken to the catheterization lab where she was found to have moderate lad disease. given the severity of her disease, the cardiac surgical service was consulted for surgical repair of her aorta. she was worked-up in the usual preoperative manner including an echocardiogram which revealed trace aortic insufficiency, 1+ mitral regurgitation, 2+ aortic insufficincy. on , mrs. was taken to the operating room. she underwent a total arch replacement with reimplatation of cephalic vessels. postoperatively she was taken to the cardiac surgical intensive care unit for monitoring. on postoperative day one, she awoke neurologically intact and was extubated. a bedside swallow evaluation was obtained for oral and pharyngeal dysphagia which was inconclusive. ent was consulted and determined that she had paresis of her left true vocal cord. beta blockade and aspirin were resumed. she was gently diuresed towards her preoperative weight. on pod 2 her pressors were weaned, chest tubes were removed. beta blockade and aspirin were resumed. she was gently diuresed towards her preoperative weight. on pod 3 the ep service was consulted regarding her remaining pacemaker dependent in heart block. the physical therapy service was consulted to assist with her postoperative strength and mobility. on pod 5 mrs. was reintubated with insertion of chest tubes for pleural effusions. on pod 6 she had a ppm implanted. she continued to have post operative atrial fibrillation for which anticoagulation was started. on pod her chest tubes were again removed, and a video swallow was performed that did show her left vocal cord paresis. her epicardial pacing wires were removed without incident. on pod 9 she had decreased urine output which was responsive to fluid boluses. on pod 13 her sternotomy incision was clean, dry, and intact without evidence of infection. she was discharged to an extended care facility on pod 13 with services in good condition, cardiac diet, sternal precautions, and instructed to follow up with her pcp and cardiologist in 2 weeks. she will follow up with dr. in two weeks. medications on admission: cozaar 50' hctz 25' atenolol 50' fosamax 70qweek 180 citracal mvi discharge medications: 1. potassium chloride 20 meq packet sig: one (1) packet po q12h (every 12 hours). disp:*60 packet(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. 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:*2* 4. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. disp:*60 tablet(s)* refills:*0* 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. disp:*qs ml(s)* refills:*0* 6. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). disp:*qs qs* refills:*2* 7. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). disp:*qs qs* refills:*2* 8. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 10. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 11. furosemide 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 12. warfarin 1 mg tablet sig: 1-2 tablets po daily (daily): dosage will vary based on inr. disp:*60 tablet(s)* refills:*2* 13. alprazolam 0.25 mg tablet sig: 1-2 tablets po qhs (once a day (at bedtime)) as needed. disp:*60 tablet(s)* refills:*0* 14. tramadol 50 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. disp:*90 tablet(s)* refills:*0* discharge disposition: extended care facility: nursing center - discharge diagnosis: ascending aortic anuerysm thrombocytonpenia-familial hiatal hernia gerd htn osteoporosis discharge condition: good discharge instructions: shower, wash incisions with mild soap and water and pat dry. no lotions, creams or powders to incisions. call with fever >101, redness or drainage from incision, or weight gain more than 2 pounds in one day or five pounds in one week. no lifting more than 10 pounds for 10 weeks. no driving until follow up with surgeon. followup instructions: dr. in two weeks, dr. in one week, dr. , ent in two weeks, ep device clinic phone: date/time: 11:00 procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle resection of vessel with replacement, thoracic vessels other repair of vessel diagnoses: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux unspecified pleural effusion unspecified essential hypertension thoracic aneurysm without mention of rupture cardiac complications, not elsewhere classified diaphragmatic hernia without mention of obstruction or gangrene atrioventricular block, complete osteoporosis, unspecified poisoning by tetracycline group poisoning by chloral hydrate group 

Answer: The patient is high likely exposed to