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: no known allergies / adverse drug reactions attending: chief complaint: shortness of breath major surgical or invasive procedure: 1. redo sternotomy. 2. attempted repair of mitral regurgitation. 3. mitral valve replacement with a 31-mm st. epic tissue valve, model #e100-31m- 00. history of present illness: 49 yo male with endocardial cushion defect, s/p asd closure and cleft mv repair in . has developed severe recurrent mr. issues including depression,continuing etoh and tobacco abuse, but has been compliant with medical appts. recent echo also shows new pulmonary hypertension and rv/lv dilatation.referred for surgery. the patient completed an alcohol detox program yesterday and was admitted for pre-op cath today. cath did not reveal signivicant coronary disease. he will be admitted for redo sternotomy and mvr tomorrow with dr. . past medical history: rul lung cancer (,chemo,xrt) mitral regurgitation pulmonary hypertension etoh abuse depression (prior suicide attempt) social history: homeless, currently staying with his former employer occupation:unemployed tobacco:current ppd etoh:6-12 beers/day, occ. vodka, detox program completed as above family history: mother and sister with cva physical exam: pulse: 80 resp: 16 o2 sat: 98% b/p right: 123/79 left: height: 5'9" weight:155# general: nad, appears stated age skin: dry intact heent: perrla eomi anicteric sclera,op unremarkable neck: supple full rom no jvd chest: lungs clear bilaterally well-healed sternotomy and right thoracotomy incisions heart: rrr irregular murmur- radiates to carotids abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema-none varicosities: none neuro: grossly intact;mae strengths; nonfocal exam pulses: femoral right: 2+ left:2+ dp right: 2+ left:2+ pt : 2+ left:2+ radial right: 2+ left:2+ carotid bruit: murmur radiates to both carotids pertinent results: admission labs: 08:07am pt-10.8 ptt-22.7 inr(pt)-0.9 08:07am plt count-137*# 08:07am wbc-5.0 rbc-4.28* hgb-15.0 hct-42.2 mcv-99* mch-35.0* mchc-35.5* rdw-13.4 08:07am glucose-91 urea n-16 creat-1.0 sodium-141 potassium-4.0 chloride-103 total co2-29 anion gap-13 10:00am %hba1c-4.9 eag-94 10:00am albumin-4.0 cholest-119 10:00am alt(sgpt)-40 ast(sgot)-41* alk phos-49 amylase-55 tot bili-0.3 04:35pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg discharge labs: 07:05am blood wbc-5.7 rbc-2.50* hgb-8.3* hct-23.6* mcv-94 mch-33.3* mchc-35.3* rdw-15.9* plt ct-106* 07:05am blood plt ct-106* 06:11am blood pt-12.5 ptt-28.0 inr(pt)-1.0 07:05am blood glucose-97 urean-10 creat-1.0 na-135 k-3.6 cl-101 hco3-25 angap-13 radiology report chest (portable ap) study date of 9:04 am medical condition: 50 year old man with s/p mvr and tv repair final report one view. comparison with the previous study done . a right chest tube has been removed. there is increased streaky density in the right lung likely representing subsegmental atelectasis and interval increase in a re-distribution of a small right effusion. there is streaky density at the left base most consistent with subsegmental atelectasis. mediastinal structures are unchanged. an endotracheal tube, nasogastric tube, and swan-ganz line have been withdrawn. impression: increased streaky density on the right likely representing subsegmental atelectasis. interval increase in or re-distribution of small right effusion. echocardiography report echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: 0.8 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: *6.1 cm <= 5.6 cm left ventricle - systolic dimension: 4.4 cm left ventricle - fractional shortening: *0.28 >= 0.29 left ventricle - ejection fraction: 55% >= 55% left ventricle - stroke volume: 35 ml/beat aorta - annulus: 2.2 cm <= 3.0 cm aorta - sinus level: 3.2 cm <= 3.6 cm aorta - sinotubular ridge: 2.4 cm <= 3.0 cm aorta - ascending: 3.1 cm <= 3.4 cm aorta - arch: 2.5 cm <= 3.0 cm aorta - descending thoracic: 1.9 cm <= 2.5 cm aortic valve - peak velocity: 0.9 m/sec <= 2.0 m/sec aortic valve - lvot vti: 10 aortic valve - lvot diam: 2.1 cm aortic valve - valve area: *2.6 cm2 >= 3.0 cm2 mitral valve - mva (p t): 3.5 cm2 findings left atrium: no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: normal lv wall thickness. mildly dilated lv cavity. overall normal lvef (>55%). right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. no as. no ar. mitral valve: moderately thickened mitral valve leaflets. no ms. eccentric mr jet. severe (4+) mr. tricuspid valve: no ts. physiologic tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. physiologic (normal) pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. 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 pre cpb: 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. no atrial septal defect is seen by 2d or color doppler, echodense material seen at likely site of prior asd repair. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is mildly dilated with normal free wall contractility. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. two eccentric jets of severe (4+) mitral regurgitation are seen. the posteriorly directed jet originates from a prolapsing a2 leaflet and exhibits coanda effect. the anteriorly directed jet originates from the base of the anterior leaflet and is suspicious for a perforated leaflet (or failure of prior repair) dr. was notified in person of the results. post cpb: the cardiac output is 4l/min on a phenylephrine infusion and a-paced. there is a well seated bioprosthetic valve in the mitral position with a centrally located trace mr jet; the mean gradient across this valve is 3mmhg. there is no aortic insufficiency. the rv systolic function is preserved. the lvef is 45-50%. the visible contours of the thoracic aorta are intact. brief hospital course: the patient was brought to the operating room on where the patient underwent a redo sternotomy and attempted repair of mitral regurgitation. please see operative report for details, in summary the patient had: 1. redo sternotomy. 2. attempted repair of mitral regurgitation. 3. mitral valve replacement with a 31-mm st. epic tissue valve, model #e100-31m- 00. his bypass time was 119 minutes with a crossclamp of 102 minutes. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring in stable condition. pod 1 found the patient extubated, alert and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker therapy was held secondary to post-operative juctional rhythm which recovered to a normal sinus rhythm. the patient was transferred to the telemetry floor on pod3 for further recovery. chest tubes and pacing wires were discontinued according to cardiac surgery protocol. the patient was evaluated by the physical therapy service for assistance with strength and mobility. at the time of discharge on pod #6 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to a friend's home with visiting nurses. he is to follow up with dr in 3 weeks. medications on admission: lisinopril 5 mg daily thiamine 100 mg daily folate 1 mg daily mvi daily seroquel 100mg prn hs insomnia discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily) for 1 months. disp:*30 tablet(s)* refills:*0* 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. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily) for 1 months. disp:*30 tablet(s)* refills:*0* 7. multivitamin tablet sig: one (1) tablet po daily (daily) for 1 months. disp:*30 tablet(s)* refills:*0* 8. magnesium oxide 400 mg tablet sig: one (1) tablet po daily (daily) for 1 months. disp:*30 tablet(s)* refills:*0* 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 10. quetiapine 50 mg tablet sig: one (1) tablet po qhs/prn as needed for insomnia. disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: s/p mitral valve replacement(tissue) pmh: rul lung cancer (,chemo,xrt) mitral regurgitation pulmonary hypertension etoh abuse depression (prior suicide attempt) discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with percocet sternal incision - healing well, no erythema or drainage edema-none 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** followup instructions: you are scheduled for the following appointments: , md phone: date/time: 9:00 , md phone: date/time: 1:45 , md phone: date/time: 11:30 , md phone: date/time: 11:30 please call to schedule appointment pcp: for 4-5 weeks from surgery **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization angiocardiography of left heart structures other and unspecified coronary arteriography open and other replacement of mitral valve with tissue graft diagnoses: mitral valve disorders personal history of malignant neoplasm of bronchus and lung other chronic pulmonary heart diseases depressive disorder, not elsewhere classified alcohol abuse, continuous personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health lack of housing postprocedural fever 

Answer: The patient is high likely exposed to