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: latex / shellfish derived attending: chief complaint: dyspnea major surgical or invasive procedure: aortic valve replacement (23mm st. mechanical), coronary artery bypass grafting times one (left internal mammary artery to left anterior descending artery) history of present illness: mr. is a 67 year-old male with known aortic stenosis/bicuspid aortic valve/coronary artery disease, now with increasing dyspnea. past medical history: 1. coronary artery disease one vessel disease status post catheterization on with an left anterior descending coronary artery stent. 2. atrial fibrillation status post dccv on the . this was unsuccessful and he was subsequently started on amiodarone. 3. hypercholesterolemia. 4. status post acetabular fracture. 5. seizure disorder 15 years ago. percutaneous coronary intervention in : 90% proxlad, 70% midlad, 95% d1, 60% ri, mid systolic and diastolic dysfunction. social history: social history: lives in with his wife. at home making signs for museums and galleries is significant for the absence of current . there is no history of alcohol abuse or ivdu/illicit drug use or tobacco use. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: pulse: 56 resp:18 o2 sat: 98 ra b/p right:100/61 left: height: 5'4" weight:180lbs general: skin: dry intact heent: perrla eomi neck: supple full rom kyphosis chest: lungs clear bilaterally heart: rrr irregular murmur iii/vi sem throughout precordium abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right: 1+ left:1+ dp right: 2+ left:2+ pt :2+ left:2+ radial right: 2+ left:2+ pertinent results: 04:24am blood wbc-9.6 rbc-3.05* hgb-9.2* hct-27.0* mcv-88 mch-30.1 mchc-34.1 rdw-15.6* plt ct-192 04:24am blood pt-19.9* ptt-52.3* inr(pt)-1.9* 07:00pm blood pt-16.9* ptt-35.8* inr(pt)-1.5* 04:24am blood glucose-104 urean-20 creat-1.0 na-142 k-3.4 cl-104 hco3-30 angap-11 echocardiography report , (complete) done at 12:25:07 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 67 m hgt (in): 65 bp (mm hg): 108/60 wgt (lb): 170 hr (bpm): 45 bsa (m2): 1.85 m2 indication: intra-op tee for avr, cabg icd-9 codes: 440.0, 424.1 test information date/time: at 12:25 interpret md: , 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 #: 2009aw03-: machine: echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.7 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.8 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.2 cm <= 5.6 cm left ventricle - ejection fraction: 55% >= 55% aorta - annulus: 2.3 cm <= 3.0 cm aorta - sinus level: *3.8 cm <= 3.6 cm aorta - sinotubular ridge: 2.9 cm <= 3.0 cm aorta - ascending: *3.9 cm <= 3.4 cm aorta - descending thoracic: 2.5 cm <= 2.5 cm aortic valve - peak velocity: *4.1 m/sec <= 2.0 m/sec aortic valve - peak gradient: *68 mm hg < 20 mm hg aortic valve - mean gradient: 45 mm hg aortic valve - lvot diam: 2.3 cm aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 findings pre-bypass exam revealed normal wall function and severely stenotic aortic valve. no pfo was recognized. left atrium: mild la enlargement. no spontaneous echo contrast is seen in the laa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: normal ra size. normal interatrial septum. no asd by 2d or color doppler. left ventricle: severe symmetric lvh. normal lv cavity size. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated aortic sinus. simple atheroma in aortic root. mildly dilated ascending aorta. mildly dilated descending aorta. aortic valve: bicuspid aortic valve. severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). moderate (2+) ar. mitral valve: mild mitral annular calcification. mild (1+) mr. tricuspid valve: physiologic tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. 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. the patient was under general anesthesia throughout the procedure. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. see conclusions for post-bypass data the post-bypass study was performed while the patient was receiving vasoactive infusions (see conclusions for listing of medications). post-bypass: conclusions pre-bypass: the left atrium is mildly dilated. no spontaneous echo contrast is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. there are simple atheroma in the aortic root. the ascending aorta is mildly dilated. the descending thoracic aorta is mildly dilated. the aortic valve is bicuspid. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). moderate (2+) aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine and is being av paced 1. a mechanical prosthesis is well positioned in the aortic position. annulus is stable, leaflets open well. washing jets are seen. no perivalvular leaks are noted. mean gradient is 4 mm of hg. 2. bi ventricular function is preserved. 3. aorta is intact post decannulation. 4. other findings are unchanged brief hospital course: mr. was admitted on for a cardiac catheterization, pre-operative work-up and intra-venous heparin. his surgery was post-poned for an elevated inr and then his inr was allowed to drift down without intervention. on he underwent an aortic valve replacement (23mm st. mechanical), coronary artery bypass grafting times one (lima to lad). please see the operative note for details. his bypass time was 133 minutes with a crossclamp x of 104 minutes he tolerated this procedure well and was transferred in critical but stable condition to the surgical intensive care unit. he remained hemodynamically stable in the immediate post-op period and on the morning of pod1 he was extubated. on post-operative day two he was transferred to the stepdown floor for continued recovery and post-op care. his tubes, lines and drains were removed according to cardiac surgery protocol. his activity was advanced with the assistance of physical therapy and on pod #6 he was discharged home with visiting nurses medications on admission: coumadin 2, asa 81, lopressor 75, lasix 40 , lipitor 80, amiodarone 200 discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(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. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours). disp:*1 mdi* refills:*2* 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 8. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*65 tablet(s)* refills:*1* 9. warfarin 1 mg tablet sig: one (1) tablet po daily (daily) as needed for avr mech : dr. to deose couamdin based on inr for mech avr. disp:*30 tablet(s)* refills:*1* 10. furosemide 40 mg tablet sig: one (1) tablet po three times a day for 7 days: 3 times daily for 7 days then twice daily on going. disp:*75 tablet(s)* refills:*1* 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 7 days: check with your cardiologist if you should continue this medication. disp:*14 tab sust.rel. particle/crystal(s)* refills:*1* 12. outpatient lab work check bun/creat, potassium and inr on . discharge disposition: home with service facility: discharge diagnosis: aortic stenosis s/p aortic valve replacement(mech), coronary artery disease s/p coronary artery bypass graft x1 , atrial fibrillation pmh: congestive heart failure(diastolic), hyperlipidemia, seizure disorder, rt hip fracture s/p repair, ptca-stent(lad), discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr (cardiac surgery) in 4 weeks (), please call for appointment. dr (pcp) in weeks (), please call for appointment. dr (cardiologist) in weeks, please call for appointment. wound check appointment 2 as instructed by nurse () inr to be drawn on with results sent to at the cardiology fax , phone . plan confirmed with ms. on . procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures diagnostic ultrasound of heart open and other replacement of aortic valve aortography diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified atrial fibrillation acute on chronic diastolic heart failure aortic valve disorders percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia epilepsy, unspecified, without mention of intractable epilepsy congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to