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: patient recorded as having no known allergies to drugs attending: chief complaint: fatigue/ dyspnia on exertion major surgical or invasive procedure: redo sternotomy/avr(#23 ce pericardial) history of present illness: 79yom who developed increasing sob and dyspnea on exertion in late . patient had known as an echo showed worsening as and 3+ mr. was referred to dr and surgery was scheduled. past medical history: htn elev. lipids gout cad s/p cabg x3 ; ptca /stent chronic renal insufficiency (baseline above 2.0) nephrolithiasis bph-outflow obstruction glomerulosclerosis social history: retired foreman lives alone with supervision quit smoking 40 years ago no etoh use family history: non-contrib. physical exam: admission: vs 98 83 151/78 20 98%ra gen: nad heent: perrl, anicteric, op benign, neck: supple, no jvd pulm: cta bilat cv rrr 2/6 sem abdm: soft, nt/nd/+bs ext: warm, trace bilat edema. rt well healed svg site. left-small varicosity discharge: gen: nad neuro: non focal exam cv: rrr, sternum stable, incision cdi pulm: cta bilat abdm: soft, nt/nd/+bs ext: warm +edema bilat pertinent results: 01:21pm glucose-124* na+-137 k+-3.2* 01:08pm urea n-38* creat-2.1* chloride-112* total co2-18* 01:08pm alt(sgpt)-14 ast(sgot)-40 alk phos-54 amylase-34 tot bili-0.4 01:08pm lipase-30 01:08pm wbc-13.3* rbc-3.21* hgb-10.0* hct-29.3* mcv-91 mch-31.1 mchc-34.2 rdw-15.6* 01:08pm plt count-148* 01:08pm pt-15.1* ptt-46.7* inr(pt)-1.3* 07:50am blood wbc-11.1* rbc-3.14* hgb-9.7* hct-30.0* mcv-95 mch-30.7 mchc-32.2 rdw-15.4 plt ct-260 07:50am blood plt ct-260 02:46am blood pt-13.8* ptt-35.8* inr(pt)-1.2* 07:50am blood glucose-180* urean-51* creat-2.1* na-152* k-4.5 cl-114* hco3-25 angap-18 12:58am blood alt-16 ast-112* alkphos-57 amylase-39 totbili-0.5 radiology preliminary report chest (pa & lat) 11:07 am chest (pa & lat) reason: eval for pleural effusion medical condition: 79 year old s/p avr reason for this examination: eval for pleural effusion pa & lateral views chest. reason for exam: s/p avr, assess pleural effusion. comparison is made with prior studies including . ___of the cardiac silhouette is due to mild cardiomegaly and mediastinal fat. there is a tiny right pleural effusion. blunting of the posterior left cp angle is longstanding due to mild elevation of the hemidiaphragm. there is no left pleural effusion. there are calcified pleural plaques posteriorly on the left. patient is post median sternotomy and avr. there is no pneumothorax or obvious chf. dr. radiology final report ct head w/o contrast 2:13 pm ct head w/o contrast reason: r/o cva medical condition: 79 year old man with not waking s/p avr reason for this examination: r/o cva contraindications for iv contrast: none. indication: 79-year-old man, not waking status post avr. comparison: . technique: non-contrast head ct. ct of the head without contrast: there is no intracranial mass lesion, hydrocephalus, shift of normally midline structures, major vascular territorial infarct, or intra- or extra-axial hemorrhage. confluent hypodensities within the periventricular white matter consistent with chronic microvascular ischemic changes. again noted, cavum septum pellucidum/vergae. prominence of the sulci and ventricles consistent with age-related cerebral atrophy. the visualized paranasal sinuses are unremarkable. the surrounding osseous and soft tissue structures are unremarkable. impression: no acute intracranial process. the study and the report were reviewed by the staff radiologist. dr. dr. echocardiography report , (complete) done at 12:21:52 pm final referring physician information , r. division of cardiothoracic , status: inpatient dob: age (years): 79 m hgt (in): 66 bp (mm hg): 130/60 wgt (lb): 180 hr (bpm): 72 bsa (m2): 1.91 m2 indication: post cabg with severe as and moderate mr 9 codes: 424.1, 424.0, v42.2 test information date/time: at 12:21 interpret 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 #: 2007aw01-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *6.0 cm <= 4.0 cm left ventricle - septal wall thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.4 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.5 cm <= 5.6 cm left ventricle - ejection fraction: 45% >= 55% aorta - sinus level: 3.2 cm <= 3.6 cm aorta - ascending: 3.2 cm <= 3.4 cm aortic valve - peak velocity: *5.2 m/sec <= 2.0 m/sec aortic valve - peak gradient: *100 mm hg < 20 mm hg aortic valve - mean gradient: 45 mm hg aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 findings left atrium: dilated la. no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. right atrium/interatrial septum: normal ra size. pfo is present. left-to-right shunt across the interatrial septum at rest. right ventricle: normal rv chamber size and free wall motion. aorta: focal calcifications in aortic root. normal ascending aorta diameter. focal calcifications in ascending aorta. normal aortic arch diameter. focal calcifications in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. severe as (aova <0.8cm2). mild to moderate (+) ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. mild mitral annular calcification. moderate (2+) mr. tricuspid valve: mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic 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. conclusions pre-bypass: the left atrium is dilated. 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. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is a central regurgitant flow with a vena contracta of 5mm, blunting of pulmonary venous flow both at rest and provocative maneuvers consistent with moderate (2+) mitral regurgitation is seen. the amitral annulus was 38mm at the long axis and 32 mm at the commisural views. the left ventricle is not dilated. these findings were conveyed to dr. there is no pericardial effusion. post_bypass: lvef 50% patient is on epinephrine 0.02mcg/kg/min to facilitate weaning from the cpb> thoracic aortic contour is intact. moderate mr persists. there is a bioprosthetic valve seen in the native aortic position, stable and functioning well with a residual mean gradient of 9mm of hg with no pathological perivalvular leaks. mild tr. electronically signed by , md, interpreting physician 12:59 brief hospital course: mr was a direct admission to the operating room where he had an redo sternotomy avr on . his bypass time was 104 minutes with a crossclamp of 75 minutes. please see or report for details. he tolerated the operation well and was transsferred to the icu in stable condition on epinephrine neosynephrine and propofol infusions. he did well in the immediate post-op period and on pod1 his sedation was stopped, however he was slow to awaken from anesthesia. he was also weaned from his vasoactive infusions. on pod2 he had a ct scan as he was still not fully awake, it showed no intracarnial abnormalities and finnally on pod3 he was more fully awake and extubated. he stayed in the icu to monitor his neuro status and for further diuresis. on pod6 he was transfered to the general floor for further post-op care/recovery and addition physical therapy. on pod8 it was decided he was stable and ready for discharge to rehabilitation at health care. medications on admission: allopurinol 300' asa 325' vytorin 10/40 qd xanax 1hs lasix 20/prn lopressor 12.5" norvasc 5' 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 daily (daily). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 5. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 6. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 7. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 8. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 9. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 10. insulin lispro 100 unit/ml solution sig: sliding scale subcutaneous ac and qhs as needed for fsbs>120. discharge disposition: extended care facility: health - discharge diagnosis: s/p redo sternotomy avr pmh: htn, cad s/p cabgx3, ^chol, cri(2.4), bph, gout, eye implants discharge condition: good discharge instructions: keep wounds clean and dry. ok to shower, no bathing or swimming. take all medication as prescribed. call for any fever, redness or drainage from wounds. followup instructions: dr in weeks dr in 4 weeks procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft injection or infusion of nesiritide diagnoses: anemia, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status chronic kidney disease, unspecified hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) mitral valve insufficiency and aortic valve stenosis personal history of urinary calculi hyperosmolality and/or hypernatremia urinary obstruction, not elsewhere classified 

Answer: The patient is high likely exposed to