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: dyspnea, mitral regurgitation, atrial fibrillation major surgical or invasive procedure: mvr (27mm prosthesis) and maze. cardiac catheterization and iabp placement. history of present illness: 82 year old man with a 1 year history of mitral regurgitation/ partial flail mitral leaflet. he states that he has had chronic dyspnea on exertion, although over the past month or so it has become significantly pronounced associated with pnd/orthopnea. he recently went to see his primary physician who found him to be in atrial fibrillation and started coumadin. on he was admitted to campus for chf exacerbation. he ruled out for an mi. echo: mild la enlargement, moderately dilated ra, mild symmetric lvh with an ef 35-40%. moderately dilated rv cavity. trace ai, 4+ mr with a torn mitral chordae, mild mvp, 2+ tr. severe pulmonary hypertension noted. persantine ett: ventricular couplets noted at peak heart rate. the preliminary was reported as a fixed mild lateral defect as well as a fixed mild inferior defect- ef 48%. the patient states that he has felt somewhat better over the past two days. yesterday he was able to do light chores around the house. earlier in the week he was finding it enormously difficult to sleep due to severe orthopnea/pnd. he denies any significant history of chest discomfort or palpitations. in cath lab , rhc revealed ra 17, rv 80/17, pa 80/43 (55), pcwp 26, ci 1.4. lhc -->, lv 92/21. lmca mild disease, lad 40% distal lesion, lcx 40% after om1, lca mild luminal irregularities. summary: severe biventricular diastolic dysfxn with severe pulm htn. iabp placed and pt sent to ccu for diuresis and surgery evaluation. patient has no complaints. denies sob or cp. past medical history: mitral regurgitation/chf atrial fibrillation - diagnosed within the past month left cataract surgery prostate cancer s/p xrt colon cancer, s/p exploratory laparotomy, lysis of adhesions, right colectomy, s/p ileocolo-anastomosis. hx of c. diff colitis non-hodgkin's lymphoma (b-cell), s/p chemo in ? , currently in remission appendectomy cholecystectomy , - hernia repairs recovered alcoholic , -duodenal ulcer iron deficiency anemia cri (creatinine 1.3-1.7) social history: denies tobacco (quit 28 years ago). patient lives alone. he is divorced and has 7 children. recovered alcoholic. family history: non-contributory physical exam: pe: t 96.7, 97/68, 73 irreg irreg, 16, 97% on 4l gen - nad, a&ox3 heent - mmm neck - supple heart - irreg irreg ii/vi hsm lungs - clear anterolaterally abd - soft, nt/nd, nabs ext - iapb in place r groin, 2+ edema to just below knees, 1+ dp on r, 2+ dp on l, 2+ pt b/l pertinent results: 01:30pm wbc-9.0 rbc-4.53* hgb-14.4 hct-42.4 mcv-94 mch-31.8 mchc-34.0 rdw-14.1 01:30pm pt-16.6* ptt-38.0* inr(pt)-1.8 01:30pm alt(sgpt)-12 ast(sgot)-18 alk phos-58 amylase-74 tot bili-2.2* dir bili-0.6* indir bil-1.6 01:30pm glucose-147* urea n-28* creat-1.1 sodium-138 potassium-3.4 chloride-100 total co2-28 anion gap-13 05:10am blood wbc-12.1* rbc-3.50* hgb-11.0* hct-32.8* mcv-94 mch-31.3 mchc-33.4 rdw-14.4 plt ct-145* 05:35am blood pt-14.8* inr(pt)-1.5 06:00am blood glucose-80 urean-16 creat-1.0 na-139 k-4.5 cl-102 hco3-29 angap-13 03:21pm blood alt-10 ast-42* ld(ldh)-415* alkphos-44 amylase-80 totbili-2.3* cxr the tip of the balloon pump lies opposite the 7th vertebral body in the mid thoracic aorta. the tip of the swan-ganz catheter lies in the right main pulmonary artery. no gross failure is seen allowing for the supine position. no infiltrates are present. cxr cardiac, mediastinal, and hilar contours are stable, status post median sternotomy and mitral valve replacement. right ij swan-ganz catheter tip is in the main right pulmonary artery. there continues to be a small left pleural effusion as well as basilar atelectasis versus possible consolidation. compared to prior exam of , bilateral chest tubes and mediastinal tubes have been removed. there is no evidence of pneumothorax. osseous and soft tissue structures are stable. ekg atrial fibrillation with a moderate ventricular response. occasional ventricular premature contractions. intraventricular conduction defect of right bundle-branch block type. qtc interval prolongation. anterolateral st-t wave changes - cannot rule out myocardial ischemia. compared to the previous tracing of ventricular response is slower. anterolateral st-t wave changes persist. abdominal ultrasound 1. status post cholecystectomy, with normal appearing bile ducts. 2. small right pleural effusion. bilateral simple renal cysts. cardiac catheterization 1. selective coronary angiography demonstrated mild, nonobstructive coronary artery disease. lmca had mild disease. lad had a 40% stenosis in the distal vessel. lcx had a 40% lesion after om1. rca had mild luminal irregularities. 2. left ventriculography was not performed. 3. resting hemodynamics demonstrated severe pulmonary arterial hypertension (80/43 mmhg). filling pressures were markedly elevated (ra 17 mmhg, rvedp 17 mmhg, pcwp 26 mmhg with "v" waves to 40 mmhg). forward cardiac output was markedly diminished at 2.8 l/min (index 1.4 l/min/m2). there was no gradient across the aortic valve. 4. administration of nitroglycerin 200 mg iv resulted in a mild decrease in pa systolic pressure to 70 mmhg, with a concomitant decrease in the systemic systolic pressure to 85 mmhg. 5. in order to improve forward flow and allow tailored preoperative medical therapy, intraaortic balloon counterpulsation was initiated with an 8 french 40 cc iab pump inserted via the right femoral artery. with iabp at 1:1, pa systolic pressure decreased to 55-60 mmhg, and pcwp decreased to ~22 mmhg. brief hospital course: mr. was admitted to then medical center on for further management of his congestive heart failure. he underwent a cardiac catheterization which revealed mild coronary artery disease, severe biventricular dysfunction, severe pulmonary hypertension and severe mitral regurgitation. an intra-aortic balloon pump was placed for severe pulmonary hypertension. due to the severity of his disease, the cardiac surgical service was consulted and mr. was worked-up in the usual preoperative manner. a carotid duplex ultrasound was performed which showed no significant stenosis of the bilateral internal carotid arteries. vitamin k was given to reverse his inr from his coumadin. the hematology service was consulted for thrombocytopenia and found evidence of myelodysplasia likely secondary to chemotherapy. no contraindication to surgery was noted after discussion with his oncologist. on , mr. was taken to the operating room where he underwent a mitral valve replacement utilizing bioprosthesis and a maze procedure. postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. on postoperative day one, his intra-aortic balloon pump was weaned off and removed with complication. platelets were transfused for thrombocytopenia. on postoperative day two, mr. neurologically intact and was extubated. gentle diuresis was initiated. he continued in atrial fibrillation. heparin was started with transition to coumadin for anticoagulation. his drains and epicardial pacing wires were removed per protocol. on postoperative day 8, mr. was transferred to the cardiac surgical step down unit for further recovery. the physical therapy service was consulted for assistance with his postoperative strength and mobility. his heparin was discontinued as his inr became therapeutic. mr. continued to make steady progress and was discharged to health care center on postoperative day eleven. he will follow-up with dr. , his cardiologist and his primary care physician as an outpatient. medications on admission: coumadin 3 mg po qw, 2 mg po mtrfss, last dose furosemide 80 mg po qd aspirin 81 mg po qd metoprolol 12.5 mg po qd discharge medications: 1. captopril 25 mg tablet sig: one (1) tablet po tid (3 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 4. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 6. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. zolpidem tartrate 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temperature >38.0. 10. warfarin sodium 1 mg tablet sig: two (2) tablet po once (once): dose for inr between 2.0-2.5. monitor daily pt/inr. discharge disposition: extended care facility: of discharge diagnosis: mitral regurgitation atrial fibrillation discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these included redness, drainage or increased pain. 2) monitor vital signs. report any fever greater then 100.5. 3) report any weight gain of more then 2 pounds in 24 hours. 4) no lifting more then 10 pounds for 1 month. no driving for 1 month. 5) do not apply lotions, creams or powders to wounds. when wound is healed, use sunscreen while in the sun. 6) coumadin for atrial fibrillation and a tissue mitral valve prosthesis. goal inr 2.0-2.5. dr. ( will manage coumadin as an outpatient. please contact office to arrange appointment upon discharge from rehab. discharge dose will be 2mg daily. please monitor daily pt/inr and adjust coumadin dose accordingly. followup instructions: follow-up with dr. in 6 weeks. ( follow-up with your cardiologist dr. in 2 weeks. follow-up with your primary care physician . in weeks for routine postoperative follow-up and immediately after discharge from rehab for coumadin management. please call providers for appointment. procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters diagnostic ultrasound of heart excision or destruction of other lesion or tissue of heart, open approach implant of pulsation balloon open and other replacement of mitral valve with tissue graft transfusion of platelets injection or infusion of nesiritide diagnoses: mitral valve disorders personal history of malignant neoplasm of gastrointestinal tract, unspecified intestinal bypass or anastomosis status atrial fibrillation personal history of malignant neoplasm of prostate acute on chronic diastolic heart failure other chronic pulmonary heart diseases other malignant lymphomas, unspecified site, extranodal and solid organ sites cardiogenic shock personal history of irradiation, presenting hazards to health 

Answer: The patient is high likely exposed to