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: codeine / morphine / nsaids attending: chief complaint: chest discomfort major surgical or invasive procedure: - avr(23mm st. mechanical regent valve) and replacement of ascending aorta (28mm gelweave graft) history of present illness: 42 year old gentleman with chest discomfort described as pressure. he has also noted increased fatigue. work-up was significant for a dilated ascending aorta and moderate aortic regurgitation. past medical history: hypercholesterolemia history of alcohol and narcotic abuse s/p gastric bypass bilateral knee surgery bilateral shoulder surgery social history: unemployed. lives with parents. no current alcohol or tobacco. family history: noncontributory physical exam: 74 pulse 145/80 gen: a+ox3, nad, pleasant heent: op benign heart: rrr, nl s1-s2 lungs: clear abd: benign ext: warm, 2+ pulses, no edema pertinent results: chest (pa & lat) 10:24 am chest (pa & lat) reason: assess pneumoperitoneum medical condition: 42 year old man with aortic replacement s/p ct removal with pneumoperitoneum reason for this examination: assess pneumoperitoneum 2 view chest x-ray : comparison: . indication: pneumoperitoneum. the patient is status post median sternotomy and aortic valve replacement. again demonstrated is free intraperitoneal air, not significantly changed. there is stable widening of the cardiac and mediastinal contours. small bilateral pleural effusions and minor atelectatic changes at the left lung base are also without change. retrosternal air is identified on the lateral view, also present previously, and likely related to recent surgery. impression: 1) persistent free intraperitoneal air, not significantly changed since one day prior. 2) left basilar atelectasis and small bilateral pleural effusions sinus rhythm early repolarization normal ecg since previous tracing of , no significant change read by: , a. intervals axes rate pr qrs qt/qtc p qrs t 68 182 108 422/438.85 33 -4 15 05:40am blood wbc-12.0* rbc-3.49* hgb-10.6* hct-29.2* mcv-84 mch-30.3 mchc-36.2* rdw-13.0 plt ct-137* 05:40am blood glucose-93 urean-13 creat-0.9 na-138 k-4.0 cl-101 hco3-30 angap-11 brief hospital course: mr. was admitted to the on for elective surgical management of his aortic valve and ascending aorta disease. he was taken directly to the operating room where he underwent an aortic valve replacement utilizing a 23mm st. mechanical regent valve and replacement of the ascending aorta. postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. within twenty-four hours, mr. e neurologically intact and was extubated. aspirn, betablockade and coumadin were started. he was then transferred to the cardiac surgical step down unit for further recovery. he was gently diuresed towards his preoperative weight. the physical therapy service was consulted for assistance with his postoperative strength and mobility. he continued to make steady progress in his ambulation and was cleared by physical therapy after he climbed a flight of stairs without difficulty. he was anticoagulated with heparin and coumadin toward a target inr of 2.5-3.0. outpatient vna will draw pt/inr on and fax pt/inr results to dr. office at . office phone # /12/06. dr. office was contact and agreed to follow the inr and coumadin doses. on pod 5 mr. was at his preop weight with good exercise tolerance, no sob, or chest pain. his blood pressure was stable. his sternotomy was clean, dry, and intact without evidence of infection. he was discharged home on pod 5 with services in good condition, cardiac diet, sternal precautions, and instructed to follow up with his pcp and cardiologist in weeks. he will follow up with dr. in four weeks. medications on admission: none 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 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 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. disp:*40 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 7. coumadin 5 mg tablet sig: one (1) tablet po at bedtime for 3 days. disp:*3 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: hypercholesterolemia gastric bypass history of alcohol and narcotic abuse. s/p knee and shoulder surgery discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increase pain. 2) report any fever greater then 100.5. 3) report any weight gain of greater then 2 pounds in 24 hours, and 5 pounds in 1 week. 4) no lifting greater then 10 pounds in 10 weeks. 5) no driving for 1 month. p instructions: follow-up with dr. in 4 weeks. follow-up with dr. (cardiologist) in weeks. follow-up with dr. in 2 weeks. call all providers for appointment. procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels diagnoses: thoracic aneurysm without mention of rupture aortic valve disorders 

Answer: The patient is high likely exposed to