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: penicillins attending: chief complaint: chest pain, hypertensive urgency major surgical or invasive procedure: redo sternotomy and mitral valve repair with a 28-mm physio ii annuloplasty ring. history of present illness: mr. is a 61 year old gentleman, with a history of cad s/p mi and vsd repair in , and recently diagnosed 2-vessel disease and moderate-severe mitral regurgitation with plan for cabg and mvr on by dr. , who presented with fatigue, chest pain and elevated blood pressure. . the patient had recently been admitted at for pre-op work-up for his upcoming surgery. at that time cardiac cath showed om with 70% proximal lesion, lad with 40% mid lesion and rca with 100% occlusion, as well as lvef 50%. echo was notable for lvef 45-50%, moderate regional lv systolic dysfunction with basal inferior hypokinesis/akineis and hypokinesis/akinesis of the inferoseptal and inferolateral walls, as well as mitral posterior leaflet tethering with moderate to severe mitral regurgitation. . he had been feeling well until the morning of admission when he got up and felt "lousy." he reports that he felt tired with unclear thinking and went back to bed. he was awakened in the late morning by vna, who measured his blood pressure to be 200/85. the patient went out to run errands and felt tired after returning. he then began to experience brief tingling "sparkler" sensation in his chest, accompanied by lightheadedness, diffuse sweating and intermittent nausea. he had no visual changes, headaches, vomiting or abdominal pain. dr. np then called to encourage him to go to the hospital. at , he wasa given nitro paste and started on a nitro drip, with which his chest discomfort dissipated. he was also given lorzepam. he was then transferred to . on arrival to the ed, the patient had initial vital signs were 97.6 64 186/86 98% 4l nc. he was continued on a nitro drip. on initial evaluation by dr. , it was noted that the patient had increased creatinine, in the context of recently restarting lisinopril 10 mg daily. there was concern for renal artery stenosis. it was recommended that he wean down on his nitro drip and start imdur. on transfer, vital signs were 97.8 61 142/45 13 96% on 2l past medical history: coronary artery disease-s/p inf. mi with s/p vsd repair htn hyperlipidemia anxiety /bipolar disorder s/p vsd repair social history: lives with: cat (alone) occupation: writer, actor, retired cigarettes: smoked no yes last cigarette _8/7____ hx: other tobacco use: 2 ppd for 20 years, 1 ppd for the past 7 years etoh: quit 20 years ago family history: heart disease in grandmother's siblings, with mi's in late 50s/early 60s. grandmother with stroke at 63, deceased one day later on her 64th birthday. great-grandfather with mi at 75. physical exam: admission physical exam: 86 kg vs: 97.9 138/70 55 15 98%2l general: well-appearing man in nad, comfortable, appropriate. very pleasant and talkative. heent: ncat, perrla, eomi, sclerae anicteric, mmm, clear oropharynx. neck: supple, no thyromegaly, no jvp 2 cm above jugular notch, no carotid bruits. heart: rrr, nl s1-s2. two murmurs: ii/vi crescendo-descrensceno murmur loudest at rusb with radiation to llsb (no radiation to carotids); iii/vi blowing systolic murmur loudest at the apex with radiation to the axilla. lungs: ctab, no r/rh/wh, good air movement, resp unlabored. abdomen: soft/nt/nd, no masses or hsm, no rebound/guarding, no abdominal bruits. extremities: wwp, no c/c/e, decreased pulses in feet. 2+ radial and carotid pulses. skin: no rashes or lesions. lymph: no cervical lad. neuro: awake, a&ox3. cns ii-xii intact. strength equal and intact bilaterally, sensation equal and intact bilaterally. pertinent results: pertinent results: ekg on admission : q waves inferiorly and 0. elevation in ii and avf. lvh with repolarization changes. no change from prior. renal artery ultrasound : normal sized kidneys, without evidence of hydronephrosis or renal artery stenosis. pre-bypass: the left atrium is mildly dilated. mild spontaneous echo contrast is seen in the body of the left atrium. no spontaneous echo contrast is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild to moderate regional left ventricular systolic dysfunction with akinesis of the basal and mid inferoseptal walls. there is hypokinesis of the basal and mid inferior wall. overall left ventricular systolic function is mildly depressed (lvef= 40-45%). intrinsic lv function is likely further depressed given degree of mitral regurgitation. the remaining left ventricular segments contract normally. there is an echogenic density in the interventricular septum that may represent a prior vsd patch repair. right ventricular chamber size is normal. with moderate global free wall hypokinesis. tricuspid annular plane systolic excursion is depressed consistent with right ventricular systolic dysfunction. there are simple atheroma in the ascending aorta. there are complex (>4mm) atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. there is calcium on the left and non-coronoary cusps. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is restricted motion of the p3 segment of the posterior leaflet. an eccentric, posteriorly directed, wall-hugging jet of at least moderate to severe (3+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results at time of surgery. post-bypass: the patient is on milrinone and epinephrine infusions. there is a mitral annuloplasty ring in place. there is a jet of moderate (2+) mitral regurgitation originating from outside of the annuloplasty ring near the posteromedial commisure. there is no central mitral regurgitation. a peak gradient across the mitral valve is 8 mmhg with a mean gradient of 5 mmhg at a cardiac output of 5.2 l/min. left ventricular function is moderately depressed (lvef = 35-40%). right ventricular appears marginally improved. no aortic regurgitation is seen. the aorta is intact after removal of the aortic bypass cannula. 06:23am blood wbc-8.4 rbc-3.28* hgb-9.5* hct-26.5* mcv-81* mch-28.9 mchc-35.7* rdw-16.4* plt ct-121* 10:25pm blood wbc-7.4 rbc-4.62 hgb-13.3* hct-37.6* mcv-81* mch-28.9 mchc-35.5* rdw-16.9* plt ct-175 06:23am blood plt ct-121* 01:55am blood pt-13.7* ptt-27.7 inr(pt)-1.2* 10:25pm blood pt-12.9 ptt-26.8 inr(pt)-1.1 10:25pm blood plt ct-175 05:44am blood urean-31* creat-0.8 na-137 k-4.1 cl-101 10:25pm blood glucose-102* urean-21* creat-1.7* na-139 k-4.3 cl-100 hco3-31 angap-12 01:25pm blood glucose-92 urean-25* creat-1.3* na-139 k-4.1 cl-100 hco3-30 angap-13 06:55am blood glucose-93 urean-27* creat-1.0 na-139 k-4.0 cl-102 hco3-26 angap-15 01:25pm blood ck(cpk)-59 06:55am blood ck-mb-2 ctropnt-<0.01 01:25pm blood ck-mb-2 ctropnt-<0.01 10:25pm blood ctropnt-<0.01 05:44am blood mg-2.4 04:12am blood calcium-8.3* phos-2.1* mg-2.3 01:25pm blood calcium-8.7 phos-3.8 mg-2.3 cholest-143 01:25pm blood hdl-35 chol/hd-4.1 ldlmeas-73 brief hospital course: admitted from emergency department due to hypertension with blood pressure > 200 requiring intravenous vasodilators. his blood pressure improved with nitroglycerin drip and he was transitioned to oral agents. his home lisinopril was not resumed due to acute kidney injury with cr 1.7 on admission. it was trended and was back to 1.1 prior to surgery. he underwent rule out and enzymes were negative. on he was brought to the operating room for mitral valve and coronary artery bypass graft surgery. see operative report for further details however he had mitral valve repair but there was no coronary bypass due to marginal branch and his right coronary artery supplying an infarcted territory as per operative note. he was brought to the intensive care unit post operatively on milrinone, epinephrine, phenylephrine and propofol drips. on post operative day one he was weaned from sedation, awoke neurologically intact and was extubated without complications. additionally he was weaned off epinephrine and milirone was weaned down. nicardipine was added for hypertension management, and on post operative day two he was weaned off milirone. he continued to progress and oral medications were adjusted for blood pressure and he was weaned off nicardipine. he remained in the intensive care unit until post operative day three and then was transferred to the floor for the remainder of his care. physical therapy worked with him on strength and mobility. he continued to progress and was ready for transfer to rehab at in . medications on admission: 1. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po bid 2. trazodone 50 mg tablet sig: one (1) tablet po hs 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid 4. aspirin, buffered 325 mg tablet sig: one (1) tablet po daily 5. simvastatin 10 mg tablet sig: one (1) tablet po daily 6. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) sublingual prn (as needed) as needed for chest pain 7. lisinopril 10 mg tablet sig: one (1) tablet po daily 9. wellbutrin 250 mg po bid discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po bid (2 times a day). 4. bupropion hcl 100 mg tablet sig: 2.5 tablets po bid (2 times a day): 250 mg . 5. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 6. trazodone 50 mg tablet sig: one (1) tablet po at bedtime. disp:*7 tablet(s)* refills:*0* 7. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 8. lasix 40 mg tablet sig: one (1) tablet po once a day. 9. metoprolol succinate 25 mg tablet extended release 24 hr sig: three (3) tablet extended release 24 hr po daily (daily): 75 mg total daily . 10. acetaminophen 325 mg tablet sig: two (2) tablet po every four (4) hours as needed for fever or pain. 11. outpatient lab work please check potassium, magnesium, bun and creatinine on friday to evaluate electrolytes discharge disposition: extended care facility: at discharge diagnosis: mitral regurgitation s/p mitral valve repair acute on chronic systolic heart failure preoperative acute kidney injury coronary artery disease - blockages to infarcted areas not bypassed hypertension hyperlipidemia anxiety bipolar disorder ventricular septal defect repaired in discharge condition: alert and oriented x3 nonfocal ambulating with 1 assist incisional pain managed with tylenol as needed incisions: sternal - healing well, no erythema or drainage edema trace lower extremity discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 surgeon: dr. date/time: 1:15 cardiologist:dr. at 3:15pm please call to schedule appointments with your primary care dr in weeks **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 open heart valvuloplasty of mitral valve without replacement central venous catheter placement with guidance diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified other and unspecified hyperlipidemia anxiety state, unspecified old myocardial infarction acute on chronic systolic heart failure bipolar disorder, unspecified 

Answer: The patient is high likely exposed to