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: shortness of breath major surgical or invasive procedure: redo-sternotomy, aortic valve replacement w/ 21mm ce perimount pericardial tissue valve history of present illness: 76 y/o male with h/o cabg in and aortic stenosis c/o increased shortness of breath along with fatigue and chest pain. most recent echo revealed severe aortic stenosis. past medical history: aortic stenosi, coronary artery disease s/p coronary artery bypass graft , hypertension, hyperlipidemia, depression s/p ect therapy, benign prostatic hypertrophy, sleep apnea, venous insuff. w/ superficial venous thrombosis, s/p nasal polypectomy, chronic pleural effusion s/p vats and pleurodesis social history: non- smoker. no exposure retired lawyer, lives w/ wife family history: non-contributory physical exam: vs: 76 12 128/80 5'" 195# gen: wdwn in nad skin: warm, dry with well healed sternotomy, left radial and right evh incisions, multiple nevi and keratosis heent: nc/at, eomi, perrl, op benign neck: supple, from, -jvd chest: ctab, diminished left base heart: rrr, 3/6 systolic murmur abd: soft, nt/nd +bs ext: warm, well-perfused, 1+ lle edema, lle grossly varicosed neuro: a&o x 3, mae, non-focal discharge vitals 99.2, 118/70 sr 80, 20 rr, ra sat 98% wt 101.8kg skin: warm dry, rash on back red no draining improving chest cta bilat card rrr no murmur/rub/gallop abd soft, nt, nd +bs + flatus bm ext warm pulses palpable +1 edema le neuro a/0 x3 nonfocal mae sternal inc healing no drainage/erythema sternum stable pertinent results: 06:30am blood wbc-6.1 rbc-3.54* hgb-11.0* hct-32.8* mcv-93 mch-31.1 mchc-33.6 rdw-14.8 plt ct-185 01:21pm blood wbc-15.3*# rbc-3.20*# hgb-10.0*# hct-29.7*# mcv-93 mch-31.2 mchc-33.6 rdw-14.9 plt ct-89*# 06:30am blood plt ct-185 03:08am blood pt-13.4* ptt-28.2 inr(pt)-1.2* 01:21pm blood plt smr-low plt ct-89*# 01:21pm blood pt-16.6* ptt-56.8* inr(pt)-1.5* 06:30am blood glucose-126* urean-23* creat-1.0 na-142 k-4.1 cl-104 hco3-32 angap-10 02:43pm blood glucose-200* urean-20 creat-0.9 na-142 k-3.6 cl-112* hco3-21* angap-13 04:12am blood alt-16 ast-58* ld(ldh)-518* alkphos-64 amylase-41 totbili-0.6 04:12am blood lipase-19 03:08am blood calcium-8.4 phos-3.2 mg-2.5 radiology final report chest (pa & lat) 8:38 am chest (pa & lat) reason: evaluate effusion medical condition: 76 year old man s/p avr reason for this examination: evaluate effusion reason for examination: follow up of patient after aortic valve replacement. heart size is mildly enlarged but unchanged. mediastinal contours are unremarkable. no pneumothorax is identified. there is no evidence of congestive heart failure. there is unchanged loculated left pleural effusion, elevated left hemidiaphragm and left lower lobe opacity which may represent atelectasis. the study and the report were reviewed by the staff radiologist. dr. dr. approved: tue 10:57 pm radiology final report portable abdomen 10:20 am portable abdomen reason: eval obstruction medical condition: 76 year old man s/p redo sternotomy/ avr with abd pain reason for this examination: eval obstruction portable abdomen single view, at 10:24 a.m. history: redo sternotomy and avr, presenting with abdominal pain. comparison: no prior radiographs. findings: single supine view demonstrates gas-filled loops of nondilated small bowel throughout the abdomen. there is scattered colonic air and stool as well. the rectum is not well visualized on the submitted view. there is mild gaseous distention of the stomach. there is suggestion of a left pleural effusion. preperitoneal fat stripes are not well defined and there is mild central clumping of the bowel loops. these may be seen in the setting of ascites. impression: suggestion of possible ascites. no frankly dilated loops of small bowel noted, although there is diffuse gaseous distention. this may be seen in the setting of ileus. continued surveillance as indicated is recommended. no definitive radiographic evidence of obstruction noted. dr. approved: sun 1:13 pm pathology examination name birthdate age sex pathology # , 76 male report to: dr. . gross description by: dr. . samedi/mtd specimen submitted: aortic valve tissue. procedure date tissue received report date diagnosed by dr. . /mrr?????? previous biopsies: rt. nasal mass. left parietal pleural biopsy, left parietal pleura skin rt upper arm. r. arm skin. (and more) diagnosis: aortic valve tissue: aortic valve with degenerative changes and calcification. clinical: aortic valve stenosis, aortic valve replacement, redo sternotomy. gross: the specimen is received fresh labeled with the patient's name, " ", the medical record number and "aortic valve tissue". it consists of a fragment of yellow-tan and calcified tissue measuring 3.4 x 2.5 x 1.1 cm in aggregate. the specimen is represented in cassette a, and also submitted for decalcification. cardiology report echo study date of patient/test information: indication: intraop redo sternotomy avr. evaluate aorta, valves, biventricular function height: (in) 71 weight (lb): 195 bsa (m2): 2.09 m2 bp (mm hg): 129/69 hr (bpm): 58 status: inpatient date/time: at 09:29 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw1-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. r. measurements: left atrium - long axis dimension: *5.6 cm (nl <= 4.0 cm) left atrium - four chamber length: *6.1 cm (nl <= 5.2 cm) right atrium - four chamber length: *6.0 cm (nl <= 5.0 cm) left ventricle - inferolateral thickness: *1.8 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 3.4 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 1.8 cm left ventricle - fractional shortening: 0.47 (nl >= 0.29) left ventricle - ejection fraction: >= 45% (nl >=55%) aorta - valve level: 2.8 cm (nl <= 3.6 cm) aorta - ascending: 2.4 cm (nl <= 3.4 cm) aorta - arch: 2.1 cm (nl <= 3.0 cm) aortic valve - peak velocity: *4.1 m/sec (nl <= 2.0 m/sec) aortic valve - peak gradient: 67 mm hg aortic valve - mean gradient: 44 mm hg aortic valve - lvot peak vel: 0.80 m/sec aortic valve - lvot vti: 23 aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *0.6 cm2 (nl >= 3.0 cm2) mitral valve - peak velocity: 1.2 m/sec mitral valve - mean gradient: 2 mm hg mitral valve - pressure half time: 90 ms mitral valve - mva (p t): 2.4 cm2 mitral valve - e wave: 1.2 m/sec interpretation: findings: left atrium: moderate la enlargement. right atrium/interatrial septum: moderately dilated ra. left ventricle: severe symmetric lvh. mildly depressed lvef. lv wall motion: regional lv wall motion abnormalities include: basal inferior - hypo; mid inferior - hypo; right ventricle: dilated rv cavity. mild global rv free wall hypokinesis. aorta: complex (>4mm) atheroma in the aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. severe as (aova <0.8cm2). trace ar. eccentric ar jet. mitral valve: moderately thickened mitral valve leaflets. moderate mitral annular calcification. minimally increased gradient consistent with trivial ms. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. no 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. no tee related complications. 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). conclusions: pre-bypass: the left atrium is moderately dilated. the right atrium is moderately dilated. there is severe symmetric left ventricular hypertrophy. overall left ventricular systolic function is mildly depressed. the right ventricular cavity is dilated. there is mild global right ventricular free wall hypokinesis. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). trace aortic regurgitation is seen. the aortic regurgitation jet is eccentric. the mitral valve leaflets are moderately thickened. there is a minimally increased gradient consistent with trivial mitral stenosis. 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 norepi, epi, vasopressin, milrinone. the patient was av paced . a well-seated bioprosthetic valve is seen in the aortic position with normal leaflet motion and gradients (mean gradient = 20 mmhg, peak 22 mmhg). no aortic regurgitation is seen. rv is now moderately hypokinetic. lv function is slightly improved on inontropes with unchanged wall motion. aortic contours are intact. remaining exam is unchanged. all findings discussed with surgeons at the time of the exam. electronically signed by , md on 18:51. physician: brief hospital course: mr. was a same day admit after undergoing all pre-operative work-up as an outpatient. on day of admission he was brought to the operating room where he underwent a redo-sternotomy and aortic valve replacement. please see operative report for surgical details. following surgery he was transferred to the csru for invasive monitoring in stable condition. within 24 hours he was weaned from sedation, awoke neurologically intact and extubated. over the next couple of days his inotropes were weaned and he was started on beta blockers and diuretics. he was gently diuresed towards he pre-op weight. on post-op day two his chest tubes were removed. on post-op day three he had some abd. pain but abd. x-ray was negative for obstruction. on post-op day four he was transferred to the telemetry floor and began working with physical therapy for strength and mobility. he continued to make improvements without complications and was discharged home with vna services and the appropriate follow-up appointments on post-op day five. medications on admission: simvastatin 40mg , 60mg , digoxin 0.125mg qd, folic acid 1mg qd, lopressor 50mg , uroxatral 10mg qd, detral la 4mg qd, ddavp 0.1mg qd, miralax 17g qd, aspirin 81mg qd, mvi discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*1* 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 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. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 5. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*1* 6. uroxatral 10 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (). disp:*30 tablet sustained release 24 hr(s)* refills:*1* 7. miralax 17 g (100%) powder in packet sig: one (1) po twice a day as needed for constipation. disp:*30 * refills:*1* 8. desmopressin 0.1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 10. tolterodine 4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily (daily). disp:*30 capsule, sust. release 24 hr(s)* refills:*1* 11. furosemide 20 mg tablet sig: two (2) tablet po q12h (every 12 hours) for 5 days. disp:*10 tablet(s)* refills:*0* 12. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours) for 5 days. disp:*20 capsule, sustained release(s)* refills:*0* 13. 60 mg tablet sig: one (1) tablet po twice a day. 14. senna 187 mg tablet sig: one (1) tablet po at bedtime. 15. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): decrease to 400mg once a day for 7 days then decrease to 200mg daily . 16. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical tid (3 times a day). 17. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. discharge disposition: extended care facility: tba discharge diagnosis: aortic stenosis s/p redo-sternotomy, aortic valve replacement pmh: coronary artery disease s/p coronary artery bypass graft , hypertension, hyperlipidemia, depression s/p ect therapy, benign prostatic hypertrophy, sleep apnea, venous insuff., s/p nasal polypectomy, chronic pleural effusion s/p vats and pleurodesis discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. please shower and wash incisions daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month. 7) call with any questions or concerns . followup instructions: dr. in 4 weeks dr. after discharge from rehab dr. in weeks please call to schedule all appointments procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: congestive heart failure, unspecified unspecified essential hypertension coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status aortic valve disorders 

Answer: The patient is high likely exposed to