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: ascending aortic aneurysm major surgical or invasive procedure: bentall procedure (#29 st. mechanical) history of present illness: this 49 year old male underwent an echocardiogram that revealed an ascending aortic aneurysm of 6.4cm and aortic regurgitation. he underwent cardiac catheterization for evaluation, that revealed no coronary artery disease. he is now transferred for surgical evaluation past medical history: hypertension dyslipidemia social history: lives with: parents occupation: not currently working tobacco: ppd for 30 years etoh: cans three times a week family history: family history: non contibutory physical exam: admission: pulse: 73 resp: 18 o2 sat: 96 ra b/p right: 112/75 left: 123/77 general: nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally expiratory wheeze left upper heart: rrr irregular murmur no abdomen: softnon-distendednon-tenderbowel sounds + extremities: warm , well-perfused edema none varicosities: none neuro: alert and oriented x3 non focal pulses: femoral right: +2 left: +2 dp right: +2 left: +2 pt : +2 left: +2 radial right: +2 left: +2 carotid bruit right: no bruit left: no bruit pertinent results: intra-op echo 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. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic root is markedly dilated at the sinus level. the ascending aorta is markedly dilated upto the mid level. the aortic arch is mildly dilated. the descending thoracic aorta is mildly dilated. there are three aortic valve leaflets. midsystolic closure of the aortic valve leaflets is not seen moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results on mr.. post-bypass: preserved biventricular systolic function.lvef 55%.the aortic valve and the conduit are in place and functioning well. the residual peak and mean gradients are 8 and 4mm of hg respectively.minimal mr, tr and pi. the thoracic aorta is intact. 02:55am blood wbc-7.0 rbc-4.01* hgb-11.6* hct-33.8* mcv-84 mch-29.0 mchc-34.4 rdw-12.9 plt ct-203 02:55am blood glucose-123* urean-15 creat-0.8 na-133 k-4.1 cl-94* hco3-32 angap-11 02:55am blood pt-22.2* ptt-51.4* inr(pt)-2.1* 11:00am blood pt-17.0* ptt-31.0 inr(pt)-1.5* 03:35am blood pt-15.3* ptt-33.5 inr(pt)-1.3* 08:25am blood pt-25.8* inr(pt)-2.5* 05:20am blood pt-33.0* inr(pt)-3.3* 05:05am blood pt-32.4* inr(pt)-3.3* brief hospital course: he was transferred from an outside hospital for evaluation of the ascending aortic aneurysm found incidentially on echocardiogram. he underwent preoperative workup that included a ct scan and echocardiogram. his medications were adjusted for blood pressure management and episodes of atrial fibrillation and junctional rhythm. on he was brought to the operating room and underwent a bentall procedure with a . aortic valve conduit. see operative report for further details. he received vancomycin for perioperative antibiotics. he weaned from bypass on neo synephrine and propofol infusions and transferred to the intensive care unit for post operative management. in the first twenty four hours he was weaned from sedationand pressors, awoke neurologically intact and was extubated without complications. on post operative day one he was started on coumadin for his mechanical valve and transferred to the floor. chest tubes and pacing wires were discontinued without complication according to prootocol. physical therapy worked with him on strength and mobility. he was placed on continuous o2 sat monitoring and found to be desaturating at nighttime, the sleep medicine service was consulted (see note). he had a cpap trial and did not desaturate. they recommended he be discharged home on oxygen, but not cpap. he will follow up with the sleep clinic as an outpatient. on postoperative day three he was started on heparin to bridge until his inr was therapuetic. he continued to have dysrhythmia and ep was consulted. ep diagnosed sinus arrest with junctional escape rhythm v. atrial fibrillation with junctional escape rhythm, most likely due to post-op inflammation/edema of the conduction system. av conduction was found to be intact, thus a pacemaker was not indicated. beta blocker was titrated carefully, and rhythm was mostly sinus by time of discharge. when the inr became therapeutic the heparin was stopped anfd the inr goal was 2.5-3.5. the patient was discharged home in good condition with vna services on pod 8. arrangements were made for his primary care physician (dr.) to manage his anticoagulation. follow up appointments, restrictions, precautions and medications were discussed with him prior to discharge. medications on admission: fish oil 500 mg tid hydrochlorathiazide 25 mg daily lisinopril 20 mg daily lovastatin 20 mg daily toprol xl 25 mg daily discharge medications: 1. 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:*0* 2. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours). disp:*qs qs* refills:*0* 3. lovastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 5. outpatient lab work serial pt/inr dx: mechanical aortic valve goal inr results to dr. 6. oxygen 2-4 liters continuous for portability pulses dose system diagnosis - copd sat 86% at rest room air saturation 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain for 4 weeks. disp:*50 tablet(s)* refills:*0* 8. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*3* 9. omega-3 fatty acids capsule sig: one (1) capsule po daily (daily). 10. amiodarone 200 mg tablet sig: two (2) tablet po twice a day as needed for atrial fibrillation: 2 tablets twice daily for two weeks, then 2 tablets daily for a week, then one tablet daily. disp:*100 tablet(s)* refills:*0* 11. metoprolol tartrate 50 mg tablet sig: 1.5 tablets po three times a day. disp:*135 tablet(s)* refills:*2* 12. dyazide 37.5-25 mg capsule sig: one (1) capsule po once a day. disp:*30 capsule(s)* refills:*2* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: s/p bentall procedure(29mm st. mechanical) ascending aortic aneurysm aortic insufficiency hypertension dyslipidemia discharge condition: alert and oriented x3, nonfocal ambulating, gait steady sternal pain managed with percocet prn discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns () your inr will be followed by dr. ()- your inr needs to be drawn on at , dr. will follow. smoking cessation - it is very important as discussed not to resume smoking. please follow up with your primary care provider if you develop urges to smoke for interventions. followup instructions: surgeon dr. on at 1pm () please call to schedule appointments primary care dr. () in weeks dr. to follow coumadin (confirmed with rn, ) cardiologist dr. in weeks provider: , md phone: date/time: 1:00 (pulmonary sleep medicine) procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels diagnoses: obstructive sleep apnea (adult)(pediatric) tobacco use disorder unspecified essential hypertension thoracic aneurysm without mention of rupture cardiac complications, not elsewhere classified atrial fibrillation mitral valve insufficiency and aortic valve insufficiency pulmonary collapse other and unspecified hyperlipidemia other specified cardiac dysrhythmias other emphysema hypoxemia surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation obesity, unspecified 

Answer: The patient is high likely exposed to