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: lisinopril attending: chief complaint: shortness of breath major surgical or invasive procedure: mitral valve repair (32 mm cg future ring) history of present illness: 74-year-old male with history of nonischemic cardiomyopathy status post aicd/ppm in and known mitral valve regurgitation followed by serial echocardiograms. he was admitted to the this past with congestive heart failure which was treated with aggressive diuresis. an revealed an ejection fraction of 26%, biatrial enlargement, 4+ mitral regurgitation and mild to moderate aortic insufficiency. he admits to some fatigue and dyspnea with exertion however he does not claim to be limited in his activities. given the severity of his mitral valve disease and his episode of heart failure, he has been referred for surgical management. he was originally seen as an inpatient and returns today for pre-op cardiac catheterization. of note, he has a large lipoma on his right forhead which he is anxious to have removed. past medical history: 1. dilated cardiomyopathy with previous coronary catheterization without significant cad, last ef in 23%, s/p biventricular pacemaker and icd 2. hypertension 3. ckd, baseline creatinine around 2 4. hearing loss 5. history of pulmonary embolism in , status post six months of anticoagulation, now off anticoagulation 6. prostate cancer 7. hypothyroidism 8. inguinal hernia, evaluated by surgery 9. old right occipital infarct, with associated encephalomalacia and ex vacuo effect (patient denies hx of stroke). social history: lives with:wife and daughter lives on the . daughter helps with medications occupation:retired tobacco:denies etoh:denies family history: brother with an mi at age 75 father - ca ? type mother - htn, otherwise well sibs - sister with ca to bones brother with an mi at age 75 and another with cad no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: pulse:70 resp:16 o2 sat:97/ra b/p left:111/78 right:112/72 height:5'5" weight:165 lbs general: nad appears stated age skin: dry intact large cyst vs. lipoma on right forehead above eye. heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally left infraclavicular pacemaker placement heart: rrr nl s1-s2, mid-late systolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused no edema varicosities: none neuro: grossly intact pulses: femoral right:2+ left:2+ dp right:2+ left:2+ pt :2+ left:2+ radial right:2+ left:2+ carotid bruit question left bruit vs transmitted murmur pertinent results: echo: prebypass: the left atrium is dilated. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no spontaneous echo contrast is seen in the left atrial appendage. no spontaneous echo contrast is seen in the body of the right atrium. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity is severely dilated. there is severe regional left ventricular systolic dysfunction with akinesis/dyskinesis of the inferoseptal, inferior, and inferolateral walls and hypokinesis of the septal, anteroseptal, anterior, anterolateral, and lateral walls. overall left ventricular systolic function is severely depressed (lvef= 20%). the right ventricular cavity is dilated with moderate global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the mitral valve leaflets do not fully coapt. the mitral regurgitation vena contracta is >=0.7cm. severe (4+) mitral regurgitation is seen. there is no pericardial effusion. postbypass: the patient is on infusions of milrinone, vasopressin, and norepinephrine and is av paced at 80 bpm. there is an annuloplasty ring in the mitral position which appears well seated. mitral regurgitation is now trace. peak/mean gradients through the valve are 2/0 mmhg at a cardiac output of 3 l/min and 4/1 mmhg at a cardiac output of 4 5 l/min. right ventricular function and left ventricular function are unchanged. the thoracic aorta is intact post decannulation. 12:54pm blood wbc-11.6*# rbc-3.14*# hgb-9.0*# hct-27.6*# mcv-88 mch-28.7 mchc-32.7 rdw-15.7* plt ct-195 03:06am blood wbc-14.5* rbc-4.19* hgb-11.7* hct-36.1* mcv-86 mch-28.0 mchc-32.5 rdw-18.1* plt ct-449* 06:09am blood wbc-5.7 rbc-3.90* hgb-11.3* hct-34.2* mcv-88 mch-29.0 mchc-33.1 rdw-17.7* plt ct-468* 12:54pm blood pt-14.9* ptt-28.3 inr(pt)-1.3* 03:10am blood pt-22.6* ptt-64.7* inr(pt)-2.1* 06:09am blood pt-22.0* inr(pt)-2.0* 01:50pm blood urean-43* creat-2.1* na-139 k-4.7 cl-111* hco3-22 angap-11 03:10am blood glucose-167* urean-86* creat-4.1* na-127* k-4.4 cl-90* hco3-24 angap-17 06:09am blood glucose-103* urean-85* creat-2.8* na-129* k-4.4 cl-90* hco3-30 angap-13 08:34pm blood calcium-8.1* phos-4.0 mg-2.8* 06:09am blood mg-2.8* 06:09am blood wbc-5.7 rbc-3.90* hgb-11.3* hct-34.2* mcv-88 mch-29.0 mchc-33.1 rdw-17.7* plt ct-468* 05:02am blood pt-21.9* ptt-28.3 inr(pt)-2.0* 05:02am blood glucose-100 urean-79* creat-3.0* na-131* k-4.8 cl-93* hco3-27 angap-16 brief hospital course: on mr. was admitted taken to the operating room and underwent mitral valve repair with a size 32 cg future band, . cardiopulmonary bypass time= 63 minutes, cross clamp time= 40 minutes. please see operative report for further details. he received cefazolin for perioperative antibiotics and transferred to the intensive care unit for post operative management. he required vasopressin, levophed, and milrinone for hemodynamic support. that evening he was weaned from sedation, awoke neurologically intact and was extubated without complications. electrophysiology was consulted and his permanent pacemaker was interrogated. on post operative day one he was started on captopril and milrinone weaned off. however on post operative day two he went into atrial fibrillation, requiring amiodarone, and milrinone was restarted due to decreased cardiac output. mr. became progressively oliguric and was started on lasix. levophed was again required due to hypotension after captopril. inotropes and pressors were titrated for hemodynamics, and amiodarone for atrial fibrillation. his renal function continued to worsen requiring increasing doses of lasix and zaroxolyn. on he was re-intubated for hypoxia and pulmonary edema requiring a lasix drip for diuresis in acute renal failure. he was started on coumadin and heparin for anticoagulation due to ongoing atrial fibrillation. on he was cardioverted and returned to sinus rhythm. that evening was able to wean off levophed and progressively over next 24 hours was weaned off epinephrine. heparin drip was stopped when inr was 2.2 and continued on coumadin for atrial fibrillation. amiodarone drip was converted over to oral amiodarone. on he was extubated without complications and continued to remain stable on milrinone. his lasix was changed from drip to bolus dosing. he remained in the intensive care unit for monitoring and remained stable. he was ultimately weaned off inotropes and a repeat was obtained. his renal function continued to slowly improve and he was transferred out of the intensive care unit on post-operative day 17. he was restarted on his home dose of oral lasix, 80mg daily. although his labs have been stable, his sodium, bun, and creatinine should be closely monitored at rehab. he was placed on antibiotics for a urinary tract infection for seven days, to end on . physical therapy was consulted for evaluation of strength and mobility. he continued to slowly progress and was cleared for discharge to rehab on post-op day 21. all follow up were advised. medications on admission: 1. outpatient lab work check chem 7 on please fax to the attention of dr on . 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 4. allopurinol 100 mg tablet sig: two (2) tablet po daily (daily). 5. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). 6. hydralazine 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 7. isosorbide dinitrate 10 mg tablet sig: one (1) tablet po tid (3 times a day). 8. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 9. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 10. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 11. spironolactone 25 mg tablet sig: 0.5 tablet po daily (daily). 12. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 13.furosemide 80 mg tablet sig: 1.5 tablets po daily (daily). 14. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 4. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 5. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. calcitriol 0.25 mcg capsule sig: one (1) capsule po every other day (every other day). 8. allopurinol 100 mg tablet sig: one (1) tablet po every other day (every other day). 9. hydralazine 25 mg tablet sig: 0.5 tablet po tid (3 times a day). 10. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): 200mg x 7 days, then 200mg daily until stopped by cardiologist. tablet(s) 11. coumadin 2.5 mg tablet sig: one (1) tablet po once a day: goal inr 2-2.5. 12. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever. 13. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for for sob. 14. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for for sob. 15. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 7 days. 16. percocet 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. 17. lasix 80 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: hebr discharge diagnosis: mitral regurgitation s/p mitral valve repair dilated cardiomyopathy hypertension chronic kidney disease hearing loss pulmonary embolism in prostate cancer hypothyroidism inguinal hernia old right occipital infarct, with associated encephalomalacia and ex vacuo effect discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage edema trace-1+ 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 females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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 surgeon: dr on at 1:45pm cardiologist: dr on at 1:30pm please call to schedule with your primary care dr in 4-5 weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances other electric countershock of heart annuloplasty diagnoses: other primary cardiomyopathies other iatrogenic hypotension coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified hyposmolality and/or hyponatremia unspecified acquired hypothyroidism cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation personal history of malignant neoplasm of prostate other chronic pulmonary heart diseases mitral valve insufficiency and aortic valve insufficiency chronic kidney disease, unspecified acute respiratory failure cardiogenic shock automatic implantable cardiac defibrillator in situ surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation acute on chronic systolic heart failure other and unspecified agents primarily affecting the cardiovascular system causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to