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: no known allergies / adverse drug reactions attending: chief complaint: worsening shortness of breath major surgical or invasive procedure: aortic valve replacement, 23-mm st. medical regent mechanical valve. coronary artery bypass grafting x2, with a left internal mammary artery graft to the left anterior descending and reversed saphenous vein graft to the posterior left ventricular branch history of present illness: 67 year old male previously admitted for bradycardia and ruled out for myocardial infarction. he was known to have aortic stenosis and coronary artery disease and underwent preoperative evaluation. he now presents for surgery past medical history: hypertension right knee osteoarthritis aortic stenosis bradycardia non st elevation myocardial infarction social history: -tobacco history: denies -etoh: 3 drinks/day -illicit drugs: denies family history: mother died of stroke at 49 father died at 69 of emphysema w/ possible asbestos exposure physical exam: physical exam pulse:47 resp:13 o2 sat:100 b/p 118/92 height:69" weight:83kgs general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade iii syst__ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right: p left:p dp right:p left:p pt :p left:p radial right:p left:p carotid bruit right:none left:none pertinent results: ekg sinus rhythm. low voltage in limb leads. non-specific intraventricular conduction delay. non-specific st-t wave changes. compared to the previous tracing of the precordial voltage is less prominent. tte: pre-bypass: no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is mildly depressed (lvef= 40-45 %). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). doppler parameters are most consistent with grade i (mild) left ventricular diastolic dysfunction. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results at time of surgery. post-bypass: the patient is on no inotropes. there is a bileaflet mechanical prosthetic valve in the aortic position. there is a small, centrally directed jet of aortic regurgitation originating from the perimeter of the valve. there is a peak gradient of 13 mmhg and a mean gradient of 6 mmhg at a cardiac output of 4.0 l/min. left ventricular function is improved (lvef > 55%). right ventricular function is unchanged. mitral regurgitation is unchanged. the aorta is intact after removal of the bypass cannula. 07:40am blood wbc-6.1 rbc-2.90* hgb-8.8* hct-25.1* mcv-86 mch-30.3 mchc-35.0 rdw-13.2 plt ct-266 11:35am blood wbc-11.0# rbc-2.92*# hgb-9.1*# hct-25.5*# mcv-87 mch-31.2 mchc-35.8* rdw-12.8 plt ct-155 07:40am blood plt ct-266 07:40am blood pt-26.5* inr(pt)-2.5* 11:35am blood plt ct-155 11:35am blood pt-14.1* ptt-31.3 inr(pt)-1.2* 07:40am blood glucose-91 urean-16 creat-0.7 na-137 k-4.3 cl-102 hco3-29 angap-10 01:14pm blood urean-21* creat-0.8 na-141 k-4.1 cl-116* hco3-21* angap-8 07:40am blood mg-1.9 03:20am blood mg-1.8 brief hospital course: he was admitted same day surgery and underwent aortic valve replacement and coronary artery bypass graft surgery. see operative report for further details. he was transfered to the intensive care unit for post operative management. in the first twenty four hours he was weaned from sedation, awoke neurologically intact and was extubated without complications. on post operative day one he was weaned off neosynephrine, he continued to progress and was transferred to the floor. chest tubes and epicardial wires were removed per protocol. physical therapy work with him on strength and mobility. he did require transfusions with packed red blood cell for post operative anemia but currently remains stable. he was started on anticoagulation for mechanical valve with coumadin, and his plavix was stopped as he was greater than one month since stent placement and now being on coumadin. on post operative day five he complained of itching on his back that started the night before, he was noted to have rash on flanks, lower back, buttock, and posterior thighs. his medications were reviewed and lasix, percocet, and protonix stopped. he was placed on ultram for pain management and after receiving benadryl with improvement, he was montiored overnight and the rash was almost completely resolved. he was ready for discharge home with services on post operative day six. medications on admission: medications at home: aspirin 325 mg daily clopidogrel 75 mg daily atorvastatin 80 mg daily benicar hct 20-12.5 mg daily metoprolol succinate 50 mg daily icy hot topical ointment for knee 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. 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:*1* 3. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*1* 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 5. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for itching. 6. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. disp:*qs qs* refills:*0* 7. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 8. warfarin 5 mg tablet sig: one (1) tablet po once a day: please take 5 mg (1 tablet) on then have inr checked and further dosing by dr . disp:*60 tablet(s)* refills:*1* 9. outpatient lab work labs: pt/inr for coumadin to be followed by dr. indication:mechanical avr goal inr 2.5-3.0 first draw results to dr phone fax phone please check inr monday, wednesday and friday for the first two weeks and then decrease as directed by dr discharge disposition: home with service facility: vna discharge diagnosis: critical symptomatic aortic stenosis s/p avr coronary artery disease s/p cabg hypertension secondary diagnosis non st elevation myocardial infarction osteoarthritis bradycardia discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram as needed incisions: sternal - healing well, no erythema or drainage leg right evh with significant ecchymosis thigh area - no hematoma no warmth, no erythema no drainage edema right leg +1 left leg trace rash noted on back and buttock improving significantly 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. on at 1:15pm cardiologist: dr. on at 1:45pm wound check @ 10:15am in cardiac surgery office **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin to be followed by dr. indication:mechanical avr goal inr 2.5-3.0 first draw results to dr phone fax phone procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve (aorto)coronary bypass of one coronary artery diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery unspecified essential hypertension aortic valve disorders percutaneous transluminal coronary angioplasty status old myocardial infarction rash and other nonspecific skin eruption examination of participant in clinical trial 

Answer: The patient is high likely exposed to