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: history of present illness: the patient is a 67-year-old man with a long cardiac history which includes coronary artery bypass grafting in , and , associated with congestive heart failure and an ef of 25-30%. he has also had a mitral valve replacement in the past, as well as an aicd placement in of this year. he presented to the hospital with complaint of and vomiting, as well as increased abdominal girth. he was found to be hypotensive and was admitted to their icu briefly requiring pressors. an echo at the hospital showed an ef of 40% with pa systolic pressures of 25-30, severe mr , as well as hypokinesis of the inferior posterior walls, as well as hypokinesis of the apical septum. the patient was transferred to to discuss treatment of his ascites and possibly redo mitral valve. past medical history: 1) significant for, as stated previously, cabg in , and , with a lima to the lad and saphenous vein graft to the pda in , and a radial graft to the lima to the pda in . 2) congestive heart failure with an ef of 25-30%, with ischemic cardiomyopathy. 3) status post mitral valve repair. 4) chronic atrial fibrillation. 5) sick sinus syndrome, status post pacer in . 6) a v-tach arrest at the time of admission for his sick sinus syndrome. 7) pulmonary hypertension. 8) hypertension. 9) chronic renal insufficiency. 10) gerd. 11) hypercholesterolemia. 12) gout. 13) bronchitis associated with hemoptysis. 14) iron deficiency anemia. past surgical history: 1) significant for coronary artery bypass grafting x 3. 2) mitral valve replacement x 1. 3) appendectomy. 4) right neck mass excision. 5) hernia repair. meds at admission: 1) lasix 120 qd, 2) zaroxolyn 2.5 prn with weight gain, 3) aspirin 325 qd, 4) lopressor 12.5 , 5) plavix 75 qd, 6) prevacid 30 qd, 7) folic acid 1 qd, 8) lipitor 10 qd, 9) imdur 30 qd, 10) hydralazine 10 tid, 11) aldactone 25 , 12) lexapro 10 qd, 13) albuterol prn, 14) atrovent prn, 15) flovent , 16) coumadin 2.5--last taken . allergies: quinidine which causes a rash. social history: lives with his wife in , . occasional alcohol. no history of alcohol abuse. denies tobacco use. physical exam at time of admission: vital signs - temperature 97.4, heart rate 55, blood pressure 129/77, respiratory rate 24, o2 sat 99% on room air. general - pleasant man, sitting upright, speaking in full sentences, in no acute distress. skin - no jaundice or rashes. heent - anicteric, noninjected. pupils equally round and reactive to light. extraocular movements intact. mucous membranes moist. op clear. neck - jvd at angle of jaw, no bruits. no lymphadenopathy. heart - irregularly irregular, iii/vi holosystolic murmur throughout. respiratory - a few vesicular breath sound at bases, otherwise clear. abdomen was distended, nontender, soft, with shifting dullness to percussion, but no fluid wave transmission, no hepatosplenomegaly, positive bowel sounds. extremities - 3+ pitting edema bilaterally up to the knees. neuro - cranial nerves ii through xii grossly intact, no focal deficits. lab data: white count 6.4, hematocrit 34.9, platelets 160, pt 18.5, ptt 39.8, inr 2.3, sodium 138, potassium 4.3, chloride 100, co2 28, bun 25, creatinine 1.3, alt 16, ast 68, ldh 994, alk phos 86, total bili 2.4, albumin 3.9. ekg was afib., paced irregularly with a rate of 63, with axis of -68??????, elevations in v3, and elevation in v2 through 4. hospital course: the patient was treated by the medical service with consultation from heart failure service, as well as cardiology. the cardiac surgery service was consulted as well. the patient was diuresed over the first 10 days of his hospitalization. following that period of time, the patient was evaluated for heart transplant, as it was felt that he may require an lvat during his mitral valve replacement. on the , the patient was brought to the cardiac catheterization lab where an intra-aortic balloon pump was placed prior to his being transferred to the operating room for a redo mitral valve replacement. please see the catheterization lab report for full details. in summary, he had an intra-aortic balloon pump placed prior to surgery. he was then brought directly to the surgical suite, at which time he underwent redo mitral valve replacement with a #27 mosaic porcine valve via a right thoracotomy. the patient tolerated the operation and was transferred from the operating room to the cardiothoracic intensive care unit. please see the or report for full details and summary. the patient was transferred, after redo mvr, with a mean arterial pressure of 82. he was v-paced at a rate of 80. his iv medications included amiodarone at 2 mg/min, epinephrine at 0.03 mcg/kg/min, milrinone at 0.5 mcg/kg/min, levophed at 0.15 mcg/kg/min, and propofol at 10 mcg/kg/min. in the immediate postoperative period, the electrophysiology service was consulted regarding ventricular ectopy. at that time, his internal pacer was increased to a rate of 90 in an attempt to control his ventricular ectopy. the patient did well in the immediate postoperative period. during the first 24 hours, epinephrine was weaned to off, and his amiodarone was decreased to 1 mg/min. on the morning of postoperative day #1, the intra-aortic balloon pump was weaned and ultimately discontinued. during that period, the patient remained hemodynamically stable. neurologically, the patient's sedation was weaned to a point that he was able to move all four extremities and nod appropriately following a quick neuro assessment. the patient was resedated therefore requiring continued ventilatory support. following removal of the intra-aortic balloon pump, the patient's levophed was weaned to off, and on postoperative day #2, the propofol was discontinued, thereby allowing us to wean the patient from the ventilator. the patient was successfully extubated on postoperative day #2. over the next several days, the patient was slowly weaned from his milrinone infusion. on postoperative day #5, the milrinone was successfully discontinued. following the successful discontinuation of the iv milrinone infusion, the patient was transferred to far-2 for continued postoperative care and cardiac rehabilitation. the patient remained on far-2 for an additional three days, during which time his activity level was increased with the assistance of the physical therapist and the nursing staff. on postoperative day #10, it was decided that the patient was stable and ready to be discharged to home with the assistance of visiting nurses. discharge physical exam: vital signs - temperature 98, heart rate 70, v-paced, blood pressure 100/52, respiratory rate 20, o2 sat 95% on room air, weight preoperatively 102 kg, and at discharge 97.3 kg. alert and oriented x 3. moves all extremities. follows commands. respiratory - breath sounds diminished at the bases, otherwise clear to auscultation. cardiac - regular rhythm, s1, s2. right thoracotomy incision with staples, no erythema. abdomen was soft, nontender, positive distention, and positive bowel sounds. extremities were warm and well-perfused with 3-4+ edema bilaterally. lab data: hematocrit 29.3, pt 14.7, inr 1.4, potassium 3.9, bun 21, creatinine 1.3. discharge medications: 1) carvedilol 3.125 mg , 2) aldactone 12.5 mg qd, 3) enalapril 5 mg , 4) amiodarone 400 mg x 1 week, then 400 mg qd x 1 week, then 200 mg qd for 1 month, 5) lasix 80 mg , 6) potassium chloride 20 meq qd, 7) enteric-coated aspirin 325 mg qd, 8) senna 2 tablets , 9) percocet 5/325, 1-2 tabs, q 6 h prn, 10) resume prevacid 30 mg qd. discharge diagnoses: 1) status post redo mitral valve replacement with a #27 mosaic porcine valve via a right thoracotomy. 2) status post coronary artery bypass grafting x 3, , , . 3) congestive heart failure. 4) chronic atrial fibrillation. 5) sick sinus syndrome and ventricular tachycardic arrest. 6) status post aicd permanent pacemaker placement. 7) pulmonary hypertension. 8) hypertension. 9) chronic renal insufficiency. 10) gastroesophageal reflux disease. 11) hypercholesterolemia. 12) gout. 13) bronchitis associated with hemoptysis. 14) iron deficiency anemia. 15) status post appendectomy. 16) status post right neck mass excision. 17) status post hernia repair. condition at discharge: good. fop: 1) he is to have follow-up with dr. in weeks. 2) follow-up with dr. from the heart failure service on at 1:00 pm. 3) follow-up with dr. , his primary care provider, 1 month. 4) he is also to have follow-up in the wound clinic in 1 week. die instructions: the patient is also to have a potassium, bun and creatinine checked by the visiting nurses with results called-in to dr. office on thursday, . , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures percutaneous abdominal drainage implant of pulsation balloon open and other replacement of mitral valve with tissue graft monitoring of cardiac output by other technique nonoperative removal of heart assist system diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified coronary atherosclerosis of autologous vein bypass graft atrial fibrillation percutaneous transluminal coronary angioplasty status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease tricuspid valve disorders, specified as nonrheumatic 

Answer: The patient is high likely exposed to