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: this is an 81-year-old male with known coronary artery disease who first presented to center on with a complaint of shortness of breath and chest tightness. he was found to be in congestive heart failure and treated with lasix and nitroglycerin. he was admitted to the medicine service and ruled in for a non-st-myocardial infarction with peak troponin's of 0.81. now, since that point, was chest pain free. past medical history: 1. coronary artery disease first diagnosed two years ago. the patient has had multiple admissions over the last six for congestive heart failure. a catheterization in of showed a 75 percent left main, 80 percent circumflex, and 99 percent right coronary artery as well as aortic stenosis with peak gradient of 30 mmhg. the patient declined surgery at that time due to high risk. 2. aortic stenosis with a mean gradient of 30 with an aortic valve area of 1. 3. peripheral vascular disease; status post bilateral femoral- to-popliteal bypass seven years ago. 4. chronic obstructive pulmonary disease. 5. hypercholesterolemia. 6. gastroesophageal reflux disease. 7. macular degeneration; the patient is currently legally blind. allergies: he states no known drug allergies. medications on admission: include ecotrin 325 mg once daily, isordil 40 mg q.6h., labetalol 200 mg q.8h., monopril 40 mg in the morning, zocor 60 mg at bedtime, protonix 40 mg once daily, lasix 80 mg in the morning and 60 mg in the evening, tylenol as needed, nitroglycerin as needed, and colace. social history: remote tobacco use. he quit six months ago. prior to that was a pack a day smoker. restarted recently, and currently smoking 10 cigarettes a day. he denies alcohol use. he denies other recreational drug use. he lives at home with his wife. worked as a manager of a cvs. he is now retired. physical examination on admission: temperature was 96.6, his heart rate was 62, his blood pressure was 154/54, his respiratory rate was 18, and his oxygen saturation was 98 percent on room air. in general, somewhat disheveled but in no acute distress. head, eyes, ears, nose, and throat examination revealed anicteric and not injected. the pupils were equally round and reactive to light. the extraocular muscles were intact. visual acuity revealed he could count the number of fingers at one to two feet but could not read letters at any distance. the oropharynx was clear. the mucous membranes were moist. the neck was supple. no jugular venous distention. no bruits. the lungs were clear to auscultation bilaterally without rales. cardiovascular examination revealed distant heart sounds. a regular rate and rhythm. first heart sounds and second heart sounds with a blowing systolic murmur heard best at the right upper sternal border. the abdomen was soft, nontender, and nondistended. there were normal active bowel sounds. there was a well-healed midline scar. the extremities were warm with 1 plus pitting edema (right greater than left). dorsalis pedis pulses were 2 plus bilaterally. neurologically, motor strength was in the upper and lower extremities. sensory examination was grossly intact. laboratory data from : white blood cell count was 7.2, his hematocrit was 36.6, and his platelets were 245. sodium was 144, potassium was 3.8, chloride was 106, bicarbonate was 27, blood urea nitrogen was 40, creatinine was 1.5, and blood glucose was 102. radiology: electrocardiogram revealed sinus bradycardia with first-degree atrioventricular block. normal axis with a right bundle branch block. st depressions in v5 and v6 with q waves in the inferior leads. a transesophageal echocardiogram done in showed a normal ejection fraction with left ventricular hypertrophy and left atrial enlargement, moderate mitral regurgitation, mild aortic insufficiency, and mild-to- moderate aortic stenosis. summary of hospital course: the patient was admitted to the medicine service and was seen by the cardiac surgery service and accepted for coronary artery bypass grafting as well as aortic valve replacement. he was followed by the medicine service until on the patient was brought to the operating room. please see the operative report for full details. in summary, the patient had an aortic valve replacement with a 21 porcine tissue valve and coronary artery bypass grafting times three with a left internal mammary artery to the left anterior descending, saphenous vein graft to the obtuse marginal, and saphenous vein graft to the posterior descending artery. his bypass time was 137 minutes with a cross-clamp time of 107 minutes. the patient tolerated the operation well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient was av paced at a rate of 88 beats per minute with a mean arterial pressure of 74. he had dobutamine at 10 mcg/kg/minute, neo-synephrine at 0.5 mcg/kg/minute, insulin at 2 units per hour, and propofol at 10 mcg/kg/minute. the patient did well in the immediate postoperative period. his blood gases were slightly acidotic. therefore, he remained intubated throughout the course of the operative day. on postoperative day one, he remained hemodynamically stable. his blood gases had somewhat corrected. he was weaned from the ventilator and successfully extubated. also on postoperative day, the patient was weaned from his dobutamine as well as neo-synephrine drips. he was begun on lasix as well as beta blockade and remained in the intensive care unit for close hemodynamic monitoring as well as pulmonary toilet. on postoperative day two, the patient was transferred from the cardiothoracic intensive care unit to two for continued postoperative care and cardiac rehabilitation. once on the floor, the patient's temporary pacing wires and chest tubes were removed as was his central venous access. additionally, on postoperative day three the patient was noted to be in a rapid atrial fibrillation with a ventricular response rate between 120 and 140. he was treated initially with intravenous lopressor and failed to convert, and ultimately was started on amiodarone. the patient remained in atrial fibrillation for several days; for which he was begun on heparin as well as coumadin. however, ultimately the patient converted to a normal sinus rhythm and both heparin and coumadin were discontinued. for several days on the floor, the patient had an uneventful course. his activity level was increased with the assistance of the nursing staff as well as physical therapy. he was gently diuresed as he had initially had an increase in his creatinine from a baseline of 1.6 to 2.5 during his initial hospital visit that gradually resolved. ultimately, by postoperative day seven, it was decided that the patient was stable and ready to be transferred to rehabilitation for continuing postoperative care. at the time of this dictation, the patient's physical examination was as follows. his temperature was 98, his heart rate was 59 (sinus rhythm), his blood pressure was 125/61, his respiratory rate was 20, and his oxygen saturation was 94 percent on room air. his weight was 73.4 kilograms; preoperatively was 70 kilograms. neurologically, alert and oriented. a nonfocal examination. pulmonary examination revealed clear to auscultation bilaterally. cardiac examination revealed a regular rate and rhythm. the sternum was stable. incision with staples. a small area of eschar at the base of his incision. the staples can be removed on or about . the abdomen was soft, nontender, and nondistended. there were normal active bowel sounds and a well-healed scar. the extremities were warm and well perfused with 1 to 2 plus edema bilaterally. saphenous vein graft harvest site is on the left. it is an endoscopic site with steri-strips open to air, clean and dry. laboratory data revealed sodium was 138, potassium was 4.1, chloride was 103, bicarbonate was 26, blood urea nitrogen was 86, creatinine was 2.4, and glucose was 165. magnesium was 2.7. hematocrit was 32.2. prothrombin time was 16, partial thromboplastin time was 64, and inr was 1.7. condition on discharge: good. discharge disposition: he is to be discharged to a rehabilitation center. discharge diagnoses: 1. aortic stenosis; status post aortic valve replacement with a 21 porcine valve. 2. coronary artery disease; status post coronary artery bypass grafting times three with a left internal mammary artery to the left anterior descending, a saphenous vein graft to obtuse marginal, and saphenous vein graft to the posterior descending artery. 3. postoperative atrial fibrillation. 4. status post aortobifemoral bypass. 5. peripheral vascular disease. 6. hypercholesterolemia. 7. gastroesophageal reflux disease. 8. chronic obstructive pulmonary disease. 9. legally blind. discharge followup: the patient was instructed to follow up with dr. in two to three weeks and follow up with dr. . in four weeks. medications on discharge: 1. potassium chloride 20 meq q.12h. 2. colace 100 mg twice daily. 3. aspirin 81 mg once daily. 4. percocet 5/325 one to two tablets q.4-6h. as needed. 5. simvastatin 60 mg once daily. 6. prilosec 40 mg once daily. 7. metoprolol 50 mg twice daily. 8. lasix 80 mg twice daily. 9. amiodarone 400 mg twice daily times one week, then 400 mg once daily times one week, then 200 mg once daily. , procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries open and other replacement of aortic valve with tissue graft continuous intra-arterial blood gas monitoring diagnoses: sciatica subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia tobacco use disorder congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders peripheral vascular disease, unspecified macular degeneration (senile), unspecified 

Answer: The patient is high likely exposed to