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: dyspnea on exertion major surgical or invasive procedure: - 1. aortic valve replacement with a size 23-mm - magna-ease tissue valve. 2. coronary artery bypass graft times 1; saphenous vein graft to right coronary artery. history of present illness: 79 year old male with severe aortic stenosis demonstrated by echocardiogram performed with 0.6-0.8 cm2 and peak/mean gradients of 141/76 mmhg. he was also noted to have mild mitral stenosis with calcified mitral apparatus and severe mitral annular calcification. he reports shortness of breath with any activity, especially when climbing one flight of stairs and is relieved after 3-4 minutes of rest. he also describes bilateral lower extremity edema half way up to knees with left greater than right. he reports difficulty breathing when first rising in the morning which is resolved with use of his inhaler. he was referred for cardiac catheterization. he was found to have coronary disease upon cardiac catheterization. he is now being referred to cardiac surgery for revascularization and an aortic valve replacement. past medical history: aortic stenosis heart murmur hypertension copd obesity renal insufficiency (baseline crt 1.1) gout history of anemia mild history ofcolitis polymyalgia rheumatica low back pain elevated psa history of basal cell cancer lesion removal , again in , osteoarthritis pilonidal cyst x2 mitral stenosis social history: race:caucasian last dental exam: lives with:wife contact: (wife) phone# occupation:retired episcopal priest cigarettes: smoked no yes quit 15 years ago, smoked for 45 years 1 ppd other tobacco use:denies etoh: scotch drinks daily illicit drug use:denies family history: premature coronary artery disease- mother with valve replacement in her 80's from which she "never recovered"; sister with pacemaker physical exam: pulse:81 resp:18 o2 sat:93/ra b/p right:130/70 left:135/67 height:5'8.5" weight:240 lbs general: nad, overweight skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade _3/6 sem_ abdomen: soft non-distended non-tender bowel sounds + , obese extremities: warm , well-perfused edema 1+ 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 right: left: radiation of cardiac murmur pertinent results: echo prebypass preserved lv systolic funciton with lvef > 55% and not swma. severe as with valve area < 1.0 cm2 and severe calcification of mitral valve - aortic valve interannular fibrosa with significant mv inflow obstruction. mv area by pressure half time is around 1.3-1.5 cm2, mva by pisa is 1.0 cm2. mean gradient is 7-8 mmhg and peak grad is 14-18 mmhg for mitral inflow consistent with severe ms. the left atrium is markedly dilated. no thrombus is seen in the left atrial appendage. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). the mitral valve leaflets are severely thickened/deformed. there is moderate valvular mitral stenosis (area 1.0-1.5cm2). there is at least moderate functional mitral stenosis (mean gradient 7-8 mmhg) due to mitral annular calcification. there is no pericardial effusion. normal tv and pv. intact ias. normal coronary sinus. postbypass: s/p avr + cabg. normally functioning av prosthesis. no sig as or ai. otherwise unchanged. 04:41am blood wbc-6.6 rbc-3.24* hgb-10.0* hct-30.8* mcv-95 mch-30.9 mchc-32.5 rdw-13.9 plt ct-197 08:55am blood wbc-7.7 rbc-3.56* hgb-10.9* hct-34.1* mcv-96 mch-30.5 mchc-31.9 rdw-13.7 plt ct-195 04:47am blood wbc-9.9 rbc-3.62* hgb-10.9* hct-34.6* mcv-96 mch-30.0 mchc-31.3 rdw-13.7 plt ct-188 04:41am blood glucose-104* urean-58* creat-1.4* na-138 k-3.4 cl-100 hco3-27 angap-14 08:55am blood glucose-95 urean-59* creat-1.5* na-141 k-4.8 cl-105 hco3-22 angap-19 04:47am blood glucose-100 urean-58* creat-1.5* na-139 k-4.0 cl-101 hco3-24 angap-18 04:41am blood pt-24.9* ptt-31.5 inr(pt)-2.4* 09:00am blood pt-15.2* inr(pt)-1.4* 02:29am blood pt-13.5* ptt-30.9 inr(pt)-1.3* brief hospital course: the patient was brought to the operating room on where the patient underwent an aortic valve replacement and coronary artery bypass grafting. please see operative note for details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 2 found the patient extubated, alert and oriented and breathing comfortably. he did need aggressive pulmonary toilet and was kept in the unit for several days post op due to respiratory issues. he did use bipap at night and will need a sleep study as an outpatient to further assess osa. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. he did have post operative atn and peak creatinine was 2.4. his baseline was 1.1 and creatinine was 1.5 decreasing towards his baseline at the time of discharge. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. he developed post-operative atrial fibrillation and was treated with amiodarone and coumadin tehrpay. he developed serous drainage from his mid sternal pole and kefzol was added. he was afebrile and wbc was normal at the time discharge with scant old bloody sternal drainage from the distal pole (mid sternal drainage had resolved). the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 9 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to home in good condition with appropriate follow up instructions. medications on admission: allopurinol 300 mg daily atenolol 25 mg daily symbicort 80 mcg-4.5 mcg/actuation hfa aerosol inhaler - two puffs inhaled twice a day felodipine 10 mg daily greek island labs natural joint dosage uncertain hydrochlorothiazide 25 mg daily ipratropium-albuterol 18 mcg-103 mcg (90 mcg)/actuation aerosol - two puffs inhaled four times a day as needed lisinopril 40 mg daily quinine sulfate 324 mg once a day as needed for leg cramps aspirin 81 mg daily magnesium 250 mg daily multivitamin dosage uncertain discharge medications: 1. outpatient lab work labs: pt/inr coumadin for post-op afib goal inr 2-2.5 first draw day after discharge then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. results to fax 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:*2* 3. amiodarone 200 mg tablet sig: one (1) tablet po once a day: for 7 days then 200mg ongoing . disp:*60 tablet(s)* refills:*2* 4. felodipine 2.5 mg tablet extended release 24 hr sig: four (4) tablet extended release 24 hr po daily (daily). 5. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 2-4 puffs inhalation q4h (every 4 hours) as needed for sob/wheezing. 6. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days: then resume hydrochlorothyazide. disp:*20 tablet(s)* refills:*0* 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 8. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 9. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation qid (4 times a day). 10. keflex 500 mg capsule sig: one (1) capsule po four times a day for 7 days. disp:*28 capsule(s)* refills:*0* 11. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 12. warfarin 2.5 mg tablet sig: daily per inr tablet po once a day: indication afib goal inr 2.0-2.5. disp:*45 tablet(s)* refills:*2* 13. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 14. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po daily (daily) for 10 days: while on lasix. disp:*20 tablet extended release(s)* refills:*0* 15. ultram 50 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. disp:*50 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease, severe aortic stenosis, post-op atrial fibrillation discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage + edema 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 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** coumadin for post-op afib goal inr 2-2.5 first draw then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. results to fax followup instructions: you are scheduled for the following appointments: wound check, thursday, , 10:45am at dr. office in the medical office building , . surgeon dr. , 1:00 in the medical office building , . cardiologist dr. (office will call you with appt) please call to schedule the following: primary care dr. ,lini s in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr coumadin for post-op afib goal inr 2-2.5 first draw then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. results to fax md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft diagnoses: hyperpotassemia thrombocytopenia, unspecified anemia, unspecified coronary atherosclerosis of native coronary artery polymyalgia rheumatica acute kidney failure with lesion of tubular necrosis unspecified essential hypertension chronic airway obstruction, not elsewhere classified cardiac complications, not elsewhere classified gout, unspecified atrial fibrillation personal history of tobacco use pulmonary collapse personal history of other malignant neoplasm of skin surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation osteoarthrosis, unspecified whether generalized or localized, site unspecified family history of ischemic heart disease obesity, unspecified urinary complications, not elsewhere classified knee joint replacement mitral valve stenosis and aortic valve stenosis body mass index 35.0-35.9, adult acute respiratory failure following trauma and surgery 

Answer: The patient is high likely exposed to