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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath, referred from osh major surgical or invasive procedure: s/p cabgx4(lima->lad, svg->pda, om, ramus)/avr(23mm ce perimount bioprosthesis) history of present illness: this 66-year-old man with copd, pvd who was admitted to osh on in respiratory failure. he was intubated and admitted to the icu. his initial blood gas was 7.06/94/134/26 (on 100% o2). chest xray showed pulmonary edema. initial ekg (not included in transfer records) was read as sinus tachycardia at 120, lvh with repolarization. initial tni 0.11 and peaked at 0.21. bnp was 874. he was treated with nebs, diuretics, antibiotics and was extubated on . he was transferred to telemetry where he has been pain free. he was stressed yesterday and found to have an ef of 20-25% with a fixed defect. patient has been on ra w/ sats >95%. he was oob with no complaints prior to transfer. upon arrival to he states that his shortness of breath started approximately 4-5 days prior to his presentation. he states that the shortness of breath was sudden onset ~1am and progressively got worse. he states that he started taking avandia 4 days prior to his symptom onset. he denies chest pain, jaw pain, or arm pain. he had a cough during this time but denies any sputum production. also, he has had no fevers, chills, or sweats. the shortness of breath was no positional. he has had intermittent leg swelling over the past few weeks but not progressively so. he does have chronic pain in his calves when walking <1 block; the pain is relieved with rest. on review of systems, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, joint pains, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. all of the other review of systems were negative. past medical history: copd pvd s/p peripheral revascularization in ?fem-fem () niddm htn "hepatitis" >20 yrs ago + tob abuse + etoh abuse (without dt's) social history: social history is significant for the presence of current tobacco use. there is history of alcohol abuse. lives alone. has one daughter ( ). retired family history: there is no family history of premature coronary artery disease or sudden death. physical exam: vs - t 97.3 bp (right) 137/58 (left) 89/69; hr 80; rr 18; 98%ra. fs: 254 gen: wdwn middle aged male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. multiple missing teeth. neck: supple with jvp of 5 cm. cv: pmi barely palpable in midclavicular line. rr, normal s1, s2. ii/vii syst murmur at rusb w/o radiation. no thrills, lifts. no s3 or s4. chest: barrel chested. no scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. well healed lower abd scar ext: no c/c/e. no femoral bruits. skin: does have mild varicose veins. no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 1+ popliteal faint dp doppler pt doppler left: carotid 2+ femoral 1+ popliteal faint dp doppler pt doppler neuro: alert and oriented x3, cn ii-xii intact, moving all four extremities symmetrically pertinent results: 07:00am blood wbc-9.6 rbc-3.53* hgb-11.3* hct-33.1* mcv-94 mch-31.9 mchc-34.0 rdw-13.1 plt ct-160 07:00am blood pt-13.6* inr(pt)-1.2* 07:00am blood glucose-182* urean-11 creat-0.6 na-134 k-4.0 cl-97 hco3-26 angap-15 06:35am blood alt-17 ast-14 ld(ldh)-166 alkphos-78 totbili-0.4 radiology final report chest (portable ap) 5:28 pm chest (portable ap) reason: pneumothorax, after removal of chest tubes. medical condition: 66 year old man with s/p avr/cabg reason for this examination: pneumothorax, after removal of chest tubes. history: status post avr, cabg, assess for pneumothorax, status post removal of chest tubes. chest, 1 vw compared with , the et tube, ng tube, left chest tube and question mediastinal drains have been removed. swan-ganz catheter remains present, tip overlying theright pulmonary artery. no pneumothorax or gross effusion is identified. no chf is seen. there is patchy increased retrocardiac density, increased compared with , consistent with development of left lower lobe collapse and/or consolidation. dr. cardiology report echo study date of patient/test information: indication: cabg/avr status: inpatient date/time: at 10:45 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw1-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. r. measurements: left ventricle - inferolateral thickness: 0.9 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: *6.0 cm (nl <= 5.6 cm) left ventricle - ejection fraction: 15% to 20% (nl >=55%) aorta - ascending: *3.8 cm (nl <= 3.4 cm) aorta - descending thoracic: *2.7 cm (nl <= 2.5 cm) aortic valve - lvot vti: 21 aortic valve - valve area: *0.7 cm2 (nl >= 3.0 cm2) interpretation: findings: left atrium: no spontaneous echo contrast is seen in the laa. right atrium/interatrial septum: normal interatrial septum. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness. moderately dilated lv cavity. severe regional lv systolic dysfunction. lv wall motion: regional lv wall motion abnormalities include: basal anterior - hypo; mid anterior - hypo; basal anteroseptal - hypo; mid anteroseptal - hypo; basal inferoseptal - hypo; mid inferoseptal - hypo; basal inferior - hypo; mid inferior - hypo; basal inferolateral - hypo; mid inferolateral - hypo; basal anterolateral - hypo; mid anterolateral - hypo; anterior apex - hypo; septal apex - hypo; inferior apex - hypo; lateral apex - hypo; apex - hypo; right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated ascending aorta. simple atheroma in ascending aorta. mildly dilated descending aorta. simple atheroma in descending aorta. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: three aortic valve leaflets. moderately thickened aortic valve leaflets. severe as (aova <0.8cm2). moderate to severe (3+) ar. mitral valve: mildly thickened mitral valve leaflets. trivial mr. tricuspid valve: physiologic tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. the patient was under general anesthesia throughout the procedure. conclusions: pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is severe regional left ventricular systolic dysfunction with moderated hk of basal segments and severe hk of mid and distal segments.. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. there are simple atheroma in the ascending aorta. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. there are complex (>4mm) atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is severe aortic valve stenosis (area <0.8cm2) by continuity, but mild as by planimetry. moderate to severe (3+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. post-cpb: an aortic valve prosthesis is in place. no leak, no ai. good rv systolic fxn. improved lv systolic fxn, with ef 35-40%, on epi and milrinone infusions. aorta intact. no mr. as pre-bypass. electronically signed by , md on 12:02. brief hospital course: mr. is a 66 year old man with pvd, multiple cardiac risk factors presented with signs and symptoms of new chf. he ruled-out for acute mi then subsequently underwent cardiac catheterization to identify the cause of the new onset heart failure. the coronary angiography revealed 3 vessel disease and he was referred to cardiac surgery for cabg. a subsequent echocardiogram revealed moderate to sever aortic regurgitation. on he was taken to the operating room and underwent a coronary artery bypass graft times four (lima to lad, svg to pda, svg to om and svg to ramus) and an avr (23mm ce perimount bioprothesis). this procedure was performed by dr. . he tolerated the procedure well and was able to be transferred in critical but stable condition to the surgical intensive care unit. in the surgical intensive care unit he progressed well. he was extubated and his chest tubes were removed by post-operative day one. he was weaned from his pressors. on the following day his epicardial wires and swan were removed. he was placed on amiodarone for atrial fibrillation. on post-operative day three he was transferred to the surgical step down floor. on the floor he was seen in consultation by the physical therapy service. the diabetes clinic saw him in consultation. by post-operative day four he was ready for discharge in stable condition to home. medications on admission: isordil 50 mg daily verapamil 240 mg lipitor 20 mg daily actos 15 mg daily discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days. disp:*14 tablet(s)* refills:*0* 2. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours) for 7 days. disp:*28 capsule, sustained release(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. 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* 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 6. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 7 days: decrease dose to 400 mg po daily for 7 days after twice a day dose completed, then decrease the dose to 200 mg po daily after that. disp:*60 tablet(s)* refills:*0* 9. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*2* 10. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* 11. actos 15 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: cad copd iddm pvd-s/p aorto bifem bypass htn pud discharge condition: good. discharge instructions: follow medications on discharge instructions. do not drive for 4 weeks. do not lift more than 10 lbs. for 2 months. do not use creams, lotions, or powders on wounds. shower daily, let water flow over wounds, pat dry with a towel. call our office for sternal drainage, temp>101.5. followup instructions: make an appointment with dr. in 1 week make an appointment with dr. for 4 weeks wound check appointment at 1200 procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using a single catheter coronary arteriography using a single catheter open and other replacement of aortic valve with tissue graft aortography right heart cardiac catheterization diagnoses: other primary cardiomyopathies coronary atherosclerosis of native coronary artery pure hypercholesterolemia tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation aortic valve disorders diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled atherosclerosis of autologous vein bypass graft of the extremities partial edentulism, unspecified unspecified gingival and periodontal disease loss of teeth due to periodontal disease 

Answer: The patient is high likely exposed to