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: decline in activity tolerance major surgical or invasive procedure: 1. aortic valve replacement with a size 25 mm magna ease tissue valve. 2. coronary artery bypass graft x1, saphenous vein graft to diagonal artery. 3. endoscopic harvesting of the long saphenous vein. 4. left atrial appendage ligation. history of present illness: 79 year old male who has been followed for aortic stenosis and his recent echo has shown severe aortic stenosis with a valve area estimated at 0.4cm2. he reports an obvious decline in his activity tolerance as compared to a year ago. this has been slowly progressing and is now limiting his ability to do the things he enjoys including playing golf. in addition, he describes new mild dyspnea on exertion. he notes palpitations when he lies down at night. he was referred for right and left heart catheterization and surgical consultation for an aortic valve replacement. past medical history: coronary artery disease hypertension hyperlipidemia aortic stenosis chronic atrial fibrillation on coumadin : prior cva in the setting of a subtheraputic inr (no residual) non insulin dependent diabetes peripheral neuropathy involving his feet right shoulder bursitis past surgical history: cholecystectomy social history: lives with:wife contact: (daughter) phone # occupation: retired attorney cigarettes: smoked no yes other tobacco use:denies etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: denies family history: non-contributory physical exam: pulse:79 resp:16 o2 sat:94/ra b/p right:151/64 left:143/65 height:5'" weight:162 lbs general: 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 + extremities: warm x, well-perfused edema _____ varicosities: b/l le varicosities noted neuro: grossly intact pulses: femoral right: p left: p dp right: p left: p pt : p left: non-palp radial right: p left: p carotid bruit none heard pertinent results: intra-op tee: conclusions prebypass: the left atrium is normal in size. no mass/thrombus is seen in the left atrium or left atrial appendage. the right atrium is moderately dilated. left ventricular wall thicknesses and cavity size are normal. there is hypokinesis of inferior wall of left ventricle and the remaining left ventricular segments contract normally. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the ascending aorta. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. moderate (2+) mitral regurgitation is seen. no evidence of systolic flow reversal in pulmonary veins. vena contracta of mitral valve is 0.57 cm. dr. was notified in person of the results in the operating room. postbypass: well seated aortic valve, no perivalvular leak. mean gradient 7 mm hg. left atrial appendage stump visualized. no sign of aortic dissection. preserved unchanged left ventricular systolic function. mitral regurgitation improved to mild (1+) following cabg, avr. dr notified in person of findings. 08:50am blood wbc-12.4* rbc-3.53* hgb-10.7* hct-33.3* mcv-94 mch-30.2 mchc-32.0 rdw-15.2 plt ct-200 05:30am blood wbc-13.3* rbc-3.36* hgb-10.2* hct-31.5* mcv-94 mch-30.3 mchc-32.3 rdw-15.2 plt ct-165 12:53am blood wbc-13.0* rbc-3.15* hgb-9.6* hct-29.0* mcv-92 mch-30.5 mchc-33.2 rdw-15.1 plt ct-182 04:21am blood wbc-15.1* rbc-3.24* hgb-9.9* hct-29.7* mcv-92 mch-30.5 mchc-33.2 rdw-15.2 plt ct-199 09:00am blood pt-26.3* ptt-43.1* inr(pt)-2.5* 08:50am blood pt-26.6* inr(pt)-2.6* 09:10am blood pt-28.4* inr(pt)-2.7* 06:25am blood glucose-93 urean-22* creat-1.1 na-141 k-4.3 cl-100 hco3-35* angap-10 08:50am blood glucose-62* urean-27* creat-1.1 na-140 k-4.1 cl-98 hco3-31 angap-15 08:45pm blood na-136 k-4.2 cl-97 05:30am blood glucose-68* urean-33* creat-1.1 na-136 k-3.7 cl-96 hco3-31 angap-13 09:00am blood pt-26.3* ptt-43.1* inr(pt)-2.5* 11:00am blood wbc-12.1* rbc-3.45* hgb-10.3* hct-32.3* mcv-94 mch-29.8 mchc-31.8 rdw-14.9 plt ct-259 brief hospital course: the patient was brought to the operating room on where the patient underwent cabg x 1, avr, laa ligation with dr. . overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. 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. coumadin was resumed on pod 1 for atrial fibrillation. the patient was transferred to the telemetry floor for further recovery. chest tubes were discontinued without complication. ace inhibitor was added for hypertension but was stopped due to an elevated creatinine to 2.7. lasix was decreased and creatinine was 1.1 at the time of discharge. he developed heart block and was evaluated by the ep service. he was transferred back to cvicu. rhythm began to recover, and the patient progressed to junctional rhythm. he was transferred back to the telemetry floor and pacing wires discontinued. he began to have increased ectopy on pod 9 and lopressor was introduced at 12.5 mg , which the patient tolerated well. this was titrated up to 25 mg per ep recommendation. he was hemdynamically stable and asymptomatic with his rhythm and ectopy. he will follow up with ep in the next 1-2 weeks. he did have a small amount of serous drainage from his upper sternal pole. he was afebrile, wbc was stable at 12.1, and he had a stable sternum at the time of discharge. he will be brought back for a wound check in 5 days and instructed to call with any fever, chills, or increased drainage. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 10 the patient was ambulating with assistance and pain was controlled with oral analgesics. the patient was discharged home with physical therapy and visiting nurse services in good condition with appropriate follow up instructions. *of note, mediastinal lymphadenopathy was noted on pre-op chest ct. repeat chest ct is recommended in 3 months.* medications on admission: preadmission medications listed are correct and complete. information was obtained from webomr. 1. digoxin 0.25 mg po daily 2. gabapentin 300 mg po bid 3. gemfibrozil 600 mg po bid 4. glipizide 2.5 mg po bid 5. lorazepam 0.5 mg po hs:prn insomnia 6. metformin (glucophage) 500 mg po bid 7. potassium chloride 20 meq po bid 8. pravastatin 40 mg po daily 9. verapamil 240 mg po q24h 10. warfarin 5 mg po daily16 11. ascorbic acid 500 mg po daily 12. aspirin 81 mg po daily 13. zyrtec *nf* 10 mg oral daily 14. vitamin d 1000 unit po daily 15. centrum complete *nf* (multivitamin-iron-folic acid) 18-400 mg-mcg oral daily 16. super b complex + c *nf* (vitamin b comp & c no.4) 150 mg oral daily 17. vitamin e 400 unit po daily discharge medications: 1. aspirin 81 mg po daily 2. gabapentin 300 mg po bid 3. gemfibrozil 600 mg po bid 4. glipizide 2.5 mg po bid 5. potassium chloride 20 meq po daily 6. pravastatin 40 mg po daily 7. ascorbic acid 500 mg po daily 8. vitamin e 400 unit po daily 9. warfarin 5 mg po once duration: 1 doses rx *coumadin 2.5 mg tablet(s) by mouth daily disp #*60 tablet refills:*0 10. docusate sodium 100 mg po bid 11. furosemide 20 mg po daily rx *lasix 40 mg 1 tablet(s) by mouth daily disp #*7 tablet refills:*0 12. metoprolol tartrate 25 mg po bid hold for hr <55 or sbp <95 rx *metoprolol tartrate 25 mg 1 tablet(s) by mouth twice a day disp #*60 tablet refills:*0 13. pantoprazole 40 mg po q24h rx *pantoprazole 40 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 14. centrum complete *nf* (multivitamin-iron-folic acid) 18-400 mg-mcg oral daily 15. lorazepam 0.5 mg po hs:prn insomnia 16. metformin (glucophage) 500 mg po bid 17. super b complex + c *nf* (vitamin b comp & c no.4) 150 mg oral daily 18. vitamin d 1000 unit po daily 19. zyrtec *nf* 10 mg oral daily discharge disposition: extended care facility: tba discharge diagnosis: coronary artery disease hypertension hyperlipidemia aortic stenosis chronic atrial fibrillation on coumadin : prior cva in the setting of a subtheraputic inr (no residual) non insulin dependent diabetes peripheral neuropathy involving his feet right shoulder bursitis past surgical history: cholecystectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage edema: trace lower extremity 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** followup instructions: you are scheduled for the following appointments: wound check at cardiac surgery office 10:30 in the medical office building, , suite2a surgeon: dr. at 2:00p in the medical office building, , suite2a cardiogolist: dr. at at 9:20 am please call to schedule the following: primary care dr. , in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** *****chest ct in 3 months to follow-up mediastinal lymph node enlargement on pre-op ct***** md procedure: extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft other operations on heart and pericardium diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation aortic valve disorders mononeuritis of lower limb, unspecified other and unspecified hyperlipidemia atrioventricular block, complete unspecified disorder of kidney and ureter long-term (current) use of anticoagulants personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits other alteration of consciousness disorders of bursae and tendons in shoulder region, unspecified 

Answer: The patient is high likely exposed to