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 major surgical or invasive procedure: : mitral valve replacement, . medical mechanical valve. tricuspid valve repair with a 28 mm contour annuloplasty ring. history of present illness: 47 year old spanish speaking male who was admitted to an osh on with progressive dyspnea on exertion and lower extremity edema. clinically and radiographically he was treated for congestive heart failure with diuresis and bipap and admitted to the osh icu. he denies chest pain, palpitations or dizziness. cardiac echo was performed which revealed severe mitral stenosis. he was transferred to for evaluation of surgical correction. past medical history: rheumatic fever social history: last dental exam:upper dental implants-last saw dentist 2 yo lives with:mom,brother contact: phone # occupation:unemployed cigarettes: smoked no yes last cigarette -1 month ago hx: other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use family history: noncontributory physical exam: physical exam pulse: 90 resp:18 o2 sat: b/p right: left: 100% ra height:5'7" weight:66.7 kg general:a&ox3, nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade _sem 4/6_____ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema none _____ varicosities: none neuro: grossly intact pulses: femoral right: left: dp right:1+ left:1+ pt :1+ left:1+ radial right: left: carotid bruit -none right:2+ left:2+ pertinent results: 05:30am blood wbc-7.7 rbc-3.76* hgb-9.4* hct-28.8* mcv-77* mch-25.0* mchc-32.6 rdw-19.2* plt ct-362 04:55am blood wbc-10.2 rbc-4.11* hgb-10.1* hct-31.0* mcv-76* mch-24.6* mchc-32.6 rdw-19.2* plt ct-277 10:12am blood wbc-10.7 rbc-4.24* hgb-10.4* hct-32.2* mcv-76* mch-24.4* mchc-32.2 rdw-18.7* plt ct-216 05:30am blood pt-37.4* ptt-33.7 inr(pt)-3.8* 10:00pm blood pt-37.4* ptt-49.9* inr(pt)-3.8* 01:00pm blood pt-34.5* ptt-39.0* inr(pt)-3.4* 04:55am blood pt-31.6* ptt-31.6 inr(pt)-3.1* 02:44pm blood pt-27.5* ptt-54.8* inr(pt)-2.6* 04:55am blood pt-24.9* ptt-58.8* inr(pt)-2.4* 10:12am blood pt-18.2* ptt-31.2 inr(pt)-1.6* 04:28am blood pt-15.9* ptt-29.6 inr(pt)-1.4* 05:30am blood glucose-82 urean-14 creat-1.0 na-133 k-4.6 cl-95* hco3-28 angap-15 04:55am blood urean-16 creat-1.0 na-134 k-4.0 cl-96 04:55am blood glucose-131* urean-15 creat-0.9 na-135 k-4.0 cl-97 hco3-27 angap-15 10:12am blood glucose-147* urean-14 creat-0.9 na-134 k-4.1 cl-96 hco3-28 angap-1410/07/11 10:00am blood wbc-3.4* rbc-4.87 hgb-10.9* hct-35.9* mcv-74* mch-22.3* mchc-30.2* rdw-17.7* plt ct-287 10:00am blood pt-18.0* inr(pt)-1.6* 10:00am blood glucose-118* urean-28* creat-1.2 na-130* k-4.0 cl-94* hco3-26 angap-14 04:52pm blood alt-20 ast-28 ld(ldh)-378* alkphos-105 amylase-72 totbili-1.3 tte pre-bypass: the left atrium is dilated. mild spontaneous echo contrast is seen in the body of the left atrium. mild spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no thrombus is seen in the left atrial appendage. the right atrium is dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricular free wall is hypertrophied. the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque to 45 cm from the incisors. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve shows characteristic rheumatic deformity. there is severe valvular mitral stenosis (area <1.0cm2). severe (4+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. the tricuspid annulus is mildly dilated (4.1 mm). there is no pericardial effusion. post-bypass: the patient is a-paced. the patient is on no inotropes. there is a well-seated, well-functioning mechanical valve in the mitral position. there is no mitral stenosis. no mitral regurgitation is seen. no paravalvular leak is seen. bileaflet mechanical valve washing jets are present. there is a tricuspid annuloplasty ring in place. there is trace tricuspid regurgitation. there is no tricuspid stenosis (mean gradient of 2 mmhg). aortic regurgitation is unchanged. biventricular function is unchanged. the aorta is intact post-decannulation. brief hospital course: 47 year old spanish speaking male who was admitted to an osh on with progressive dyspnea on exertion,lower extremity edema, and was treated for congestive heart failure with diuresis and bipap. cardiac echo was performed which revealed severe mitral stenosis/ mitral regurgitation and pulmonary artery hypertension. mr. was transferred to for evaluation of surgical correction. cardiac cath was done and revealed no coronary disease. he was worked up for surgery and diuresed for several days. he was taken to the operating room on where he underwent mitral valve replacement, . medical mechanical valve and tricuspid valve repair with a 28 mm contour annuloplasty ring. see operative note for full details. he was brought out of the or on multiple vasoactive medications, including vasopressin and milrinone, with high pulmonary artery pressures initially. he was weaned from vasoactive medications and extubated on pod #2 without incidence. he was started on coumadin for mechanical valve and heparin was started on pod#3 until inr>3.5. pacing wires and chest tubes were removed per cardiac surgery protocol. he went into atrial fibrillation post op day 4 and converted to sinus rhythm on amiodarone. coreg and lisinopril were started for blood pressure control with low ef and these are to be titrated by outpatient cardiologist. he was ambulating without difficulty, tolerating a full oral diet and his incisions were healing well on pod#7. he was given prescriptions for free care medications and he is to have his inr checked at hospital with results called into the cardiac surgery office for coumadin dosing instructions until follow-up with his cardiologist on . his inr at discharge was 3.8. he was discharged home in stable condition. all follow up appointments were advised. medications on admission: none discharge medications: 1. outpatient work pt/inr as needed for coumadin dosing - results to cardiac surgery office phone # 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 6. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): take 400 mg x 1 week then 200 mg x 2 weeks then 200 mg daily x 1 month then as directed by cardiologist. disp:*100 tablet(s)* refills:*0* 7. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*100 tablet, delayed release (e.c.)(s)* refills:*0* 8. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 7 days. disp:*7 tablet(s)* refills:*0* 9. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po once a day for 7 days. disp:*7 tablet, er particles/crystals(s)* refills:*0* 10. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 11. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 12. coumadin 2 mg tablet sig: 1-2 tablets po once a day: take as directed for inr goal 3.5 for mech mvr/ atrial fibrillation. disp:*100 tablet(s)* refills:*0* 13. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever, pain. 14. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. disp:*30 suppository(s)* refills:*0* discharge disposition: home discharge diagnosis: severe mitral stenosis/mr/severe pa htn. rheumatic fever discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage leg 1+ edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 surgeon: dr on at 1:30pm wound check - at 10:45am cardiology - , md at 3 pm **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication mech mvr/ a fib goal inr 3.5 first draw at hospital results to phone cardiac surgery office until follow up with cardiologist # procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization insertion of endotracheal tube open and other replacement of mitral valve open heart valvuloplasty of tricuspid valve without replacement diagnoses: tobacco use disorder acute posthemorrhagic anemia cardiac complications, not elsewhere classified atrial fibrillation other chronic pulmonary heart diseases rheumatic heart failure (congestive) diseases of tricuspid valve rheumatic mitral insufficiency acute respiratory failure following trauma and surgery other secondary thrombocytopenia 

Answer: The patient is high likely exposed to