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: the patient is a 74 year old male with known aortic stenosis who came in to the cardiac catheterization laboratory for evaluation. he had eight to nine years of intermittent chest pain and ruled out for myocardial infarction in . he has had symptoms of shortness of breath and palpitations and diagnosed with atrial fibrillation. he had been cardioverted in the past and was managed on coumadin. he was found to have aortic stenosis at that time which was watched carefully. his ejection fraction was normal, however, his pa pressures were elevated and he was found to have severe tricuspid regurgitation as well. he denied any claudications or shortness of breath symptoms at time of presentation, paroxysmal nocturnal dyspnea or lightheadedness. past medical history: 1. aortic stenosis. 2. atrial fibrillation. 3. b12 deficient anemia. 4. hypothyroidism. 5. lower gastrointestinal bleed while on coumadin requiring six units, which spontaneously resolved. 6. hypertension. 7. osteoarthritis. past surgical history: 1. incarcerated hernia. 2. partial colectomy for a small bowel obstruction. allergies: he had no known drug allergies. medications on admission: 1. lopressor 25 mg p.o. three times a day. 2. lasix 40 mg p.o. q. day. 3. levoxyl 0.1 mg q. day. 4. iron three times a day. 5. coumadin 7.5 on sunday, tuesday and thursday; 10 mg on all other days. 6. metamucil. 7. calcium 600 mg p.o. twice a day. 8. multivitamin. physical examination: on physical the patient is afebrile and vital signs are stable. he had a regular rate and rhythm with a iv/vi systolic ejection murmur in the right upper sternal border radiating into the carotids. his lungs were clear to auscultation bilaterally. his abdomen was soft, nontender, nondistended, bowel sounds present. his extremities are warm and well perfused with trace edema. hospital course: the patient was taken to the cardiac catheterization laboratory where the aortic stenosis was evaluated. he was found to have clear coronaries at that time and ct surgery was consulted. at the time of consultation, his white blood cell count was 4.5, hematocrit of 32.3, platelet count of 229. his pt was 13.5, ptt of 26.4, inr of 1.3. sodium 145, potassium 4.8, chloride 111, bicarbonate of 26, bun of 20 and creatinine of 1.0. he had a blood sugar of 93. a dental consultation was taken at that time and he had teeth removal on the 18th and due to that, the operation was cancelled. however, he was rescheduled for the operation and was taken to the operating room on , where an avr pericardial valve was done. the patient was transferred to the csru postoperatively. he did well and was able to be weaned and extubated and he continued to improve. on , he was transferred to the floor. he did well on the floor and physical therapy was consulted to assess his ambulation. he did well with physical therapy, however, due to his age and lack of endurance, it was felt that he would do best with rehabilitation placement. on postoperative day number two, his chest tubes were removed, his wires were removed and his foley was removed. the patient continued to improve on the floor and is currently awaiting rehabilitation placement. discharge medications: 1. oxazepam 15 to 30 mg p.o. q. h.s. p.r.n. 2. percocet one to two tablets p.o. q. four hours p.r.n. 3. motrin 400 mg p.o. q. six hours p.r.n. 4. enteric-coated aspirin 325 mg p.o. q. day. 5. zantac 150 mg p.o. twice a day. 6. lasix 40 mg p.o. twice a day. 7. lopressor 25 mg p.o. twice a day. 8. synthroid 0.1 mg p.o. q. day. 9. calcium 600 mg p.o. twice a day. 10. 20 meq p.o. twice a day. discharge diagnoses: 1. aortic stenosis status post aortic valve replacement. 2. atrial fibrillation. 3. b12 deficient anemia. 4. hypothyroidism. 5. lower gastrointestinal bleed. 6. hypertension. 7. osteoarthritis. 8. status post incarcerated hernia. 9. status post small bowel obstruction. disposition: the patient is discharged to rehabilitation in stable condition. anticipated date of discharge is . condition on discharge: stable die instructions: 1. the patient is instructed to follow-up with dr. in four weeks. 2. the patient is instructed to follow-up with his primary care physician in one to two weeks. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures open and other replacement of aortic valve extraction of other tooth diagnoses: unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation aortic valve disorders other chronic pulmonary heart diseases osteoarthrosis, unspecified whether generalized or localized, site unspecified other vitamin b12 deficiency anemia dental caries, unspecified 

Answer: The patient is high likely exposed to