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: past medical history: 1. hypertension. 2. hypercholesterolemia. 3. rheumatoid arthritis. 4. history of bacterial endocarditis. 5. mitral valve prolapse. 6. recent onset of atrial flutter. preoperative medications: 1. sulindac. 2. plaquenil. 3. arrova. 4. prednisone prn. 5. lipitor. 6. lasix. 7. toprol xl. 8. lisinopril. 9. amiodarone. allergies: penicillin and sulfa, both of which cause rash. preoperative physical examination: this is a well-nourished and well-developed male in no apparent distress, appears slightly younger than stated age. skin is without rashes or lesions. heent: pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. normal mucosa, normal dentition. neck is supple without jugular venous distention. no thyromegaly. chest was clear to auscultation bilaterally, no wheezes, rales, or rhonchi. heart is regular, rate, and rhythm, s1, s2 with 3/6 systolic murmur heard best at apex, no rubs. abdomen is soft, nontender, nondistended, no guarding, rebound, or rigidity. extremities are warm, no edema, no cyanosis. cranial nerves ii through xii are grossly intact. no motor or sensory deficits. ho course: the patient was admitted to on for a minimally invasive mitral valve replacement with dr. . patient had a 33 mm mosaic porcine valve placed through a minimally invasive surgery. patient tolerated the procedure well. please see operative note for further details. the patient was transferred to the intensive care unit on a neo-synephrine drip. patient was weaned the next day from mechanical ventilation on his first postoperative evening. the neo-synephrine was weaned. in the afternoon of postoperative day #1, the patient converted from sinus rhythm to atrial flutter, which he tolerated well. patient's chest tubes were removed without incident. patient was transferred from the intensive care unit to the regular floor on postoperative day #2. on postoperative day #3, the patient ambulated with physical therapy and was able to walk 500 feet and climb one flight of stairs, was cleared for discharge to home from a physical therapy standpoint. on postoperative day #3, the electrophysiology service was consulted for patient's atrial flutter. their recommendation was for the patient to be taken to the catheterization laboratory for a flutter ablation and cardioversion. patient was on heparin infusion at this time for anticoagulation. the patient was taken to the catheterization laboratory on postoperative day #4, where he underwent a-flutter ablation and conversion into sinus rhythm with first degree a-v block. the patient tolerated the procedure well. the electrophysiology service recommended discontinuing the patient's amiodarone after the flutter ablation due to his age, they felt that it would be better if the patient were on an anti-arrhythmic with fewer long-term side-effects. however, since the patient's electrocardiogram at that time showed sinus rhythm, first degree a-v block with a right bundle branch block plus or minus a left anterior fascicular block, it was decided that patient would not be placed on any anti-arrhythmics at this time and will follow up with his cardiologist, dr. in one month for further monitoring of his rhythm and further decisions about his rhythm would be made by dr. . it is also recommended that if the patient required further anti-arrhythmic therapy, the patient should be considered for a permanent pacer for his a-v node conduction delay. the patient was restarted on heparin and coumadin was begun for anticoagulation. by postoperative day #8, patient's inr was therapeutic at 2.2, and the patient was cleared for discharge to home. condition on discharge: pulse 82 sinus rhythm with first degree a-v block, blood pressure 100/64, respiratory rate 14 and on room air oxygen saturation 96%. neurologically, the patient is alert, awake, oriented x3. heart is regular, rate, and rhythm without murmur or rub. lungs are clear bilaterally without wheezes, rales, or rhonchi. abdomen is soft, nontender, nondistended. patient is tolerating a regular diet. the incision in his right chest is clean and dry without erythema. the steri-strips are intact. laboratory data: white blood cell count 7.4, hematocrit 31.4, platelet count 319. sodium 143, potassium 4.2, chloride 109, bicarb 27, bun 16, creatinine 1.0, glucose 88. pt 18.2, inr of 2.2. patient has no peripheral edema. discharge diagnoses: 1. status post minimally invasive mitral valve replacement with a 33 mm mosaic valve. 2. postoperative atrial fibrillation/atrial flutter. 3. status post atrial flutter/ablation. discharge medications: 1. colace 100 mg po bid. 2. zantac 150 mg po bid. 3. aspirin 81 mg po q day. 4. percocet 5/325 1-2 tablets po q4h prn. 5. lipitor 20 mg po q day. 6. coumadin 2.5 mg po on and . instructions: the patient is to followup with dr. clinic on for pt/inr and further coumadin dosing. the patient is not being discharged home on any beta blockers or anti-arrhythmics. patient is to followup with dr. in two weeks, and at that time patient will be evaluated for initiation of this therapy. condition on discharge: good. fo: the patient is to followup with dr. clinic on at 11 am. patient is to followup with dr. in two weeks, and the patient is to followup with dr. in one month. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach open and other replacement of mitral valve with tissue graft monitoring of cardiac output by other technique cardiac mapping diagnoses: mitral valve disorders unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation other chronic pulmonary heart diseases atrial flutter 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 rheumatoid arthritis first degree atrioventricular block 

Answer: The patient is high likely exposed to