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: type a aortic dissection major surgical or invasive procedure: graft repair ascending dissection, aortic valve resuspension,vein graft to right coronary artery history of present illness: 57 year old white male presented to on with back and chest pain and shortness of breath. he was found to have a creatinine of 2.7 and no ct scan was done. he was treated for a pulmonary embolism. he was stable by report. a transthoracic echocardiogram the next morning demonstrated a flap in the aorta and he was transferred here as a type a dissection. past medical history: hypertension hyperlipidemia social history: nonsmoker, no etoh works as equity trader lives with his wife family history: mother died of cancer age 57 physical exam: admission: pe: mild distress bp 120's/60's hr 90's temp 98 cta b/l neuro: grossly intact, moves 4 ext. appropriate. l handed rrr abd: benign vasc: palp pulses everywhere b/l (radial, fem, d.p, pt) tee: no evidence of tamponade but + pericardial effusion wbc 20k, ht 40.3. k 5.3, cr 2.7. inr 1 ptt 52, trop 0.02 pertinent results: 11:00am blood wbc-14.8* rbc-3.02* hgb-9.1* hct-28.0* mcv-93 mch-30.0 mchc-32.3 rdw-15.9* plt ct-310 05:42am blood wbc-20.2* rbc-4.40* hgb-13.9* hct-40.3 mcv-92 mch-31.6 mchc-34.5 rdw-13.2 plt ct-275 11:00am blood plt ct-310 11:00am blood pt-17.9* inr(pt)-1.6* 05:42am blood pt-11.8 ptt-52.5* inr(pt)-1.0 05:42am blood plt ct-275 11:00am blood glucose-130* urean-22* creat-1.2 na-138 k-3.9 cl-99 hco3-33* angap-10 05:42am blood glucose-153* urean-32* creat-2.7* na-142 k-5.3* cl-102 hco3-25 angap-20 11:00am blood mg-2.1 , fa6a 2:53 pm chest (pa & lat) clip # reason: f/u rt pneumothorax medical condition: 57 year old man with type a repair reason for this examination: f/u rt pneumothorax provisional findings impression: sp tue 5:05 pm right-sided apical pneumothorax absorbed. no new pulmonary abnormalities. observed that mediastinal prominence still remains. final report type of examination: chest pa and lateral. indication: followup of small right-sided pneumothorax. status post type-a aortic dissection repair. findings: pa and lateral chest view were obtained with patient in upright position. available for comparison is the next previous ap single chest view of . previously described right internal jugular approach central venous line remains in unchanged position. the previous small right- sided apical pneumothorax cannot be identified any more. status post sternotomy is unchanged. also still present is the mediastinal widening with aortic ascending contour still prominent as it was prior to the operation. it is, however, slightly less marked in comparison with the pre-operative chest findings of . the lateral view discloses a mild degree of displacement of the subepicardial fat line, consistent with some remaining pericardial effusion. this finding existed already on the first pre-operative study. the mild degree of posterior pleural sinus blunting is postoperative as it was not present on the initial study. no new pulmonary infiltrates or atelectasis are seen. impression: status post sternotomy and aortic dissection repair. remaining upper mediastinal prominence compatible with non-evacuated extra-aortic hematoma. compare with events described in o.r. report. dr. approved: tue 5:27 pm echocardiography report , (complete) done at 1:29:50 pm final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 57 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: aortic dissection. aortic valve disease. left ventricular function. mitral valve disease. pericardial effusion. right ventricular function. valvular heart disease. icd-9 codes: 786.51, 440.0, 441.00, 423.3 test information date/time: at 13:29 interpret md: , md test type: tee (complete) 3d imaging. son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw04-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: 4.0 cm <= 4.0 cm left ventricle - ejection fraction: 50% to 55% >= 55% aorta - annulus: 2.0 cm <= 3.0 cm aorta - sinus level: 3.3 cm <= 3.6 cm aorta - ascending: *4.1 cm <= 3.4 cm findings emergency tee for rule out dissection. large sized pericardial effusion with echocardiographic signs of tamponade. echocardiographic guidance provided for placement of femorally placed arteraila nd venous access cannulae multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: normal la size. no spontaneous echo contrast or thrombus in the body of the laa. all four pulmonary veins not identified. right atrium/interatrial septum: normal ra size. a catheter or pacing wire is seen in the ra. no asd by 2d or color doppler. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness and cavity size. right ventricle: mildly dilated rv cavity. borderline normal rv systolic function. aorta: normal aortic diameter at the sinus level. moderately dilated ascending aorta. simple atheroma in ascending aorta. ascending aortic intimal flap/dissection.. aortic arch intimal flap/dissection. descending aorta intimal flap/aortic dissection. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets (3). no as. trace ar. mitral valve: mildly thickened mitral valve leaflets. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: moderate to large pericardial effusion. effusion circumferential. rv diastolic collapse, c/w impaired fillling/tamponade physiology. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-bypass: the left atrium is normal in size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. the right ventricular cavity is mildly dilated with borderline normal free wall function. the ascending aorta is moderately dilated. there are simple atheroma in the ascending aorta. a mobile density is seen in the ascending aorta consistent with an intimal flap/aortic dissection. a mobile density is seen in the aortic arch consistent with an intimal flap/aortic dissection. a mobile density is seen in the descending aorta consistent with an intimal flap/aortic dissection. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is a moderate to large sized pericardial effusion. the effusion appears circumferential. there is right ventricular diastolic collapse, consistent with impaired fillling/tamponade physiology. post cpb: 1. preserved lv systolci function 2. imorioved global rv systolci function. 3. a tube graft in ascending aortic position identified. 4. trace a!. 5. no other change in valvular structure and function electronically signed by , md, interpreting physician 15:19 brief hospital course: in the ed a transesophageal echo revealed a type a dissection with pericardial effusion and cardiac compression. he was taken emergently to the operating room for surgical repair. see operative report for further details. he was transferred to the intensive care unit for hemodynamic monitoring. he required pressors but they were weaned off. he awoke intact and was extubated the following morning, having been kept intubated overnight due to some difficulty intubating him. his urine output was adequate and his renal numbers improved. beta blockade was begun and ace inhibitor resumed to control his hypertension. he developed rapid atrial fibrillation and amiodarone was given with conversion to sinus rhythm. he continued to have intermittent episodes of atrial fibrillation and coumadin was started for anticoagulation. physical therapy worked with him on strength and mobility. ultrasound of right arm due to edema revealed non occlusive venous clot, continues on coumadin. he was ready for discharge home on . medications on admission: lisinopril 20mg lipitor 10 mg daily asa 81 mg daily discharge medications: 1. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): take 1 tablet twice a day then decrease to 1 tablet daily on and follow up with cardiologist . disp:*67 tablet(s)* refills:*0* 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day for 1 months. disp:*30 tablet(s)* refills:*0* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for severe pain. disp:*60 tablet(s)* refills:*0* 5. lisinopril 20 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*0* 6. atorvastatin 10 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 7. outpatient work pt/inr for coumadin dosing indication atrial fibrillation goal inr 2.0-2.5 results to dr ( fax attn - first draw 8. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). disp:*270 tablet(s)* refills:*0* 9. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 5 days. disp:*5 tablet(s)* refills:*0* 10. warfarin 2 mg tablet sig: goal inr 2.0-2.5 tablets po once a day: take 2mg on then draw for further dosing - dose to adjust based on inr results . disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: type a aortic dissection acute renal failure on admission hypertension hyperlipidemia discharge condition: good discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming monitor wounds for infection and report any redness, warmth, swelling, tenderness or drainage please take temperature each evening and report any fever 100.5 or greater report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month until follow up with surgeon no lifting more than 10 pounds for 10 weeks monitor right arm please call for increase edema or pain, please elevate at or above heart level please call with any questions or concerns followup instructions: dr. in weeks please call to schedule wound check at 2pm 6 , md phone: date/time: 1:00 labs: pt/inr for coumadin dosing indication atrial fibrillation goal inr 2.0-2.5 results to dr ( fax attn - first draw ct scan chest in three months - please arrange at follow up visit with dr md procedure: extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery resection of vessel with replacement, thoracic vessels open heart valvuloplasty of aortic valve without replacement diagnoses: unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation other and unspecified hyperlipidemia dissection of aorta, thoracic cardiac tamponade acute venous embolism and thrombosis of upper extremity, unspecified coronary artery anomaly 

Answer: The patient is high likely exposed to