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: penicillins / yellow jackets attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: - mitral valve replacement (st. mechanical valve) history of present illness: 57 yo male who was found to have heart murmur. subsequent tte revealed mr/ms . htn, and a possible vegetation seen on anterior mv . tee then done. cath did not show cad. he does heavy physical labor and walks one mile daily with mild doe. past medical history: past medical history: mitral regurgitation mitral stenosis hyperlipidemia benign brain tumor ( resect. ) pneumothorax ( age 23) prior pneumonia tobacco abuse colon polyps hemorrhoids past surgical history: resect. brain tumor r ing. herniorrhaphy (childhood) social history: last dental exam: 1 yr ago lives with:alone (has a son) occupation:physical laborer tobacco:smokes one ppd currently x 30 yrs etoh:sober 5 years family history: non-contrib.; mother had cabg and cva at 85 physical exam: pulse:58 97% o2 sat b/p 116/75 height: 6'3" weight: 178 general:tall, thin, nad skin: dry intact heent: perrla eomi anicteric sclera;op unremarkable neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr irregular murmur- 2/6 sem radiates throughout chest to carotids abdomen: soft non-distended non-tender bowel sounds + ;no hsm extremities: warm , well-perfused edema-none varicosities: none neuro: grossly intact;mae strengths, nonfocal exam pulses: femoral right:2+ left: 2+ dp right:1+ left:1+ pt :1+ left:1+ radial right: 2+ left:2+ carotid bruit: murmur radiates bilat.carotids pertinent results: echo prebypass: the left atrium is moderately dilated. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending, transverse and descending thoracic aorta are normal in diameter and free of significant atherosclerotic plaque. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are severely thickened/deformed. the mitral valve shows characteristic rheumatic deformity. there is no pericardial effusion. mean mitral valve gradient was 13mm hg with mva of 1.2 by pht. severe mr is present. normal lv function with lvef > 55% postbypass: normal functioning mechanical bileaflet dilting disc valve. no significant mr. motion. no stenosis (gradient = 3 mmhg). normal lv systolic function with lvef > 55% and no significant wall motion abnormalities. 06:45am blood wbc-7.1 rbc-3.19* hgb-10.3* hct-29.4* mcv-92 mch-32.3* mchc-35.0 rdw-13.6 plt ct-258 06:00am blood wbc-8.5 rbc-3.05* hgb-10.1* hct-28.0* mcv-92 mch-33.2* mchc-36.1* rdw-13.7 plt ct-175 04:27am blood pt-32.2* inr(pt)-3.2* 01:17pm blood pt-26.0* inr(pt)-2.5* 03:19am blood pt-24.2* ptt-36.4* inr(pt)-2.3* 06:45am blood pt-19.7* ptt-29.6 inr(pt)-1.8* 06:00am blood pt-15.9* inr(pt)-1.4* 04:09am blood pt-14.1* ptt-27.9 inr(pt)-1.2* 02:37am blood pt-13.3 ptt-27.6 inr(pt)-1.1 11:45am blood pt-14.2* ptt-27.1 inr(pt)-1.2* 10:50am blood pt-14.7* ptt-26.7 inr(pt)-1.3* 04:27am blood urean-22* creat-1.1 na-134 k-4.6 cl-101 03:19am blood urean-17 creat-1.0 na-137 k-4.5 cl-100 06:45am blood glucose-102* urean-20 creat-1.1 na-137 k-4.8 cl-98 hco3-33* angap-11 04:27am blood mg-2.2 brief hospital course: mr. was admitted to the on for surgical management of his mitral valve disease. he was taken to the operating room where he underwent a mitral valve replacement using a st. mechanical valve. please see operative note for details. postoperatively he was taken to the intensive care unit for monitoring. over the next several hours, he awoke neurologically intact and extubated. he was started on beta blockade and amiodarone for atrial fibrillation. a heparin drip was started as a bridge to coumadin for his mechanical valve with a goal inr of 2.5-3.5. heparin was discontinued when his inr was therapuetic. he was in sinus rhythm on discharge. chest tubes and pacing wires were discontinued without complication. he was evaluated by physical therapy for strength and conditioning. he was slow to wean from oxygen therapy, but was stable on room air by discharge. on postoperative day 6 he was discharged to house in . medications on admission: none discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*75 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. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 5. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 6. warfarin 1 mg tablet sig: one (1) tablet po daily (daily): md to dose daily for goal inr 2.5-3.5 for mechanical mitral valve. disp:*60 tablet(s)* refills:*2* 7. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): 400mg x 1 week, then 400mg daily x 1 week, then 200mg daily until further instructed. 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 9. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). discharge disposition: extended care facility: house discharge diagnosis: past medical history: mitral regurgitation mitral stenosis hyperlipidemia benign brain tumor ( resect. ) pneumothorax ( age 23) prior pneumonia tobacco abuse colon polyps hemorrhoids past surgical history: resect. brain tumor ring herniorrhaphy (childhood) discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage no edema discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) 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 9am at cardiologist: dr. on at 1pm. please call to schedule appointments with your 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** labs: pt/inr for coumadin ?????? indication is mechanical mitral valve goal inr 2.5-3.5 first draw , then daily until inr consistently within stable range. will need coumadin follow up upon discharge from rehab. procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve diagnoses: acute posthemorrhagic anemia cardiac complications, not elsewhere classified atrial fibrillation other chronic pulmonary heart diseases personal history of tobacco use other and unspecified hyperlipidemia surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation mitral stenosis with insufficiency personal history of benign neoplasm of the brain 

Answer: The patient is high likely exposed to