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: phenergan attending: chief complaint: left adrenal pheochromocytoma. major surgical or invasive procedure: left adrenalectomy. history of present illness: the patient is a 54-year-old man with a previous somewhat complicated medical history significant for placement of a mechanical mitral valve approximately 15 years ago. the patient is on coumadin for this valve prosthesis since then. in addition,the patient has atrial fibrillation and occasional supraventricular tachycardia which are additional indications for his coumadin treatment.on a recent abdominal ct scan, the incidental finding of an approximately 4.5 cm left adrenal mass was found.this prompted an endocrinological workup providing evidence of pheochromocytoma with elevated both plasma and urinary catecholamines.the patient has now been appropriately alpha blocked for approximately 2 weeks with the most recent dose of phenoxybenzamine being 30 mg b.i.d. the patient has been admitted to the hospital a couple of days before surgery to be bridged with heparin drip considering his mitral valve prosthesis and after having stopped his coumadin about 5 days ago.the patient is scheduled to undergo a left adrenalectomy today.risks and benefits associated with procedure have been discussed in great detail and the consent form has been signed. past medical history: - hyperlipidemia - hypertension (patient and wife both deny this history) - history of atrial fibrillation/flutter s/p dccv () and ablation () - history of prostatitis - herpes simplex i (takes valtrex prn) - hemorrhoids psh: - reveal device implant - cardiac ablation () - s/p mechanical st. mitral valve replacement in - s/p left knee surgery - umbilical hernia repair - lipoma removal, right shoulder social history: married, lives at home with his wife. is employed as a facilities manager. -tobacco history: none -etoh: none -illicit drugs: none family history: mother - htn, dm, arthritis, . father had quadruple cabg and deceased cancer. brother - htn, hyperlipidemia, sister - thyroid abnormalities. no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: vitals:98.6,77, 110/69,18, 98% ra general-nad,alert,oriented respiratory:clear cardiac:rrr,audible s1s2 with mechanical click over left lateral cardiac border abdomen:soft,nontender,non-distended incision: left abdominal incision c/d/i, no erythema extremities:warm,well,perfused, no c/c/e pertinent results: 05:00am blood wbc-10.0 rbc-3.39* hgb-10.3* hct-30.3* mcv-90 mch-30.4 mchc-33.9 rdw-13.6 plt ct-107* 05:30pm blood wbc-11.6* rbc-3.70* hgb-11.4* hct-33.1* mcv-90 mch-30.8 mchc-34.4 rdw-14.2 plt ct-130* 03:40am blood wbc-10.0 rbc-3.43* hgb-10.6* hct-30.3* mcv-89 mch-31.1 mchc-35.1* rdw-13.5 plt ct-117* 02:08pm blood hct-35.3* 02:35pm blood wbc-10.9 rbc-3.83* hgb-11.6* hct-33.9* mcv-89 mch-30.4 mchc-34.3 rdw-14.3 plt ct-139* 07:05am blood wbc-7.7 rbc-4.32* hgb-13.1* hct-38.7* mcv-90 mch-30.3 mchc-33.9 rdw-13.7 plt ct-152 05:00am blood pt-24.8* ptt-69.5* inr(pt)-2.4* brief hospital course: icu course: patient was admitted to the icu for hemodynamic monitoring post-operatively. he was continued on a beta blocker with metoprolol 5 mg iv q6h. remained hemodynamically stable, and did not require any nitroprusside or phenylephrine to maintain bp in target range of maps 60-100. his fsbs were monitored, and he did not develop hypoglycemia. post-op pain was controlled with a dilaudid pca. on pod #1, plan was to restart warfarin. plan also to restart heparin gtt 36 hours post-op.once patient was hemodynamically stable he was transferred to the floor. pod 1. patient was restarted on anticoagulation therapy; heparin drip and coumadin. ptt/inr levels were monitored closely .patient was started on clear sips to clear liquids. patient had decrease oral intake due to nausea and required several doses of iv zofran. his foley catheter was discontinued however he had postoperative urinary retention and required replacement of foley catheter. flomax was also started due to his history of bph. pod 2, patient was noted to be mildly hypotensive with sbp 90's.his metoprolol was briefly titrated down due to his soft blood pressures. patient subsequently reported nausea and migraine headache, and sbp 130. of note reported mild left sided tenderness likely muscular. ekg was performed and there were no cardiac changes. he was also started on morphine pca and tylenol atc for pain control. in addition,he was switched back to his home dose metoprolol tartrate 100 mg per his cardiologist reccomendations.of note he also received an additional dose of metoprolol to normalize his blood pressure to his baseline. by pod 3, patient was subjectively feeling better,and had no headaches. his nausea had markedly improved and he was advanced brat to regular diet which was tolerated well. his pca was discontinued and he was started on oral pain medication. his foley catheter was also discontinued and he subsequently voided. patient will continue on flomax for a total of five days.ptt level was therapeutic and his heparin drip was discontinued. inr was sub therapeutic and his coumadin was dosed appropriately. patient will have his inr level monitored closely and dosed by his cardiologist/pcp (dr.). pod 4: patient was tolerating a regular diet. he was passing flatus and having bowel movements. his pain was well controlled with oxycodone 5 mg po q 4 prn pain. his am inr was 3.2. he was ambulating and feeling well reporting no nausea. patient was instructed prior to discharge to return to on saturday to have his inr and pt drawn for monitoring. he was told to return to his home coumadin regimen. patient was voiding appropriately and was instructed to continue taking flomax at home until . finally patient was instructed to followup with his cardiologist regarding coumadin management as an outpatient. patient received postoperative discharge teaching and follow-up instructions. patient was discharged home in good condition.patient and will follow-up with dr. for his post operative appointment. medications on admission: metoprolol tartrate 100 mg po bid, dibenzyline 30 mg po bid, simvastatin 20mg po qd, coumadin 6 mg (,tu,w,f,sa), coumadin 9 mg (m,thurs) discharge medications: 1. acetaminophen 1000 mg po q6h 2. docusate sodium 100 mg po bid rx *docusate sodium 100 mg 1 capsule(s) by mouth twice a day disp #*60 capsule refills:*0 rx *docusate sodium 100 mg 1 tablet(s) by mouth every 12 hours disp #*14 tablet refills:*0 3. metoprolol tartrate 100 mg po bid hold for sbp < 90/60 or hr < 50 4. oxycodone (immediate release) 5 mg po q4h:prn pain rx *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours disp #*40 tablet refills:*0 5. senna 1 tab po bid:prn constipation rx *sennosides 8.6 mg 1 tablet by mouth twice a day disp #*60 tablet refills:*0 6. simvastatin 20 mg po daily 7. tamsulosin 0.4 mg po daily rx *tamsulosin 0.4 mg 1 capsule(s) by mouth once a day disp #*3 capsule refills:*0 8. warfarin 6 mg po daily16 coumadin 6mg (,tu,w,f,sa), 9. warfarin 9 mg po daily16 coumadin 9mg (m,thurs) 10. laboratory please have pt and inr drawn on in the am. please fax results to , md fax: . discharge disposition: home discharge diagnosis: left adrenal pheochromocytoma. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you have tolerated a regular diet, passing gas and your pain is controlled with pain medications by mouth. you may return home to finish your recovery. following your surgery your coumadin (blood thinner) was restarted and your inr level were monitored closely. please have your inr level checked frequently and follow-up with your pcp/cardiologist for coumadin dosing. you will be prescribed a small amount of the pain medication please take this medication exactly as prescribed. you may take tylenol as recommended for pain. please do not take more than 4000 mg of tylenol daily. do not drink alcohol while taking narcotic pain medication or tylenol. please do not drive a car while taking narcotic pain medication. continue taking stool softeners while taking narcotic medications. please monitor your incision for signs of infection. if you have sutures/staples it will stay in place until your first post-operative visit at which time they can be removed in the clinic. please monitor the incision for signs and symptoms of infection including:increasing redness at the incision, opening of the incision, increased pain at the incision line, draining of white/green/yellow/foul smelling drainage, or if you develop a fever. please call the office if you develop these symptoms or go to the emergency room if the symptoms are severe. you may shower, let the warm water run over the incision line and pat the area dry with a towel, do not rub. continue to walk several times a day.you may gradually increase your activity as tolerated but clear heavy excercise with your surgeon. no heavy lifting for at least 6 weeks after surgery unless instructed otherwise by your surgeon. if you have any questions or concerns please call the office. thank you for allowing us to participate in your care! our hope is that you will have a quick return to your life and usual activities. good luck! note you are to return to laboratory on to have your pt and inr drawn so that we can monitor your coumadin level appropriately. note you experienced difficulty voiding after having the foley removed and were started on flomax. you are to continue taking this medication until . follow up with your cardiologist regarding your coumadin levels and monitoring your ventricular ectopy. followup instructions: follow-up with dr. department: surgical specialties when: friday at 10:00 am building: campus: east best parking: garage md, procedure: other partial adrenalectomy unspecified instrumental delivery diagnoses: thrombocytopenia, unspecified unspecified essential hypertension atrial fibrillation atrial flutter paroxysmal ventricular tachycardia other and unspecified hyperlipidemia heart valve replaced by other means hypotension, unspecified other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants retention of urine, unspecified nausea alone urinary complications, not elsewhere classified myalgia and myositis, unspecified migraine, unspecified, without mention of intractable migraine without mention of status migrainosus benign neoplasm of adrenal gland 

Answer: The patient is high likely exposed to