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: procainamide / flomax / uroxatral attending: chief complaint: fatigue, dyspnea major surgical or invasive procedure: cardiac catheterization coronary artery bypass graft times two and aortic valve replacement with a 27mm mosaic porcine valve history of present illness: this 87 year old gentleman has a history significant for aortic stenosis, tachy-brady syndrome s/p pacemaker and paroxysmal atrial fibrillation. recently, he has been experiencing shortness of breath with minimal exertion and also reports intermittent chest pressure that occurs unrelated to activity. he had a fall in his basement last week. he denies having syncope and states he tripped. he denies loc. he denies any dizziness or lightheadedness at all. he has chronic right foot edema after knee replacement surgery. he denies any pnd or orthopnea andstates he sleeps very well. he sleeps in a recliner due tochronic back pain. he denies any claudication symptoms. hereports frequent skin tears and currently has one on his right lower leg and left forearm. due to concern about these symptoms, the patient was seen by his pcp and an echo was done on . this report is not presently available, however it reportedly revealed worsening aortic stenosis. the patient was referred for catheterization to further evaluate need for avr and possbly cabg. on patient cardiac cath which revealed a tight stenosis in lcx and rca. it was therefore decided that he would undergo both cabg for his cad as well as avr for his severe as complicated by chf. past medical history: prostate cancer diagnosed 7 months ago, treated conservatively turp 21 years ago for bph aortic stenosis atrial fibrillation pacemaker chronic back pain s/p remote spinal fusion surgery breast tumor removed at age 15 bilateral hernia repairs rectal surgery x 4 for fissures and hemorrhoids total knee replacement- right appendectomy age 13 elbow surgery s/p cardiac catheterization approx 13 years ago with clean coronaries essential tremor of unknown origin hypothyroid cardiac risk factors: diabetes(-), dyslipidemia(+), hypertension(+) pacemaker/icd for af/tachy-brady syndrome social history: social history is significant for the 3ppd x 20yrs quit 47 years ago. there is no history of alcohol abuse. married, patient??????s wife and daughter will accompany pt to procedure and then return home. they would like to be called post procedure and can be reached at or cell # . family history: both parents died at age 76-mother died from a stroke, father died following a stroke from complications from carotid artery surgery. father had an mi at age 60. brother died from suicide. another brother died from pancreatic cancer. physical exam: vs - t 96.6 hr 60s bps 130s-160s/40s-60s rr18 o2sat 98ra gen: wdwn elderly male in nad. heent: ncat. sclera anicteric. conjunctiva were pink. mmm neck: supple with no jvd. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. soft systolic murmur at rusb radiating to carotids no thrills, lifts. no s3 or s4. chest: ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. groin site without hematoma, dressing c/d/i. no bruit. ext: edema to ankles bilaterally r>l. neg homans signs skin: stasis dermatitis bilaterally, no ulcers. pulses: right: femoral 2+ dp 2+ pt 2+ left: dp 2+ pt 2+ pertinent results: 09:15am glucose-150* urea n-27* creat-1.4* sodium-137 potassium-3.5 chloride-100 total co2-28 anion gap-13 09:15am alt(sgpt)-10 ast(sgot)-16 alk phos-119* amylase-54 tot bili-0.5 dir bili-0.1 indir bil-0.4 09:15am albumin-3.8 09:15am %hba1c-5.4 09:15am wbc-5.1 rbc-3.07* hgb-9.8* hct-29.0* mcv-94 mch-31.9 mchc-33.8 rdw-14.6 09:15am neuts-78.5* lymphs-14.1* monos-4.4 eos-2.7 basos-0.2 09:15am plt count-144* 08:56am type-art po2-114* pco2-44 ph-7.44 total co2-31* base xs-5 intubated-not intuba 08:56am hgb-12.2* calchct-37 o2 sat-98 08:00am inr(pt)-0.9 05:16am blood wbc-8.8 rbc-3.07* hgb-9.8* hct-27.8* mcv-91 mch-32.0 mchc-35.4* rdw-16.6* plt ct-91* 05:16am blood pt-15.5* inr(pt)-1.4* 05:16am blood glucose-106* urean-26* creat-1.0 na-139 k-3.3 cl-104 hco3-28 angap-10 brief hospital course: a cardiac catheterization was performed on which demonstrated two vessel coronary artery disease. on carotids were performed and revealed less than 40% stenosis on the right and 70-79% on the left. dental clearance was obtained. he was seen by podiatry for right 2nd digit pain and an abscess was drained at bedside. he was seen by speech and swallow and found to have mild dysphagia. he was seen by wound care for a right lower leg ulcer which has been healing poorly. adaptic was recommended to be placed on the wound. he was placed on kefzol for thrombophlebitis on his right upper extremity. on mr. a coronary artery bypass grafting times two and an aortic valve replacement with a 27mm mosaic porcine valve. he tolerated the procedure well and was transferred in critical but stable condition to the surgical intensive care unit. mr. was weaned from the ventilator and extubated without difficulty. his pacing wires were removed on pod#2 since he has his own internal pacer. he was transferred from the icu to the floor on pod#2. he was started on coumadin for baseline atrial fibrillation which he was in prior to surgery and betablocker and diuretics. his platelet count was noted to be steadily declining. his medications were reviewed and zantac d/c'd. a hit panel was negative. his chest tubes were removed on pod#3. hematocrit and platelets are recovering. mr. was evaluated by physical therapy and rehab was recomended. the patient was found stable for discharge to rehab on pod 5. medications on admission: slow k 600mg 1 capsule warfarin 5mg/7.5mg mwf, last dose monday amiodarone 200mg daily amlodipine 5mg daily primidone 50mg daily lasix 20mg, 3 tablets daily docusate sodium 100mg erythromycin ophthalmic ointment daily for dry eye synthroid 0.125mg daily konsyl otc for fiber 6 grams daily with juice aspirin 81mg daily discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). tablet, delayed release (e.c.)(s) 2. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 3. erythromycin 5 mg/g ointment sig: one (1) ophthalmic daily (daily). 4. docusate sodium 50 mg/5 ml liquid sig: two (2) po bid (2 times a day). 5. primidone 50 mg tablet sig: one (1) tablet po daily (daily). 6. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 8. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 10. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 11. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 12. warfarin 5 mg tablet sig: one (1) tablet po once a day: dose will change daily for goal inr , dx: a-fib. 13. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 14. potassium & sodium phosphates 280-160-250 mg powder in packet sig: one (1) powder in packet po tid (3 times a day) for 2 days: through . 15. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 16. furosemide 40 mg iv q12h 17. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours). discharge disposition: extended care facility: tba discharge diagnosis: two vessel coronary artery disease severe aortic stenosis hypertension hypercholesterolemia prostate cancer tachy-brady syndrome atrial fibrillation chronic back pain essential tremor of unknown origin hypothyroidism s/p fall last week (no syncope) s/p rectal surgery for fissures s/p appendectomy s/p permanent pacemaker s/p right total knee replacement s/p transurethral resection of prostate s/p bilateral elbow surgery s/p spinal fusion in s/p breast tumor removed age 15 s/p hernia repairs s/p bilateral cataract surgery discharge condition: good discharge instructions: you were admitted to the hospital with fatigue and an abnormal valve in your heart. you had a catheterization to evaluate the valve and this showed some coronary artery disease as well. you were having trouble swallowing. you had some tests that show that the muscles that help you swallow are very tight which is causing your trouble swallowing. you were given instructions for how to swallow and should follow them at home. you should crush your medications to take them. you may at some point want to have surgery for this and your primary care doctor can help you arrange this. please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 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 no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr in 4 weeks () please call for appointment dr in 1 week ( please call for appointment dr in weeks ( please call for appointment wound check appointment 2 as instructed by nurse () md procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries open and other replacement of aortic valve with tissue graft right heart cardiac catheterization debridement of nail, nail bed, or nail fold artificial pacemaker rate check diagnoses: other iatrogenic hypotension other chronic pain coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism atrial fibrillation personal history of malignant neoplasm of prostate aortic valve disorders other acquired absence of organ long-term (current) use of anticoagulants cardiac pacemaker in situ sinoatrial node dysfunction knee joint replacement arthrodesis status history of fall essential and other specified forms of tremor dermatophytosis of nail 

Answer: The patient is high likely exposed to