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 / lipitor / toprol xl attending: chief complaint: chf/+ ett major surgical or invasive procedure: mvr(29mm st. bioprosthesis)/cabgx1(svg->rca) history of present illness: 54 year old man with chest pain earlier this year and admitted for chf in 5/. he subsequently underwent an ett which was positive for ischemia. he underwent a cardiac catheterization which revealed + mitral regurgitation and 2 vessel coronary artery disease. past medical history: 1) htn x 10-15 years 2) dyslipidemia 3) gout 4) possible past cocaine abuse 5) ef 50% 6) marajuana use daily 7) tobacco pack per day 20-30 years 8) geruen social history: he works as an electrical engineer for a software company. he is married with three children ages 35 to 16. he drinks one cup of coffee per day. he has used marijuana in the past and presently (~1 joint per day). he has used cocaine in the past and possibly presently. he does not take tea or alcohol. + tobacco ppd x 20-30 yrs family history: father died of mi in his late 40's, mother with unspecified " problem" physical exam: pe: 99.0, 76, 157/97, 24, 97% on 4l gen- lying in bed in nad, aaox3 neck- +jvd to angle of jaw at 30 degrees heent- eomi cv-rr, +ii/vi apical systolic murmur with axillary radiation. chest- bibasilar crackles abd- soft, nt/nd, +bs ext- no edema, +right toe red, warm, tender to touch neuro- cn 2-12 intact, moving all extremities. pertinent results: 11:10am blood wbc-11.1* rbc-2.61* hgb-8.1* hct-22.8* mcv-87 mch-31.0 mchc-35.5* rdw-14.3 plt ct-214# 11:10am blood plt ct-214# 11:10am blood glucose-64* urean-17 creat-0.9 na-141 k-4.6 cl-101 hco3-32 angap-13 cxr large postoperative cardiomediastinal silhouette is stable since the earliest films, postoperative films on . small right pleural effusion has decreased since . mild bibasilar atelectasis, right greater than left is probably not clinically significant. no pneumothorax or pulmonary edema. echo prebypass no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is an inferobasal/inferoseptal left ventricular aneurysm. there is moderate global left ventricular hypokinesis with above focal abnormalities. overall left ventricular systolic function is moderately depressed. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened(most at the distal anterior leaflet. there is moderate thickening of the mitral valve chordae. a very prominent chord attaches to the base of the anterior leaflet causing probable anterior leaflet retraction. the posterior leaflet appears retracted as well moderate to severe (3+) mitral regurgitation is seen. postbypass the patient is receivihng milrinone at 0.375 ucg/kg/min overall lv systolic function appears improved in the setting of inotropes. (lvef~45%) there is a well seated well functioning bioprosthesis in the mitral position. there is a mild perivalvular leak anteriorly located. the remaining study is unchanged compared to prebypass. brief hospital course: mr. was admitted to the on for surgical management of his coronary artery disease and mitral valve regurgitation. he was taken directly to the operating room where he underwent coronary artery bypass grafting to two vessels and a mitral valve replacement with a 29 mm biocor porcine valve. postoperatively he was taken to the cardiac intensive care unit for monitoring. by postoperative day one, mr. was awake, neurologically intact and extubated. gentle diuresis was initiated. aspirin was resumed. his blood pressure was slightly labile postoperatively which required pressors until postoperative day three. he was then transferred to the step down unit for further recovery. the physical therapy service was consulted for assistance with his postoperative strength and mobility. he developed some paroxysmal atrial fibrillation which responded to repleting his electrolytes. mr. complained of some left thigh numbness which was present prior to his surgery. the neurology service was consulted who suspected that his symptoms most likely represented meralgia paresthetic which is pressure or contraction of the cutaneous nerve at the thigh that is from either position, obesity or tight undergarments among other possibilities. it was felt that this would improve with mobility. mr. continued to make steady progress and was discharged home on postoperative day five. he will follow-up with dr. , his cardiologist and his primary care physician as an outpatient. medications on admission: aspirin 81mg qd lasix 80mg qd lisinopril 10mg qd digoxin 0.375mg qd allopurinol 100mg qd aldactone 12.5mg qd discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days. disp:*14 tablet(s)* refills:*0* 2. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours) for 7 days. disp:*28 capsule, sustained release(s)* refills:*0* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. ferrous sulfate 300 mg/5 ml liquid sig: five (5) ml po daily (daily) as needed. disp:*150 ml* refills:*0* 6. ascorbic acid 90 mg/ml drops sig: five (5) ml po twice a day as needed. disp:*300 ml* refills:*0* 7. hydromorphone 2 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 8. docusate sodium 150 mg/15 ml liquid sig: ten (10) ml po bid (2 times a day). disp:*600 ml* refills:*2* 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 10. polysaccharide iron complex 150 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 11. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 12. multivitamin capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 13. dilt-cd 180 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po once a day. disp:*30 capsule, sust. release 24hr(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: coronary artery disease mitral regurgitation discharge condition: good. discharge instructions: follow medications on discharge instructions. do not drive for 4 weeks. do not lift more than 10 lbs. for months. shower daily, let water flow over wounds, pat dry with a towel. do not use creams, lotions, or powders on wounds. call our office for temp>101.5, sternal drainage. followup instructions: make an appointment with dr. for 1-2 weeks. make an appointment with dr. for 4 weeks. procedure: extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open and other replacement of mitral valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation 

Answer: The patient is high likely exposed to