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: lipitor / lovastatin / furosemide attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement(tissue 25mm), coronary artery bypass grafting times two with left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to obtuse marginal artery. history of present illness: this 80 year old man with a history of polymyalgia rheumatica on chronic steroids and aortic stenosis that has been followed by serial echocardiograms for many years. he has noted a decline in his activity tolerance over the past six months. dyspnea with limited amounts of activity and several episodes of exertional lightheadedness with no syncope. he is now being referred for cardiac catheterization to assess his aortic valve. past medical history: severe aortic stenosis hypertension hyperlipidemia polymyalgia rheumatica on chronic steroids recent nose bleeds requiring cauterization (aspirin since d/c'd) thrombocytopenia gerd right sided sciatica gout hard of hearing (right sided hearing aid) carpal tunnel syndrome bilaterally (wearing splints at night) arthritis right shoulder surgery for a "separation" social history: lives with his wife and is retied. he does not smoke cigarettes. consumes alcoholic beverages per week. he denies use of illigal drugs. family history: father died at age 77 from unknown causes, might have had a stroke. mother with "cardiac disease", dying in her 50's from a "giant embolism" physical exam: admission exam: pulse:58 b/p right: left:138/62 resp:20 o2 sat:100% ra height:175cm weight:93.4kg general:nad, aaox3,no focal deficits skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade _3/6_____ abdomen:softnon-distendednon-tenderbowel sounds extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right:+2 left:+2 dp right:+1 left:+1 pt :+2 left:+2 radial right:cath site left:+2 carotid bruit: none discahrge exam: vs 98.9 76 120/62 18 97% ra wt 102.1kg gen: nad neuro: a&o x3, mae. nonfocal exam pulm: cta-bilat cv: rrr, no murmur. sternum stable-incision cdi abdm: soft, nt/nd/+bs ext: warm, well perfused. 2+ pedal edema bilat pertinent results: echocardiography report bp (mm hg): 129/69 wgt (lb): 207 hr (bpm): 56 bsa (m2): 2.10 m2 indication: aortic valve disease. coronary artery disease. left ventricular function. echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.2 cm <= 4.0 cm left atrium - four chamber length: 4.7 cm <= 5.2 cm right atrium - four chamber length: 4.7 cm <= 5.0 cm left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.3 cm <= 5.6 cm left ventricle - systolic dimension: 2.4 cm left ventricle - fractional shortening: 0.44 >= 0.29 left ventricle - ejection fraction: >= 65% >= 55% left ventricle - stroke volume: 125 ml/beat left ventricle - cardiac output: 7.02 l/min left ventricle - cardiac index: 3.35 >= 2.0 l/min/m2 left ventricle - lateral peak e': *0.03 m/s > 0.08 m/s left ventricle - septal peak e': *0.04 m/s > 0.08 m/s left ventricle - ratio e/e': *26 < 15 aorta - sinus level: 3.6 cm <= 3.6 cm aorta - ascending: *3.6 cm <= 3.4 cm aorta - arch: 3.0 cm <= 3.0 cm aortic valve - peak velocity: *5.1 m/sec <= 2.0 m/sec aortic valve - peak gradient: *106 mm hg < 20 mm hg aortic valve - mean gradient: 67 mm hg aortic valve - lvot pk vel: 1.19 m/sec aortic valve - lvot vti: 33 aortic valve - lvot diam: 2.2 cm aortic valve - valve area: *0.8 cm2 >= 3.0 cm2 mitral valve - e wave: 0.9 m/sec mitral valve - a wave: 1.3 m/sec mitral valve - e/a ratio: 0.69 mitral valve - e wave deceleration time: *343 ms 140-250 ms pulmonic valve - peak velocity: 1.1 m/sec <= 1.5 m/sec findings this study was compared to the prior study of . left atrium: mild la enlargement. right atrium/interatrial septum: normal ra size. left ventricle: mild symmetric lvh with normal cavity size and regional/global systolic function (lvef>55%). tdi e/e' >15, suggesting pcwp>18mmhg. no resting or valsalva inducible lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. mildly dilated ascending aorta. normal aortic arch diameter. no 2d or doppler evidence of distal arch coarctation. aortic valve: severely thickened/deformed aortic valve leaflets. severe as (area 0.8-1.0cm2). no ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. mild mitral annular calcification. calcified tips of papillary muscles. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. indeterminate pa systolic pressure. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. general comments: suboptimal image quality - poor subcostal views. conclusions the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>65%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). there is no left ventricular outflow obstruction at rest or with valsalva. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8cm2). no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: severe aortic valve stenosis. mild symmetric left ventricular hypertrophy with preserved regional and excellent global biventricular systolic function. increased pcwp. compared with the prior study (images reviewed) of , the aortic valve gradient is slightly higher. admission labs: 11:21am pt-15.3* ptt-29.9 inr(pt)-1.4* 11:21am plt smr-low plt count-88* 01:45pm urea n-17 creat-0.7 sodium-141 potassium-3.9 chloride-113* total co2-21* anion gap-11 01:46pm freeca-1.05* 01:03pm wbc-15.9*# rbc-2.81* hgb-8.4* hct-25.1*# mcv-89 mch-29.7 mchc-33.4 rdw-15.1 discharge labs: 06:09am blood wbc-8.0 rbc-3.06* hgb-9.1* hct-27.7* mcv-91 mch-29.9 mchc-33.0 rdw-14.5 plt ct-171 06:09am blood plt ct-171 05:23am blood pt-13.2* ptt-29.4 inr(pt)-1.2* 06:09am blood glucose-117* urean-24* creat-0.7 na-135 k-4.2 cl-96 hco3-31 angap-12 radiology report chest (pa & lat) study date of 1:38 pm final report: a small right and moderate-to-large left pleural effusion are unchanged since the prior exam yesterday. central pulmonary vascular congestion has significantly improved. sternotomy wires are intact and mediastinal clips are in unchanged position. a right-sided internal jugular catheter tip remains in the low svc. impression: stable small right and moderate-to-large left effusions. brief hospital course: the patient was a same day admission and was brought to the operating room on where the patient underwent an aortic valve rreplacement(tissue 25mm) and coronary artery bypass grafting times two with left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to obtuse marginal artery. his cardiopulmonary bypass time was 90 minutes with a crossclamp of 73 minutes. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. he had some post-operative bleeding and was transfused with several units of packed red blood cells, fresh frozen plasma and received protamine with resolution of bleeding. post-operative day one found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable. over the next 48hours he was weaned from pressor support and beta blockers were initiated, the patient was gently diuresed toward his preoperative weight. on pod3 the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued per cardiac surgery guidelines without complication. the patient worked with the physical therapy service for assistance with strength and mobility. by the time of discharge on post-operative day 6 the patient was ambulating with assistance, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to life care center of in good condition with appropriate follow up instructions. medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. allopurinol 100 mg po daily 2. fluticasone-salmeterol diskus (250/50) 2 inh ih 3. hydrochlorothiazide 25 mg po daily 4. lisinopril 20 mg po daily 5. omeprazole 20 mg po daily 6. pravastatin 10 mg po daily 7. prednisone 6 mg po daily 8. calcium carbonate 500 mg po daily 9. vitamin d unit po daily discharge medications: 1. acetaminophen 650 mg po/pr q4h:prn temperature >38.0 2. aspirin ec 81 mg po daily if extubated 3. docusate sodium 100 mg po bid 4. milk of magnesia 30 ml po daily:prn constipation 5. omeprazole 20 mg po daily 6. fluticasone-salmeterol diskus (250/50) 2 inh ih 7. vitamin d unit po daily 8. calcium carbonate 500 mg po daily 9. allopurinol 100 mg po daily 10. pravastatin 10 mg po daily 11. prednisone 6 mg po daily 12. metoprolol tartrate 12.5 mg po bid hold hr<55 sbp<100 13. tramadol (ultram) 25 mg po q6h:prn pain rx *tramadol 50 mg 1 tablet(s) by mouth every six (6) hours disp #*50 tablet refills:*0 14. metolazone 5 mg po bid 15. furosemide 40 mg po bid 16. potassium chloride 20 meq po bid hold for k > 4.5 discharge disposition: extended care facility: life care center of discharge diagnosis: aortic stenosis coronary artery disease discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with ultram sternal incision - healing well, no erythema or drainage edema- 2+ bilat discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for one month or while taking narcotics. driving will be discussed at follow up appointment with surgeon. no lifting more than 10 pounds for 10 weeks **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: wound check-cardiac surgery office phone: date/time: 10:30 surgeon- dr. , md phone: date/time: 1:15 cardiologist- , m.d. phone: date/time: 7:40 please call to schedule the following: primary care dr., d. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: venous catheterization, not elsewhere classified single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft diagnoses: other iatrogenic hypotension thrombocytopenia, unspecified anemia, unspecified coronary atherosclerosis of native coronary artery polymyalgia rheumatica esophageal reflux unspecified pleural effusion unspecified essential hypertension long-term (current) use of steroids gout, unspecified aortic valve disorders atrial flutter other and unspecified hyperlipidemia hemorrhage complicating a procedure surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation unspecified hearing loss accidents occurring in residential institution arthropathy, unspecified, site unspecified carpal tunnel syndrome 

Answer: The patient is high likely exposed to