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: proair hfa attending: chief complaint: shortness of breath/possible syncopal event major surgical or invasive procedure: none. history of present illness: 62 y/o male with htn, hld, ar and ascending aortic aneurysm s/p resection and avr (st. ) on with course c/ with recent admission from for pericardial effusion with tamponade physiology s/p pericardiocentesis followed by pericardial window, believed to be post-surgical, also s/p chest tube for pleural effusion who presented to today for inr check and developed shortness of breath with subsequent syncopal event. he reports that he was walking into the ed and "lost breath" and was breathing heavy. + loc for 5-10 seconds; denies any urinary/stool incontinence, no shaking, no tongue biting. pt unsure if he felt flushed prior to the episode; just remembers feeling very short of breath. a tte was performed that by report revealed a medium-sized effusion with rv collapse. he was subsequently transferred to for further evaluation. . the patient states that he has had increasing doe over the last 1-2 weeks to the point that he cannot walk to the bathroom without developing sob. his sob does resolve with rest. he was recently started on lovenox for a subtherapeutic inr. since his surgery, the patient reports having intermittent episodes of shortness of breath. denies any associated chest pain, palpitations, chest tightness. just reports some chest tightness, pleuritic chest pain. denies any pnd, has not noticed any increasing le edema. reports using two pillows to sleep at night, but is able to lay flat without getting short of breath. . denies any headaches, changes in vision, no chest pain, no palpitations, no n/v/d. reports constipation for three days, abdominal pain which he attributes to lovenox injections, no recent fevers/chills. . on transfer to the ccu, the patient reports feeling well. chest pain free, breathing comfortably on room air. bedside echo showed small pericardial effusion without clear e/o ra/rv collapse though visualization of the ra and rv was difficult past medical history: 1. cardiac risk factors: -diabetes, +dyslipidemia, +hypertension 2. cardiac history: - percutaneous coronary interventions: , (see below) - pacing/icd: none - aortic regurgitation s/p avr - ascending aortic aneurysm 3. other past medical and surgical history: - h/o hyponatremia - cataract - glaucoma - depression - anxiety - vitamin d deficiency - s/p skin tag removal - mild varicose veins - left patellar fracture () - left foot crush injury () - s/p left knee surgery with titanium wires in place - tonsillectomy social history: lives alone. reports high stress after being laid off in from job at in cargo. smoked 1 ppd x 40+ years but quit . former heavy drinker who drank 12 oz beers on most days but stopped on . used to smoke occasional marijuana. family history: premature coronary artery disease - none reports cardiac issues in his family, but unsure of what. physical exam: admission pe: vs: 97.1 97 123/80 19 98% on 1.5l general: nad. oriented x3. pleasant elderly gentleman, laying comfortably in bed heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple, jvp to earlobe chest: + well healed vertical scar extending from midsternum down to xiphoid, three horizontal 2 cm scars near xiphoid, all well healed cardiac: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4, + mechanical valve click lungs: clear to auscultation b/l, good air movement, respirations unlabored, no crackles/wheezes/rhonchi abdomen: soft, nontender, nondistened, +bs extremities: 1+ le edema, warm, well perfused skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ neuro: strength and sensation normal throughout . discharge pe: tmax: 37.1 ??????c (98.7 ??????f) tcurrent: 36.9 ??????c (98.4 ??????f) hr: 104 (88 - 104) bpm bp: 120/79(88) {97/64(74) - 127/80(90)} mmhg rr: 18 (12 - 19) insp/min spo2: 96% heart rhythm: sr (sinus rhythm) general: nad. oriented x3. pleasant elderly gentleman, laying comfortably in bed heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple, jvp to earlobe chest: + well healed vertical scar extending from midsternum down to xiphoid, three horizontal 2 cm scars near xiphoid, all well healed cardiac: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4, + mechanical valve click lungs: clear to auscultation b/l, good air movement, respirations unlabored, no crackles/wheezes/rhonchi abdomen: soft, nontender, nondistened, +bs extremities: 1+ le edema, warm, well perfused skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ neuro: strength and sensation normal throughout pertinent results: admission labs: . 10:13pm blood wbc-6.6 rbc-3.87* hgb-9.1* hct-29.7* mcv-77* mch-23.4* mchc-30.5* rdw-15.7* plt ct-534* 10:13pm blood pt-23.9* ptt-37.9* inr(pt)-2.2* 10:13pm blood glucose-213* urean-18 creat-1.0 na-134 k-4.3 cl-101 hco3-26 angap-11 10:13pm blood calcium-8.5 phos-3.4 mg-2.2 . pertinent labs: . 07:53am blood ck-mb-2 ctropnt-<0.01 10:13pm blood alt-35 ast-26 alkphos-130 totbili-0.4 . discharge labs: . 07:53am blood wbc-7.0 rbc-3.74* hgb-9.0* hct-29.0* mcv-78* mch-24.1* mchc-31.1 rdw-15.7* plt ct-588* 07:53am blood pt-29.6* inr(pt)-2.9* 07:53am blood glucose-82 urean-15 creat-0.8 na-134 k-4.1 cl-101 hco3-25 angap-12 07:53am blood ck(cpk)-32* 07:53am blood ck-mb-2 ctropnt-<0.01 07:53am blood mg-2.1 . micro/path: . mrsa screen (final ): no mrsa isolated. . imaging/studies: . echo : overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. a mechanical aortic valve prosthesis is present. there is borderline pulmonary artery systolic hypertension. there is a small to moderate sized pericardial effusion with preferential fluid deposition along the anterolateral aspect of the left ventricle measuring up to 1.3 centimeters in greatest dimension. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. there are no echocardiographic signs of tamponade. no right atrial or right ventricular diastolic collapse is seen. impression: small to moderate sized, echo dense pericardial effusion without echcardiographic evidence of pericardial tamponade. borderline pulmonary artery systolic hypertension. . cxr pa/lat : findings: as compared to the previous radiograph, the retrocardiac lung areas are better ventilated. the right lung also shows improved ventilation. small bilateral pleural effusions persist. mild areas of atelectasis at the left lung bases. status post cabg. the gas collection in the left lateral soft tissues has decreased in the interval. . tte : overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. a mechanical aortic valve prosthesis is present. there is borderline pulmonary artery systolic hypertension. there is a small to moderate sized pericardial effusion with preferential fluid deposition along the anterolateral aspect of the left ventricle measuring up to 1.3 centimeters in greatest dimension. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. there are no echocardiographic signs of tamponade. no right atrial or right ventricular diastolic collapse is seen. impression: small to moderate sized, echo dense pericardial effusion without echcardiographic evidence of pericardial tamponade. borderline pulmonary artery systolic hypertension. brief hospital course: 62 y/o male with htn, hld, h/o ar and ascending aortic aneurysm s/p avr c/b pericardial effusion s/p pericardiocentesis and pericardial window who presents with recurrent pericardial effusion without echocardiographic findings of tamponade physiology. . active diagnoses: . # syncope/recurrent pericardial effusion: mr. was transferred from osh for concern of pericardial tamponade after he experienced a syncopal event with an echo showing pericardial fluid. he was found to be clinically stable on arrival without clinical evidence of tamponade. he had an echo which demonstrated a significant amount of pericardial fluid but without echocardiographic evidence of tamponade. he also did not have any arrythmias on telemetry but was found to have borderline blood pressures with mild orthostatic symptoms. other labs and imaging were unrevealing for a cause of his syncopal event and repeat tte did not show significant interval progression of his effusion. it was determined that his pericardial effusion was not the cause of his syncopal event or intermittent shortness of breath and no further management of this issue was undertaken at this time. his home lasix was discontinued as it was beleived that he was likely hypovolemic and that his event may have been caused by orthostatic hypotension. he was arranged with outpatient follow-up. . chronic diagnoses: . #. asending aortic aneurysm and ar s/p avr (st. ): his admission inr of 2.9 (goal of 2.5-3.5). he was briefly taken off his coumadin and managed on heparin drip for his valve but his coumadin was resumed when it was determined he would not require a procedure. . #. hypertension: he had somewhat borderline blood pressures during this admission but without tamponade. he was continued on his home metoprolol but his home lasix was discontinued. . # bph: stable. his tamsulosin was initially held for concern of tamponade but was later continued. he was instructed to take this medication at night given our concern for possible orthostatic hypotension. he stated his continued need for it in order for him to get a good night's sleep. . #. glaucoma: stable. he was continued on his home latanoprost and brinzolamide eye drops. . transitional issues: -he will need continued close outpatient monitoring of his symptoms as he may develop tamponade in the future if his pericardial window malfunctions. -should he continue to have pre-syncopal or syncopal events, he will need another syncopal workup. medications on admission: 1. latanoprost 0.005% 1 drop ou qhs (need to confirm if ou) 2. aspirin ec 81 mg po daily 3. multivitamin 1-2 tablets po daily 4. brinzolamide 1% 1 drop ou (need to confirm if ou) 5. tamsulosin er 0.4 mg po qhs 6. docusate sodium 100 mg po bid 7. metoprolol tartrate 100 mg po bid 8. tramadol 50 mg po q4h prn pain (usually only takes dose before bed) 9. furosemide 40 mg po daily for 2 weeks (at d/c so likely still on) 10. warfarin 2.5-5 mg po daily discharge medications: 1. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 2. brinzolamide 1 % drops, suspension sig: one (1) ophthalmic (). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. warfarin 2.5 mg tablet sig: one (1) tablet po once daily at 4 pm. 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po at bedtime. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. tramadol 50 mg tablet sig: one (1) tablet po every four (4) hours as needed for pain. 9. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: status post pericardial window for pericardial effusion aortic valve replacement discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure taking care of you while you were hospitalized at . you were admitted to the hospital because you had an episode of shortness of breath and then fell at an outside hospital. while you were there, they did an echocardiogram of your heart and thought that they saw fluid around your heart. you were transferred to for further management. when you got here, we also did an echocardiogram, and on our study, we did not think that you had a significant amount of fluid around your heart that would account for your shortness of breath. we did not think that any intervention was indicated at this time. we do not think that you need to continue your water pill anymore. the following changes were made to your medications: stop lasix 40 mg daily decrease metoprolol to 100 mg daily please continue to take the rest of your medications as directed. . please call tomorrow to schedule an appointment with your pcp. will also have to get your inr checked tomorrow, and send the results to your pcp. followup instructions: name: , md location: hospital department: cardiology address: , phone: appointment: monday 2:30pm . department: hematology/oncology when: tuesday at 9:30 am with: , md building: sc clinical ctr campus: east best parking: garage department: cardiac surgery when: wednesday at 2:00 pm with: , md building: lm campus: west best parking: garage . name: , w location: health medical associates address: , , phone: appointment: tuesday 4:45pm *the office is going to call you at home with the next available cancellation appointment. . procedure: pericardiocentesis pericardiotomy thoracoscopic drainage of pleural cavity diagnoses: pure hypercholesterolemia tobacco use disorder unspecified essential hypertension unspecified glaucoma hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) heart valve replaced by other means unspecified disease of pericardium long-term (current) use of anticoagulants hypovolemia tachycardia, unspecified unspecified cataract unspecified vitamin d deficiency cardiac tamponade edema other specified forms of effusion, except tuberculous body mass index 27.0-27.9, adult 

Answer: The patient is high likely exposed to