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: pravachol / questran / beta-adrenergic blocking agents attending: chief complaint: chest pain major surgical or invasive procedure: - mvr(31mm mosaic porcine)/cabgx4(lima->lad, svg->diag, om, rca) history of present illness: the patient is a 72 year old male who was transferred from following admission for chest pain while playing golf and had non specific st changes (troponin 111, ck 2502 peaks), ruled in for non st elevation myocardial infarction. went for cardiac catherization at which showed three vessel coronary artery disease (100% diagonal 80% left anterior descending, and 100% right coronary artery). past medical history: cad obesity hypercholesterolemia mr s/p ptca s/p ventrial hernia repair polymyalgia rheumatica social history: lives with wife : 15 pack year history - quit 5 years ago alcohol: 2-3 beers per week family history: unknown physical exam: admission: vitals: blood pressure 134/65, heart rate 108, respiratory rate 20, oxygen saturation 100% on room air, temperature 96.8 weight 92.6 kilograms general: well developed male in no acute distress heent: oropharynx benign, neck: supple, no jvd, heart: regular rate, normal s1s2, no murmur or rub lungs: clear bilaterally abdomen: soft, nontender, normoactive bowel sounds, old incision healed ext: + edema, groin site clean dry and intact no varicosities pulses: 2+ distally neuro: nonfocal pertinent results: 08:33pm urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 08:33pm urine color-straw appear-clear sp -1.014 08:58pm pt-12.1 ptt-23.5 inr(pt)-1.0 08:58pm wbc-8.3 rbc-5.13 hgb-13.5* hct-40.6 mcv-79* mch-26.4* mchc-33.3 rdw-17.0* 08:58pm glucose-337* urea n-22* creat-1.0 sodium-136 potassium-4.8 chloride-99 total co2-28 anion gap-14 06:50am blood wbc-8.1 rbc-4.96 hgb-12.8* hct-39.3* mcv-79* mch-25.9* mchc-32.6 rdw-16.7* plt ct-294 06:50am blood plt ct-294 06:50am blood glucose-152* urean-25* creat-1.1 na-138 k-4.3 cl-97 hco3-30 angap-15 carotid duplex u/s mild atherosclerotic changes bilaterally with less than 40% stenosis of the internal carotid arteries on both sides. this is a baseline examination at the . echo the left atrium is elongated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is severe regional left ventricular systolic dysfunction. overall left ventricular systolic function is severely depressed. tissue velocity imaging e/e' is elevated (>15) suggesting increased left ventricular filling pressure (pcwp>18mmhg). resting regional wall motion abnormalities include thinned and aneurysmal basal inferior/inferolateral wall, mid inferior hypokinesis/akinesis, akinetic mid to distal septum, and apical akinesis/hypokinesis. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated. the ascending aorta is mildly dilated. the aortic arch is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. there is an anterior space which most likely represents a fat pad, though a loculated anterior pericardial effusion cannot be excluded. echo conclusions: 1. the left atrium is mildly dilated. 2. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is severe global left ventricular hypokinesis. overall left ventricular systolic function is severely depressed. 3. the ascending aorta is mildly dilated. 4. the aortic valve leaflets (3) are mildly thickened. 5. a bioprosthetic mitral valve prosthesis is present. the mitral prosthesis appears well seated, with normal leaflet motion and transvalvular gradients. 6. compared with the prior study (images reviewed) of , the mitral prosthetic valve is new. brief hospital course: mr. was admitted to the on for further management of his coronary artery disease. he was worked-up in the usual preoperative manner by the cardiac surgical service. heparin was continued for anticoagulation. a carotid duplex ultrasound was performed which showed mild atherosclerotic changes bilaterally with less than 40% stenosis of the internal carotid arteries bilaterally. an echocardiogram was performed which showed his ejection fraction to be 25%, no mitral valve regurgitation and an inferior basal aneurysm. the cardiology service was consulted for assistance with the management of his ischemic . carvedilol, aspirin, ace inhibition and statin therapy were started. as mr. hematocrit fell, a cause of his anemia was explored. a tagged red blood cell scan was negative for an active bleed. the gastrointestinal service was consulted. a colonoscopy was notable for only diverticula and hemorrhoids. an esophageal duodenoscopy was notable for angioectasia which was cauterized and gastritis. mr. was subsequently cleared for surgery. on , mr. was taken to the operating room where he underwent coronary artery bypass grafting to four vessels and a mitral valve replacement using a 31mm mosaic porcine valve. please see operative note for details. an intra-aortic balloon pump was placed for poor hemodynamics. an initial attempt was made to place the balloon in the left groin which failed. the left groin thus needed to be explored with repairs made to the femoral artery. the balloon was then placed in the right groin. postoperatively he was taken to the cardiac surgical intensive care unit for monitoring. he required multiple pressors and blood products for postoperative bleeding. amiodarone was started for ectopy. over the next several days, mr. slowly weaned from pressors, the balloon pump and sedation. on , mr. was successfully extubated. he developed atrial fibrillation which was treated with amiodarone and beta blockade. he initially had some confusion however cleared appropriately. he was gently diuresed towards his preoperative weight. the physical therapy service was consulted for assistance with his postoperative strength and mobility. on postoperative day seven, mr. was transferred to the step down unit for further recovery. he remained in normal sinus rhythm. a repeat echocardiogram showed his ejection fraction to be 20%. mr. continued to make steady progress and was discharged home on postoperative day ten. he will follow-up with dr. , his cardiologist and his primary care physician as an outpatient. medications on admission: verapamil sr 240mg daily, aspirin 81mg daily, imdur er 30mg daily, prilosec 20 mg daily, fish oil, folic acid, calcitrate 950mg daily, vitamin c, vitamin e, metformin 500mg twice a day, prednisone 5mg in am and 3mg in pm, lipitor 10mg daily, allopurinol 300mg daily, xanax prn , discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 4. 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* 5. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 10 days. disp:*10 tablet(s)* refills:*0* 10. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): 400mg x 1 week then 400mg qd x1 wk then 200mg qd. disp:*60 tablet(s)* refills:*2* 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 10 days. disp:*10 tab sust.rel. particle/crystal(s)* refills:*0* 12. calcitrate 950 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 13. prednisone 1 mg tablet sig: five (5) tablet po q am: take 3 mg po q pm. disp:*240 tablet(s)* refills:*2* 14. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: s/p mitral valve replacement (#31 mosaic porcine) coronary artery bypass graft (left internal mammary artery to left anterior descending, saphenous vein graft to diagonal, saphenous vein graft to obtuse marginal, saphenous vein graft to right coronary artery)intra aortic balloon pump discharge condition: good discharge instructions: keep wounds clean and dry. ok to shower, no bathing or swimming. take all medications as prescribed. call for any fever, redness or drainage from wounds. followup instructions: dr in weeks dr in weeks dr in 4 weeks see your urologist in weeks. procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart colonoscopy implant of pulsation balloon endoscopic control of gastric or duodenal bleeding open and other replacement of mitral valve with tissue graft other repair of vessel diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery polymyalgia rheumatica pure hypercholesterolemia mitral valve disorders congestive heart failure, unspecified long-term (current) use of steroids acute posthemorrhagic anemia atrial fibrillation percutaneous transluminal coronary angioplasty status other specified forms of chronic ischemic heart disease hemorrhage complicating a procedure cardiogenic shock obesity, unspecified diverticulosis of colon (without mention of hemorrhage) angiodysplasia of stomach and duodenum with hemorrhage 

Answer: The patient is high likely exposed to