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 attending: chief complaint: chest heaviness major surgical or invasive procedure: dental extractions cardiac catherization aortic valve replacement (21mm pericardial) replacement of ascending aorta hemiarch replacement history of present illness: 70 year old male with known aortic aneurysm followed by ct scan which is now enlarged enough to require surgical repair. past medical history: gastroesophageal reflux disease meningioma rheumatoid arthritis hyperlipidemia vertigo chronic bronchitis diet controlled diabetes mellitus ascending aortic aneurysm social history: occupation: hospital courier lives: with wife : 2ppd x40yrs, quit 9 years ago etoh: 2 glasses wine/day family history: unremarkable physical exam: physical exam pulse: 75 resp: 18 o2 sat: b/p right: 115/55 left: height: 68 in weight: 185 lbs general:nad-anxious skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 3/6 sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused no edema varicosities: none peripheral vascular color changes neuro: grossly intact pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : left: radial right: 2+ left: 2+ carotid bruit rt radiated murmur left: radiated murmur pertinent results: carotid ultrasound 1. less than 40% stenosis of the bilateral internal carotid arteries. 2. absence of diastolic flow in the left vertebral artery, suggestive of distal stenosis or occlusion. cardiac catheterization 1. selective coronary angiography of this right dominant system demonstrated moderate two vessel branch coronary artery disease with diffuse atherosclerosis. the lmca was heavily calcified with a distal 35% stenosis. the lad was heavily calcified with a mild 20% stenosis at the origin. there was mild diffuse plaquing throughout the proximal and mid lad to 30%. a large d1 had a 50% stenosis at the origin with a small adjacent diagonal branch. the next d2 is of modest caliber. the distal lad was turtuous. in the mid-distal segment was likely intramyocardial. the lcx was heavily calcified and supplied a modest high om1 and a small long om2, and a large om3/lpl with low density of vessels in the lateral wall. there was mild diffuse plaquing in av groove cx. the om2 had a proximal 50% stenosis. the rca had an anterior takeoff and had to canulated using an -1. the rca was heavily calcified and had diffuse disease to 40% mid vessel. 2. resting hemodynamics revealed elevated right and left ventricular enddiastolic pressures measured at 12 and 28 mmhg, respectively. the mean pcwp was 13 mmhg. the mean pa pressure was 23 mmhg (phasic 31/14 mmhg). the cardiac index was 2.5 l/min/m2 (using an assumed oxygen consumption). there was mild aortic stenosis with a mean gradient of 15 mmhg and a calculated aortic valve area of 1.3 cm2 (based on an assumed vo2 and an underestimate in the setting of known aortic regurgitation). the could not be quantitate precisely due to the presence of aortic regurgitation and an artificial gradient created by the methodology of measuring simultaneous lv-ao pressures. 3. left ventriculography was not performed. the aortic valve was calcified. echo the left atrium is elongated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mitral regurgitation is present but cannot be quantified (likely trivial or mild). the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. cxr findings: as compared to the previous radiograph, the size of the cardiac silhouette is unchanged. unchanged extent of the right-sided pleural effusion, on the left, the effusion is barely visible. no newly occurred parenchymal opacities suggestive of pneumonia. 06:15am inr 1.9* brief hospital course: admitted for preoperative workup which included dental extraction and cardiac catherization. on he was brought to the operating room for aortic valve replacement and repair of ascending aortic aneurysm. see operative report for further details. he received vancomycin for perioperative antibiotics due to being in the hospital greater than twenty four hours prior to surgery. postoperatively he was transferred to the intensive care unit for hemodynamic management. he was hemodynamically unstable requiring multiple vasoactive medications and remained intubated. he progressively improved and post operative day one medications were slowly weaned, post operative day two all vasoactive medications were weaned off. he was weaned from sedation, awoke and was extubated. lasix was started for diuresis. on post operative day two he also had rapid atrial fibrillation treated with amiodarone and betablockers, he converted back to normal sinus rhythm. due to persistent thrombocytopenia, a hit was checked which was negative. physical therapy worked with him on strength and mobility. he remained in the intensive care unit for pulmonary management and was ready for transfer to the floor on post operative day five. he had additional episodes of atrial fibrillation, and coumadin was initiated. progressively he improved and was ready for discharge to rehab on post operative day nine. medications on admission: asa 325 mg daily metoprolol 25 mg twice a day meclazine 12.5 mg twice a day omeprazole 20 mg daily lovastatin 40 mg daily colace 100 mg daily tylenol prn pain discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily) for 1 months. 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 6. lorazepam 0.5 mg tablet sig: 0.25 tablet po every twelve (12) hours as needed for anxiety. 7. multivitamin tablet sig: one (1) tablet po daily (daily) for 1 months. 8. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 9. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): please give 400 mg twice a day until then decrease to 400 mg once a day then decrease to 200 mg daily until follow up with cardiologist . 10. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 11. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 12. meclizine 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). 13. simvastatin 20 mg tablet sig: one (1) tablet po once a day: dose decreased due to interaction with amiodarone, increase dose back to 40 mg daily when off amiodarone. 14. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 15. lasix 40 mg tablet sig: one (1) tablet po once a day for 10 days: to assess for further need for diuresis at course completion. disp:*14 tablet(s)* refills:*0* 16. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 7 days. 17. warfarin 1 mg tablet sig: based on inr tablet po daily (daily) as needed for afib : patient received 4mg on and 5mg on . inr on was 1.9. disp:*30 tablet(s)* refills:*0* discharge disposition: extended care facility: life care center of discharge diagnosis: aortic stenosis s/p avr ascending aortic aneurysm s/p replacement post operative atrial fibrillation gastroesophageal reflux disease meningioma rheumatoid arthritis hyperlipidemia vertigo chronic bronchitis diabetes mellitus discharge condition: good discharge instructions: 1)please shower daily including washing incisions, no baths or swimming 2) monitor wounds for infection - redness, drainage, or increased pain 3) report any fever greater than 101 4) report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week 5) no creams, lotions, powders, or ointments to incisions 6) no driving for approximately one month 7) no lifting more than 10 pounds for 10 weeks 8) take lasix and potassium daily for 7 days then stop. 9) please call with any questions or concerns 10) pt/inr daily for coumadin dosing with goal inr 2.0-2.5 for atrial fibrillation. please contact dr. office to arrange coumadin follow-up upon discharge from rehab. followup instructions: please call to schedule appointments dr. after discharge from rehab. ( (pcp). dr. (cardiac surgery) for 4 weeks (. dr. (cardiology)after discharge from rehab pt/inr for coumadin dosing with goal inr 2.0-2.5 for atrial fibrillation. dr. office needs to be contact on discharge from rehab to set up coumadin follow-up. md procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels other surgical extraction of tooth diagnoses: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled thoracic aneurysm without mention of rupture chronic airway obstruction, not elsewhere classified cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders rheumatoid arthritis dental caries, unspecified 

Answer: The patient is high likely exposed to