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: lisinopril attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: avr (23mm st. porcine), cabg x 1 svg-pda) history of present illness: 80yo m w h/o known aortic stenosis, followed by echo. has noticed increasing dyspnea on exertion. previously could walk 1 mile, now becomes short of breath around half of a mile. also notes some chest tightening with exertion. cardiac cath reveals two vessel disease in addition to known aortic stenosis. he presents for surgical opinion. past medical history: paroxysmal a-fib- since (on coumadin) aortic stenosis hyperlipidemia hypertension tia, 10 yrs ago tachy-brady syndrome, s/p ppm () hemorrhoids/hematochezia (hospitalized - did not require transfusion) diverticulosis social history: race: caucasian last dental exam: 3 months ago lives with: wife occupation: retired from and ne telephone tobacco: quit 25yrs ago etoh: rare family history: family history: mother died of mi 83yo physical exam: pulse: 60 (av paced) resp: 18 o2 sat: 98% b/p right: 132/70 left: height: 5'7" weight: 179lb general: skin: dry heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly pulses: femoral right: p left: p dp right: p left: p pt : p left: p radial right: p left: p carotid bruit right: p left: p pertinent results: 07:00am blood wbc-12.2*# rbc-3.28*# hgb-10.0*# hct-29.3* mcv-89 mch-30.6 mchc-34.2 rdw-14.1 plt ct-81* 07:00am blood pt-13.1 inr(pt)-1.1 07:00am blood glucose-114* urean-22* creat-1.0 na-137 k-3.5 cl-98 hco3-29 angap-14 04:25am blood calcium-7.9* phos-2.8 mg-2.2 05:58pm urine color-yellow appear-clear sp -1.013 urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.0 leuks-neg cxr: findings: dual lead pacemaker in situ, unchanged in position. previous median sternotomy noted. compared to the prior study, there has been interval widening of the superior mediastinum. there is a persistent pneumopericardium, most evident along the left heart border. bilateral lower lobe airspace opacities likely reflect atelectasis. possible small bilateral pleural effusions. on the lateral view, there is a loculated air collection seen anteriorly, although distant from the sternum. this could represent loculated air within the pericardium. echo: pre-cpb: mild spontaneous echo contrast is present in the left atrial appendage. overall left ventricular systolic function is normal (lvef>55%). with normal free wall contractility. there are simple atheroma in the descending thoracic . the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. post-cpb #1: there is a significant paravalvular leak at the right end of the left cusp. re-clamped and opened for repair. post-cpb #2: the patient is av-paced, on epinephrine. preserved biventricular systolic fxn. the paravalvular leak is now insignificant. the prosthetic aortic valve is competent and well-seated. the residual mean gradient is 15 mmhg. trace mr. . the tip of the sgc is in the right pa just beyond the bifurcation. ekg: atrial paced rhythm. intraventricular conduction delay may be right ventricular conduction delay. consider prior inferior myocardial infarction, although it is non-diagnostic. qtc interval appears prolonged but it is difficult to measure. clinical correlation is suggested. since the previous tracing of no significant change. brief hospital course: the patient was brought to the operating room on where he underwent avr (23mm st. porcine), cabg x 1 svg-pda). overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 5 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to a rehab in good condition with appropriate follow up instructions. coumadin was restarted for atrial fibrillation after the temporary pacing wires were removed. his pcp should his inr on discharge from rehab. he was discharged on post-operative day five to rehab in . medications on admission: warfarin 4mg as directed, flecainide 150", atenolol 25', lipitor 40', diovan 40' discharge medications: 1. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 2. atorvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 5. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 6. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 7. flecainide 50 mg tablet sig: three (3) tablet po q12h (every 12 hours). 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation . 9. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 10. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 12. potassium chloride 10 meq capsule, extended release sig: one (1) capsule, extended release po twice a day for 10 days. disp:*20 capsule, extended release(s)* refills:*0* 13. coumadin 4 mg tablet sig: one (1) tablet po once a day: please follow inr for goal of for afib. first inr to be drawn on . disp:*30 tablet(s)* refills:*2* 14. insulin insulin sc (per insulin flowsheet) sliding scale fingerstick qachs insulin sc sliding scale breakfast lunch dinner bedtime regular glucose insulin dose 0-70 mg/dl proceed with hypoglycemia 71-119 mg/dl 0 units 0 units 0 units 0 units 120-159 mg/dl 2 units 2 units 2 units 2 units 160-199 mg/dl 4 units 4 units 4 units 4 units 200-239 mg/dl 6 units 6 units 6 units 6 units 240-279 mg/dl 8 units 8 units 8 units 8 units > 280 mg/dl notify m.d. 15. furosemide 10 mg/ml solution sig: twenty (20) mg injection twice a day for 10 days. disp:*qs * refills:*0* 16. tele please place patient on telemetry secondary to s/p avr/cabg discharge disposition: extended care facility: northeast - discharge diagnosis: dyspnea on exertion, cad, aortic stenosis discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage 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 approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: provider: , md phone: date/time: 2:30 please call to schedule the following: cardiologist dr. , schedule an appointment for 2 weeks primary care dr. , a. in weeks phone: **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** on coumadin for afib, goal inr . first inr draw should be on . procedure: 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: coronary atherosclerosis of native coronary artery unspecified essential hypertension atrial fibrillation aortic valve disorders other and unspecified hyperlipidemia long-term (current) use of anticoagulants cardiac pacemaker in situ 

Answer: The patient is high likely exposed to