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 / morphine attending: chief complaint: this patient is a 37 year old male who complains of chest pain. this patient has a history of aortic insufficiency and is scheduled to have an aortic valve replacement next week. he was doing some snow shoveling and developed the abrupt onset of severe chest pain and went to the . an ekg showed lateral st segment depressions and he was sent here for further treatment and to have an aortic dissection ruled out major surgical or invasive procedure: 1. replacement of ascending hemi arch aorta with a 26 mm gelweave graft. 2. bentall procedure with a st. composite mechanical valve graft reference #. 3. coronary artery bypass grafting x1, with the saphenous vein graft to the right coronary artery history of present illness: this patient is a 37 year old male who complains of chest pain. this patient has a history of aortic insufficiency and is scheduled to have an aortic valve replacement next week. he was doing some snow shoveling and developed the abrupt onset of severe chest pain and went to the . an ekg showed lateral st segment depressions and he was sent here for further treatment , he was found to have aortic dissection and was brought emergently to the operating room. past medical history: past medical history: - aortic insufficiency - history of ventricular tachycardia and placed on amiodarone - connective tissue disorder, ? cystic medial necrosis - left common iliac aneurysm 2.7 cm with dissection flap - left external iliac dissection, 1.8cm - history of carotid aneurysm - hypertension - arthritis - history of gout - anxiety - history of kidneys stones, s/p ureteral stents and lithotripsy - herniated cervical discs - history of subdural hematoma secondary to mva(resolved) past surgical history: - s/p left ica stenting and coiling dr. - s/p ligation right femoral av fistula with complicated repair of right cfa with dr. - s/p orif left femur - s/p right knee arthroscopy - s/p left biceps tendon repair - s/p uvulectomy social history: race: causcasian last dental exam: this thursday lives: alone occupation: insurance company tobacco: denies, admits to occasional cigar etoh: rare other: denies recreational and intravenous drugs family history: no premature coronary artery disease physical exam: temp:96.0 hr:63 bp:126/44 resp:18 o(2)sat:98 normal constitutional: comfortable but slightly diaphoretic heent: extraocular muscles intact no jvd chest: clear to auscultation cardiovascular: normal first and second heart sounds with a systolic murmur but i cannot hear a diastolic murmur abdominal: soft, nontender gu/flank: no costovertebral angle tenderness extr/back: no edema calf tenderness. both posterior tibialis pulses are normal. neuro: speech fluent without lateralizing motor findings psych: normal mood pertinent results: 12:05pm pt-14.5* ptt-22.5 inr(pt)-1.3* 12:05pm plt count-278 12:05pm wbc-8.8 rbc-4.34* hgb-11.8* hct-36.3* mcv-84 mch-27.2 mchc-32.5 rdw-14.3 12:05pm ctropnt-<0.01 12:05pm glucose-145* urea n-23* creat-1.3* sodium-142 potassium-4.7 chloride-106 total co2-26 anion gap-15 08:31pm fibrinoge-66* 08:31pm pt-18.3* ptt-51.6* inr(pt)-1.7* 08:31pm plt count-115*# 08:31pm wbc-6.9 rbc-2.16*# hgb-6.1*# hct-18.9*# mcv-87 mch-28.3 mchc-32.5 rdw-14.1 08:31pm glucose-227* lactate-6.3* na+-135 k+-4.8 cl--112 12:12pm blood wbc-9.8 rbc-2.05*# hgb-6.1*# hct-18.1*# mcv-88 mch-29.7 mchc-33.7 rdw-16.6* plt ct-25*# 03:18am blood wbc-15.1* rbc-3.02* hgb-9.0* hct-28.3* mcv-94 mch-29.7 mchc-31.7 rdw-16.2* plt ct-295 12:12pm blood plt ct-25*# 03:18am blood plt ct-295 03:18am blood pt-22.2* ptt-28.2 inr(pt)-2.1* 12:12pm blood glucose-145* urean-56* creat-2.0* na-greater th k-4.8 cl-93* hco3-greater th 03:18am blood glucose-162* urean-68* creat-2.6* na-149* k-4.4 cl-108 hco3-32 angap-13 12:12pm blood alt-46* ast-71* alkphos-42 01:10am blood alt-1811* ast-2233* ld(ldh)-1397* alkphos-70 amylase-60 totbili-5.9* 03:17am blood alt-3570* ast-5815* ld(ldh)-4104* alkphos-72 amylase-75 totbili-5.2* , m 37 radiology report chest (portable ap) study date of 5:32 am , csru 5:32 am chest (portable ap) clip # reason: eval right effusion medical condition: 37 year old man with cabg/ and effusion reason for this examination: eval right effusion final report chest on history: status post cabg with right effusion. reference exam: . findings: compared to the study from the prior day, there has been interval decrease in size of the right effusion. there is no pneumothorax. the heart continues to be moderate-to-severely enlarged with pulmonary vascular redistribution. et tube, ng tube, and right subclavian line are unchanged. there continues to be dense retrocardiac opacification consistent with volume loss/effusion/infiltrate. dr. approved: sat 11:15 am imaging lab echocardiography report , (complete) done at 12:01:00 am preliminary referring physician information , - department of cardiac s , 2a , status: inpatient dob: age (years): 37 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: intraoperative tee for re-exploration for bleeding icd-9 codes: 441.00, 423.9, 424.0 test information date/time: at 00:01 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2011aw1-: machine: 1 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *2.0 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.8 cm 0.6 - 1.1 cm aortic valve - peak gradient: *43 mm hg < 20 mm hg findings left atrium: dilated la. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left ventricle: severe symmetric lvh. moderately depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: aortic arch intimal flap/dissection. descending aorta intimal flap/aortic dissection. aortic valve: mechanical aortic valve prosthesis (avr). normal avr leaflets. mild (1+) ar. mitral valve: normal mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. results were personally reviewed with the md caring for the patient. conclusions an echodense mass is seen in the pericardial space, compressing the right atrium, consistent with clot. after removal of clot from mediastinum, the left atrium appears dilated. there is severe symmetric left ventricular hypertrophy. overall left ventricular systolic function is moderately depressed (lvef= 35 %). the septal and anteroseptal segments appear hypokinetic. right ventricular chamber size and free wall motion are normal. a mobile density is seen in the aortic arch consistent with an intimal flap/aortic dissection. a mobile density is seen in the descending aorta consistent with an intimal flap/aortic dissection. a mechanical aortic valve prosthesis is present. the prosthetic aortic valve leaflets appear normal. a small paravalvular leak is seen in the area that would have been the junction of the left- and non-coronary cusps. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. dr. was notified in person of the results at the time of study. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician ?????? caregroup is. all rights reserved. echocardiography report , (complete) done at 12:01:00 am preliminary referring physician information , - department of cardiac s , 2a , status: inpatient dob: age (years): 37 m hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: intraoperative tee for re-exploration for bleeding icd-9 codes: 441.00, 423.9, 424.0 test information date/time: at 00:01 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2011aw1-: machine: 1 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *2.0 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.8 cm 0.6 - 1.1 cm aortic valve - peak gradient: *43 mm hg < 20 mm hg findings left atrium: dilated la. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left ventricle: severe symmetric lvh. moderately depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: aortic arch intimal flap/dissection. descending aorta intimal flap/aortic dissection. aortic valve: mechanical aortic valve prosthesis (avr). normal avr leaflets. mild (1+) ar. mitral valve: normal mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. results were personally reviewed with the md caring for the patient. conclusions an echodense mass is seen in the pericardial space, compressing the right atrium, consistent with clot. after removal of clot from mediastinum, the left atrium appears dilated. there is severe symmetric left ventricular hypertrophy. overall left ventricular systolic function is moderately depressed (lvef= 35 %). the septal and anteroseptal segments appear hypokinetic. right ventricular chamber size and free wall motion are normal. a mobile density is seen in the aortic arch consistent with an intimal flap/aortic dissection. a mobile density is seen in the descending aorta consistent with an intimal flap/aortic dissection. a mechanical aortic valve prosthesis is present. the prosthetic aortic valve leaflets appear normal. a small paravalvular leak is seen in the area that would have been the junction of the left- and non-coronary cusps. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. dr. was notified in person of the results at the time of study. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician ?????? caregroup is. all rights reserved. brief hospital course: patient was admitted with chest pain, he was found to have aortic dissection and was brought to the operatin g room for and emergent bentall. he survived the initial surgery and was brought to the cardiac surgery icu with an open chest on multiple pressors and inotropes. he returned to the operating room three times over the next several days for bleeding and washouts. during this period he suffered acute renal failure and elevated lft's. on pod5 his chest was closed. the following day his paralytics were stopped and his sedation was lightened. he took several days to diurese and wean from the ventilator. on pod10 he was extubated. later during that day he had a cardiopuolmonary arrest and despite efforts to he was pronounced at 12:30pm medications on admission: medications at home: lisinopril 5mg daily, metoprolol 50 mg daily, amiodarone 400 mg daily, soma 350 mg tid, aspirin 325mg daily, xanax 0.5mg , erythromycin for dental procedures discharge medications: expired discharge disposition: expired discharge diagnosis: s/p bentall -cardiopulmonary arrest discharge condition: expired discharge instructions: expired followup instructions: expired procedure: extracorporeal circulation auxiliary to open heart surgery enteral infusion of concentrated nutritional substances open and other replacement of aortic valve (aorto)coronary bypass of one coronary artery arterial catheterization reopening of recent thoracotomy site reopening of recent thoracotomy site other repair of chest wall resection of vessel with replacement, thoracic vessels suture of artery diagnoses: acute kidney failure with lesion of tubular necrosis unspecified essential hypertension acute and subacute necrosis of liver aortic valve disorders accidental puncture or laceration during a procedure, not elsewhere classified hemorrhage complicating a procedure dissection of carotid artery other and unspecified coagulation defects examination of participant in clinical trial dissection of aorta, thoracic dissection of other artery dissection of coronary artery hypersensitivity angiitis, unspecified 

Answer: The patient is high likely exposed to