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: patient recorded as having no known allergies to drugs attending: chief complaint: asymptomatic major surgical or invasive procedure: coronary artery bypass grafting x1 ( svg to ramus)/aortic valve replacement( . mechanical valve) history of present illness: this 60 year old man, known to our service, who has a history of hypertension, hyperlipidemia, diabetes and prior smoking. he has been followed for at least the past ten years with serial echocardiograms for aortic valve disease. previously his testing had been at , but he has recently switched his medical care to the . referred for surgical evaluation after cardiac cath on revealed severe aortic stenosis and coronary artery disease. past medical history: aortic stenosis and insufficiency cad postop a fib htn hyperlipidemia dm chronic leukocytosis mild diverticulitis noted on colonoscopy social history: single, lives with his signficiant other; works for media company making educational material. has past hx of tobacco years ago; drinks only occasionally at social events family history: non-contributory physical exam: height: 5'7" weight: 198# general: well-developed male in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 3/6 systolic abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: trace varicosities: none neuro: grossly intact pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit right: trans murmur left: trans murmur pertinent results: prebypass a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity is mildly dilated. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the descending thoracic aorta is mildly dilated. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. postbypass biventricular systolic function is preserved. there is a well seated, well functiong bileaflet mechanical valve in the aortic position. ai is present which is normal in quantity and location for this type of prosthesis. the exam is otherwise unchanged from the prebypass exam. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 12:53 05:30am blood wbc-16.5* rbc-3.55* hgb-10.5* hct-30.0* mcv-85 mch-29.6 mchc-35.0 rdw-15.0 plt ct-335 05:30am blood pt-30.1* ptt-30.9 inr(pt)-3.0* 05:30am blood glucose-96 urean-21* creat-0.9 na-139 k-3.6 cl-106 hco3-27 angap-10 brief hospital course: mr. was admitted on and underwent surgery with dr. . he was transferred to the cvicu in stable condition on titrated propofol and insulin drips. he was extubated the following morning. he went into a fib and was treated with amiodarone. coumadin was started for a mechanical avr. he was transferred to the floor on pod #3 to begin increasing his activity level. he was gently diuresed toward his preop weight. he continued to progress and was cleared for discharge to home with vna by dr. on pod #five. his first blood draw will be monday with results to the . target inr 2.0-3 for mechanical avr/atrial fibrillation. medications on admission: atenolol 75 mg lisinopril 60 mg daily metformin 1000 mg nifedipine sr 90 mg daily simvastatin 20 mg daily aspirin 81 mg daily mag. oxide 400 mg daily discharge medications: 1. 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* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 3. simvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* 4. magnesium oxide 400 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 5. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 6. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): 400 mg through ; then 200 mg ; then 200 mg daily ongoing. disp:*60 tablet(s)* refills:*1* 7. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*1* 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. disp:*14 tablet(s)* refills:*0* 9. lisinopril 10 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*2* 10. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 11. lasix 40 mg tablet sig: one (1) tablet po twice a day for 2 weeks. disp:*28 tablet(s)* refills:*2* 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po twice a day for 2 weeks. disp:*56 tab sust.rel. particle/crystal(s)* refills:*2* 13. outpatient lab work coumadin will be followed by the in (. inr to be drawn on . inr goal for a mechanical avr/afib . 14. warfarin 2.5 mg tablet sig: one (1) tablet po once (once) for 1 doses: coumadin will be followed by the in (. inr to be drawn on . inr goal for a mechanical avr/afib . . disp:*40 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: as/ai/ cad s/p avr/cabg x1 postop a fib niddm htn hyperlipidemia mild diverticulitis ( on colonoscopy ) discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with tramadol incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema : 1+ throughout discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: coumadin will be followed by the in (. inr to be drawn on . inr goal for a mechanical avr/afib 2-2.5. you are scheduled for the following appointments surgeon:dr. thursday at 1:00 pm please call to schedule appointments with your: primary care dr. in weeks cardiologist dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? mechanical avr/ a fib goal inr 2.0-2.5 first draw sunday results to phone procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve (aorto)coronary bypass of one coronary artery diagnoses: other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders personal history of tobacco use other and unspecified hyperlipidemia surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation phlebitis and thrombophlebitis of superficial veins of upper extremities leukocytosis, unspecified 

Answer: The patient is high likely exposed to