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: past medical history: 1. atrial fibrillation. 2. hypothyroidism. 3. hypertension. 4. sleep apnea, requiring bipap p.r.n. at night. 5. psoriasis. 6. benign prostatic hypertrophy. past surgical history: 1. right inguinal hernia repair. 2. transurethral resection of the prostate. 3. cryoablation by electrophysiology service. 4. right nephrolithiasis. 5. thyroid biopsy. medications on admission: 1. coumadin 5 mg alternating with 2.5 mg. 2. amiodarone. 3. lipitor. 4. levoxyl. 5. accupril. 6. norvasc. 7. multivitamins. 8. folate. 9. vitamin b6 and b12. 10. . 11. temazepam p.r.n. at night with bipap. allergies: no known drug allergies. social history: the patient is a psychologist. he currently lives alone. he has a son living nearby for support. history of smoking; quit in . prior alcohol was three drinks per night. the patient states that he quit three months ago to admission. family history: the patient's father is deceased at the age of 56 from a cva. mother deceased at 86 due to breast cancer. laboratory data: preoperative laboratory data: wbc 5.3, hematocrit 38.4, platelet count 255,000. sodium 138, potassium 4.8, chloride 102, co2 27, bun 21, creatinine 1.1, glucose 77, pt 16.4, inr 1.9, ptt 28.9. cardiac catheterization performed on . please see the cardiac catheterization report for full details. summary: left ventriculography revealed 4+ mr with normal wall motion and ef estimated between 50% to 60%. lvedp 2. the lmca had a mild plaque. the lad had a mid 40% lesion. the lcx had minimal luminal irregularities. the rca had minimal lumen irregularities. physical examination: examination revealed the following: the patient presented asymptomatically. vital signs were noted normal. heent: unremarkable. heart sounds were irregular with a noted systolic murmur. lungs: lungs were clear to auscultation. abdomen: abdomen revealed no masses, but soft and nontender. extremities: palpable pulses, no varicosities identified. the patient was evaluated in preadmission testing on of this year for preoperative evaluation of the mitral valve replacement scheduled on . the patient was admitted to on , where he was brought to the operating room. please see the operating room report for full details. in summary, the patient underwent an aortic valve replacement with - #25 and a mitral valve repair with #26. the patient tolerated the operation well, and the patient was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient was on epinephrine 0.03 mcg per kilogram per minute; neo-synephrine 0.3 mcg per kilogram per minute; and propofol. the patient did well immediately postoperatively. he was weaned from his inotropes and pressor support. the anesthesia was reversed. he weaned from the ventilator and he was successfully extubated. the patient remained hemodynamically stable on postoperative day #1. he continued to be atrial paced. he was transferred to the floor on postoperative day #1. the patient was noted to return to the baseline of atrial fibrillation on postoperative day #2. the amiodarone bolus was administered and po amiodarone was initiated and coumadin for anticoagulation. over the next several days, the patient continued to make slow progress with the assistance of the nursing staff in the department of physical therapy. the patient did receive two units of blood while on the floor on and , where the hematocrit progressed from 22 to 24 and remained stable at 27.7 with anticoagulation. the patient's epicardial wires were discontinued on postoperative day #3. the patient continued to be hemodynamically stable with increased activity level and continued with pulmonary toilet. rehabilitation screen was performed on postoperative day #3. on postoperative day #4, the patient remained hemodynamically stable and the patient is ready to transfer to a rehabilitation facility to continue pulmonary care and increased activity levels and regain strength. anticipated discharge is tomorrow a.m. . physical examination presently revealed a temperature of 99.2, heart rate 80s to 90s in atrial fibrillation, lopressor was increased today from 12.5 to 25 b.i.d. blood pressure 130s to 140s/70. respiratory rate 20. the patient is on room air saturating between 93% to 95%. preoperative weight is 95 pounds. current weight as of today is 207.4 pounds. laboratory data: chemistries from revealed the following: sodium 138, potassium 4.7, chloride 104, co2 23, bun 20, creatinine 1.0, glucose 129. cbc from revealed the following: wbcs 10.2, hemoglobin 8.8, hematocrit 27.7, platelet count 145,000. goagulations on revealed pt of 13.8 with inr of 1.3. the patient is to have hematocrit and pt level re-evaluated in the morning and have coumadin dosed accordingly. physical examination: the patient neurologically is alert and oriented and moving all extremities. the patient follows commands. respiratory: the patient continues on room air. he has no dyspnea, no cough, no wheeze. respiratory rate is unlabored. he does have rales in the left base. cardiac: s1 and s2 irregular, no rub or murmur appreciated. gi: abdomen is distended. it is soft and nontender. he does have bowel sounds in four quadrants. he reports no nausea or vomiting. he is passing flatus, but he has not had a bowel movement. he continues on milk of magnesia and colace. extremities: there was no pedal edema appreciated. legs are warm and well perfused bilaterally. wound: sternal incision is open to air, dry, intact with steri strips. sternal incision has no drainage or no erythema. the patient does have approximately 1 cm subcutaneous emphysema area on the right clavicular area approximately 1 cm. discharge medications: 1. lipitor 10 mg po q.d. 2. levothyroxine sodium 125 mcg po q.d. 3. enteric coated aspirin 81 mg po q.d. 4. amiodarone 200 mg po b.i.d. 5. lopressor 25 mg po b.i.d. 6. lasix 20 mg po b.i.d. times two weeks. 7. 20 meq po b.i.d. times two weeks. 8. coumadin dose adjusted for goal inr of 2.0 to be checked daily. current coumadin doses given , 2 mg; , 5 mg; , 5 mg; , 5 mg for inr of 1.3. repeat pt/inr pending on am day of discharge. 9. milk of magnesia 30 cc po q.6h.p.r.n. constipation. 10. colace 100 mg po b.i.d. 11. oxycodone-acetaminophen one to two tablets po q.4h. p.r.n.pain. discharge diagnoses: 1. valvular disease status post aortic valve replacement -, #25, and mitral valve replacement with #26. 2. atrial fibrillation. 3. hypothyroidism. 4. hypertension. 5. sleep apnea with bipap p.r.n. at night. 6. psoriasis. die disposition: this patient is to be discharged to rehabilitation. he is to followup in the clinic in one week. he is to followup with dr. in four weeks post discharge. he is to followup with the primary care physician three weeks post discharge. he is to followup p.r.n. with the cardiologist at his primary physician's discretion. note: the patient is discharged to rehabilitation. the patient has a history of sleep apnea requiring bipap at home. the patient has not required the support of bipap during hospitalization. , m.d. dictated by: medquist36 d: 15:08 t: 15:24 job#: 1 1 1 dr procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve open heart valvuloplasty of mitral valve without replacement diagnoses: unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation mitral valve insufficiency and aortic valve insufficiency long-term (current) use of anticoagulants precipitous drop in hematocrit insomnia with sleep apnea, unspecified 

Answer: The patient is high likely exposed to