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: amoxicillin attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: coronary artery bypass graft x 3 lima->lad, svg->om2, svg->rca, mitral valve repair history of present illness: 68 year old male with history of mitral valve prolapse, transferred to from with new-onset afib and troponin elevation to 0.07. he reports 6-7 days of fatigue, and day history of sore throat. over past several days, has also had a dull pain in his left shoulder, which typically occurs in the morning and has resolved with aspirin. he was not having any dyspnea, though did note dyspnea on exertion earlier today when walking across the street (usually able to do so w/o difficulty). upon echocardiogram was found to have moderate to severe mitral regurgitation and is now being referred to cardiac surgery for a mitral valve replacement. past medical history: mitral valve prolapse hl bph constipation s/p hernia surgery s/p remote throat surgery (30-40 yrs ago per patient) for speech problems social history: married, lives with wife. owns small business selling hearing aids. denies tobacco or illicit drug use. has never smokd. no etoh. family history: father had cad, mi in 60s. no known family history of arrythmias or sudden death. physical exam: physical exam pulse:99 resp:18 o2 sat:99/ra b/p 135/78 height:5'1.5" weight:57.6 kgs general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade iii/vi, systolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ 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: none left: none pertinent results: 10:00am blood hct-23.9* 05:45am blood wbc-9.2 rbc-2.45* hgb-7.8* hct-22.2* mcv-91 mch-31.9 mchc-35.2* rdw-13.0 plt ct-96* 03:00pm blood wbc-6.0 rbc-3.98* hgb-12.6* hct-36.6* mcv-92 mch-31.7 mchc-34.4 rdw-12.3 plt ct-220 05:45am blood pt-23.1* inr(pt)-2.2* 03:00pm blood pt-13.0* ptt-31.4 inr(pt)-1.2* 05:45am blood glucose-107* urean-20 creat-1.0 na-133 k-3.7 cl-99 03:00pm blood glucose-163* urean-25* creat-1.2 na-136 k-4.2 cl-102 hco3-26 angap-12 echocardiography report , (complete) done at 9:22:39 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 68 m hgt (in): 54 bp (mm hg): 112/50 wgt (lb): 119 hr (bpm): 69 bsa (m2): 1.39 m2 indication: chest pain. congestive heart failure. coronary artery disease. left ventricular function. mitral valve disease. preoperative assessment. valvular heart disease. icd-9 codes: 428.0, 402.90, 786.05, 424.0, 424.2 test information date/time: at 09:22 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 #: 2012aw-1: machine: us2 echocardiographic measurements results measurements normal range left atrium - four chamber length: *5.7 cm <= 5.2 cm left ventricle - septal wall thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.0 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.2 cm <= 5.6 cm left ventricle - ejection fraction: 55% >= 55% left ventricle - stroke volume: 36 ml/beat left ventricle - cardiac output: 2.46 l/min left ventricle - cardiac index: *1.77 >= 2.0 l/min/m2 aorta - annulus: 2.0 cm <= 3.0 cm aorta - sinus level: 2.9 cm <= 3.6 cm aorta - sinotubular ridge: 2.7 cm <= 3.0 cm aorta - ascending: 2.8 cm <= 3.4 cm aorta - arch: 2.0 cm <= 3.0 cm aorta - descending thoracic: 2.1 cm <= 2.5 cm aortic valve - peak velocity: 1.1 m/sec <= 2.0 m/sec aortic valve - peak gradient: 5 mm hg < 20 mm hg aortic valve - mean gradient: 2 mm hg aortic valve - lvot vti: 14 aortic valve - lvot diam: 1.8 cm aortic valve - valve area: *2.0 cm2 >= 3.0 cm2 findings left atrium: moderate la enlargement. no spontaneous echo contrast in the body of the laa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: normal lv wall thickness. normal lv cavity size. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. normal descending aorta diameter. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: myxomatous mitral valve leaflets. moderate/severe mvp. no ms. eccentric mr jet. mr vena contracta is >=0.7cm severe (4+) mr. tricuspid valve: moderate tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: written informed consent was obtained from the patient. the patient was under general anesthesia throughout the procedure. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. see conclusions for post-bypass data conclusions pre-bypass: the left atrium is moderately dilated. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are myxomatous. there is moderate/severe anterior leaflet mitral valve prolapse. an eccentric, posteriorly directed jet of mitral regurgitation is seen. the mitral regurgitation vena contracta is >=0.7cm. severe (4+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results prior to incision. post-bypass: the patient is in sinus rhythm. the patient is on no inotropes. biventricular function is unchanged. there is a mitral annuloplasty ring in place. trace to mild mitral regurgitation is seen. there is a peak gradient of 6 mmhg at a blood pressure of 92/51. tricuspid regurgitation is mild. the aorta is intact post-decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 12:41 ?????? caregroup is. all rights reserved. brief hospital course: on mr. was taken to the operating room and underwent coronary artery bypass grafting x 3 (left internal mammary artery grafted to the left anterior diagnal/ saphenous vein grafted to right coronary artery and obtuse marginal) with dr.. cardiopulmonary bypass time=114 minutes. cross clamp time=96 minutes. please refer to the operative report for further surgical details. he tolerated the procedure well and was transferred to the cvicu intubated and sedated requiring pressor support. he awoke neurologically intact and was extubated. he weaned off pressor support and was started on beta-blocker/statin/ aspirin and diuresis. he had ventricular ectopy requiring an amiodarone drip. his postop rhythm went back to his baseline paroxysmal atrial fibrillation and anticoagulation was resumed with coumadin. all lines and drains were discontinued per protocol. pod#1 he was transferred to the step down unit for further monitoring and increased activity. physical therapy was consulted for evaluation of strength and mobility. he received a unit of packed red blood cells for postoperative anemia likely due to volume resuscitation. his hematocrit remained stable. the remainder of his hospital course was essentially uneventful. he was cleared for discharge to home with services on pod#5. all follow up appointments were advised. medications on admission: losartan 25mg daily tamsulosin 0.4mg daily finasteride 5mg hs mvi daily fibercon 625mg hs colace 100mg florigen 1 po bid miralax daily coumadin 5mg daily for afib**** cephalexin until for strep throat plavix - last dose:none 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). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever/pain. 4. warfarin 1 mg tablet sig: as directed tablet po once a day: indication: afib goal inr 2.0-2.5. disp:*30 tablet(s)* refills:*2* 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 6. finasteride 5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 7. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). 8. amiodarone 200 mg tablet sig: two (2) tablet po once a day: 2 tabs daily for 7 days then on begin 1 tablet daily until advised to stop. disp:*60 tablet(s)* refills:*2* 9. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 weeks. disp:*28 tablet(s)* refills:*0* 11. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*65 tablet(s)* refills:*0* 12. lasix 20 mg tablet sig: one (1) tablet po once a day for 5 days. disp:*5 tablet(s)* refills:*0* 13. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po once a day for 5 days. disp:*10 tablet extended release(s)* refills:*0* 14. outpatient lab work inr check on and call to dr. for coumadin dosing ****very senstitve to coumadin****** discharge disposition: home with service facility: vna discharge diagnosis: coronary artery disease, mitral valve prolapse discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. trace edema 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 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** followup instructions: you are scheduled for the following appointments surgeon: dr. on date/time: 1:15 in the medical office building , wound care nurse phone: date/time: 10:00 in the medical office building , cardiologist: dr at 11:30am please call to schedule appointments with your primary care 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 ?????? indication paroxysmal atrial fibrillation goal inr 2.0-2.5 first draw results to phone dr procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries open heart valvuloplasty of mitral valve without replacement diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders atrial fibrillation hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) constipation, unspecified other and unspecified hyperlipidemia long-term (current) use of anticoagulants 

Answer: The patient is high likely exposed to