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: fatigue major surgical or invasive procedure: - 1. mitral valve repair, radical mitral valve repair with posterior leaflet (p2) triangular leaflet resection and ring annuloplasty using an 32-mm physio ii ring. 2. coronary artery bypass grafting x1, left internal mammary artery to left anterior descending coronary artery. 3. full left and right-sided maze procedure with resection of left atrial appendage using combination of gemini x bipolar rf system and the cryocath system. 4. left atrial reduction procedure. - cardiac catheterization history of present illness: 75 year old gentleman with known mitral valve regurgitation and prolpase which has been followed by echocardiogram. this was first discovered in when he established primary care with dr. . he previously had not been to a physician in many years however notes a 26 year history of being told he had a heart murmur. his history is complicated by an episode last year of delerium and dementia which was possibly caused by acute alcohol toxicity and or acute renal failure. he is left with a bilateral frontal lobe dysfunction which leave him with cognitive and psychomotor dysfunction but his laguage function, visuospacial and memory are intact. given the severity of his disease, he has been referred for surgical evaluation. past medical history: mitral regurgitation mitral valve prolapse paroxysmal atrial fibrillation hypertension vitamin b12 deficiency dementia alcohol abuse social history: lives with: wife occupation: retired police officer tobacco: 1ppd for 15 years quit 40 years ago etoh: ?past etoh abuse. none in 1 year family history: noncontributory physical exam: pulse: 65 resp: 16 o2 sat: 100% b/p right: 154/95 left: 154/99 height: 70 weight: 195 general: wdwn skin: warm dry intact heent: ncat perrla eomi sclera anicteric, op . teeth in good repair. neck: supple full rom jvd chest: lungs clear bilaterally heart: rrr, iv/vi blowing systolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused no edema varicosities: none neuro: slowing in regards to his reponse to questions noted. did repeat questions. a+ox3. strength equal bilaterally. gait steady. no focal deficits. pulses: femoral right:2 left:2 dp right:2 left:2 pt :2 left:2 radial right:2 left:2 carotid bruit- right: transmitted vs bruit left: none pertinent results: echo prebypass the left atrium is massive. no atrial septal defect is seen by 2d or color doppler. the left ventricle is not well seen. overall left ventricular systolic function however appears normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. the mitral valve leaflets are mildly thickened. there is partial posterior mitral leaflet flail. an eccentric, anteriorly directed jet of severe (4+) mitral regurgitation is seen. postbypass the lv remains difficult to visualize. lv systolic function appears at least mildly impaired. the ventricular septum appears dyskinetic and the inferior wall appears hypokinetic. there is a ring prostheis in the mitral position. the mv leaflets coapt and no mr . the laa is no longer . rv systolic function remains normal. - cardiac catheterization 1. coronary angiography in this right dominant system demonstrated single vessel disease. the lmca in some views appeared to have a 50% ostial lesion however with repositioning of the catheter there was no stenosis present and there was no catheter dampening observed. the lad had 30% proximal stenosis and 50-60% mid vessel stenosis. the lcx and rca had minimal disease. 2. limited resting hemodynamics revealed mild systemic arterial systolic hypertension with sbp 140 mmhg. final diagnosis: 1. one vessel coronary artery disease. 2. mild systemic arterial systolic hypertension. - carotid ultrasound impression: right ica stenosis <40%. left ica stenosis <40%. coumadin at hospital - received 2mg coumadin - inr 1.3 , 5mg coumadin - inr 1.2 , coumadin 2mg - inr 1.3 - coumadin 2 mg - inr 1.8 brief hospital course: presented for cardiac catheterization and admitted post procedure for preoperative workup. on he was taken to the operating room and underwent mitral valve repair, a maze procedure and coronary artery bypass graft surgery. please see operative note for further details. postoperatively he was taken to the intensive care unit for monitoring. he required epinephrine, fluids, and neosynephrine for hemodynamic management, continued on amiodarone drip for maze procedure. he remained intubated due to hypoxia requiring increased peep. on postoperative day and fluids vasn postoperative day one, he was weaned off the neosynephrine and epinephrine and hemodynamically remained stable. the amiodarone was stopped due to slow junctional rhythm at rate of 50. he remained on propofol while intubated and postoperative day two he was weaned and extubated from the ventilator. he was started on betablockers when he was in atrial fibrillation with ventricular rate 70-80, and started on ace inhibitor for blood pressure management. the physical therapy service was consulted for assistance with his postoperative strength and mobility. on postoperative day three he was transferred to the step down unit for further recovery. he continued to progress, ep was consulted for rhythm management with plan for betablockers at this time and potential cardioversion and amiodarone in one month. his epicardial wires were cut due to low platelet count and he was restarted on coumadin for his atrial fibrillation. he was ready for discharge to rehab on post operative day five to the in . coumadin at hospital - received 2mg coumadin - inr 1.3 , 5mg coumadin - inr 1.2 , coumadin 2mg - inr 1.3 - coumadin 2 mg - inr 1.8 plan from ep for treatment of atrial fibrillation from omr note 76 yo male with history of cad, atrial fibrillation, and mvp/mr s/p mv repair/cabgx1(lima->lad)/maze/laa resection on . patient had successful repair of mitrial valve and persistent atrial fibrillation with adequate ventricular response. at this point the patient is asymptomatic, rate controlled with metoprolol and anti-coagulated with warfarin (inr subtherapeutic). goal will be to revert to sinus rhythm, however we do not want to cardiovert this patient in the post-op period without adequate anti-coagulation --continue anti-coagulation with warfarin --after 4 weeks will initiate amiodarone 400mg po daily --plan for dc cardioversion in 5 weeks - we will arrange this procedure --follow up with surgery/primary cardiologist as scheduled medications on admission: atenolol 100 mg daily coumadin 2mg daily (ld ) aricept 10mg daily folate 1mg daily lorazepam prn vitamin b12 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). 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. 4. aricept 10 mg tablet sig: one (1) tablet po once a day. 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours). 7. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 8. warfarin 2 mg tablet sig: one (1) tablet po once a day: please check pt/inr mon and wed and fri - and adjust dose based on inr with goal inr 2.0-2.5 for afib . 9. cyanocobalamin 100 mcg tablet sig: one (1) tablet po daily (daily). 10. coumadin and inr coumadin at hospital - received 2mg coumadin - inr 1.3 , 5mg coumadin - inr 1.2 , coumadin 2mg - inr 1.3 - coumadin 2 mg - inr 1.8 11. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 2 weeks. 13. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dry eyes. 14. lisinopril 10 mg tablet sig: one (1) tablet po bid (2 times a day). 15. metoprolol tartrate 50 mg tablet sig: 1.5 tablets po bid (2 times a day): 75 mg twice a day . 16. labs please check pt/inr monday, wednesday and friday for minimum of 2 weeks please check cr and potassium and magnesium weekly while at rehab discharge disposition: extended care facility: at discharge diagnosis: mitral regurgitation s/p mv repair mitral valve prolapse paroxysmal atrial fibrillation s/p maze coronary artery disease s/p cabg hypertension vitamin b12 deficiency dementia discharge condition: alert and oriented x2, nonfocal ambulating with assistance incisional pain managed with tylenol atc incisions: sternal - healing well, no erythema or drainage with steri strips 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 **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 tuesday at1:30pm () cardiologist: dr at 10:30 am please call to schedule appointments with your: primary care: dr. () in weeks labs: pt/inr for coumadin indication: atrial fibrillation goal inr 2.0-2.5 first draw day after discharge friday then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by pcp please contact coumadin clinic at for management of coumadin after discharge from rehab coumadin at hospital - received 2mg coumadin - inr 1.3 , 5mg coumadin - inr 1.2 , coumadin 2mg - inr 1.3 - coumadin 2 mg - inr 1.8 **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization excision or destruction of other lesion or tissue of heart, open approach open heart valvuloplasty of mitral valve without replacement excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: acidosis other iatrogenic hypotension coronary atherosclerosis of native coronary artery mitral valve disorders unspecified essential hypertension acute posthemorrhagic anemia atrial fibrillation other persistent mental disorders due to conditions classified elsewhere other b-complex deficiencies pulmonary collapse 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 long-term (current) use of anticoagulants 

Answer: The patient is high likely exposed to