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 attending: chief complaint: increasing sob/doe major surgical or invasive procedure: avr/maze ( 23mm ce pericardial valve) history of present illness: 66 yo male with sob/doe, found to be in a fib, admitted to . known history of as with 0.6 cm2. transferred for cath and surgical evaluation by dr. .carotid us showed minimal plaque bilat. echo showed severe lvh, ef 60%, trace ai, mild mr, peak gradient 90/mean 55. past medical history: as htn niddm new onset afib elev. chol. bilat. inguinal herniorrhaphies surgical of abd. foreign body 15 years ago social history: smoked 1-1.5 ppd x 18 years, quit 30 years ago occ. glass of wine retired and lives with companion last dental visit in family history: 2 daughters with aortic valve problems physical exam: nad, flat after cath hr 76 afib 111/79 rr 25 96% sat on 2l 3/6 systolic murmur loudest at usb, irregularly irregular rhythm ctab anterolaterally abd obese, nt, soft extrems no edema, with 1+ peripheral pulses radiated murmur to carotids 71" 216 # pertinent results: 05:35am blood wbc-10.4 rbc-2.47* hgb-7.7* hct-22.7* mcv-92 mch-31.2 mchc-33.9 rdw-13.3 plt ct-156 07:30am blood hct-23.2* 05:35am blood plt ct-156 07:30am blood pt-16.8* inr(pt)-1.5* 05:35am blood urean-28* creat-0.8 na-138 k-3.6 cl-100 hco3-29 angap-13 07:30am blood k-4.0 05:15am blood alt-133* ast-75* alkphos-43 amylase-111* totbili-0.5 09:00am blood alt-48* ast-33 alkphos-53 amylase-72 totbili-0.8 05:15am blood lipase-30 07:30am blood calcium-8.4 phos-3.1 mg-2.5 09:00am blood vitb12-292 09:00am blood %hba1c-5.7 -done -done final report history: status post aortic valve replacement. comparison: /06. chest: ap portable view. the endotracheal tube, swan-ganz catheter, feeding tube, chest tubes and drains have been removed. there is a very small right apical pneumothorax. there is new atelectasis at the right lung base. increased opacity at the left lung base likely represents a combination of atelectasis and pleural effusion. there is no pulmonary edema. cardiac and mediastinal contours are unchanged. impression: 1. very small right apical pneumothorax. 2. new right lower lobe atelectasis. worsening left lower lobe atelectasis/left pleural effusion. the study and the report were reviewed by the staff radiologist. dr. . dr. approved: mon 2:31 pm procedure date: , t: cath detail - ccc record # - ccc *** preliminary *** procedure date: indications for catheterization: aortic stenosis. final diagnosis: 1. no angiographically apparent flow limiting coronary artery disease. 2. severe aortic stenosis. 3. severe rv and lv diastolic dysfunction. comments: 1. selective coronary angiography demonstrated no angiographically apparent flow limiting coronary artery disease in this right dominant circulation. the lmca had no angiographically apparent flow limiting disease. the lad and its diagonal branch had no flow limiting disease. the lcx and the om branches had no flow limiting disease. the rca was a dominant vessel without flow limiting disease. 2. resting hemodynamics demonstrated elevated right and left sided filling pressures with rvedp=27 mmhg, lvedp=33mmhg and mean pcwp=33mmhg. cardiac output and index were 4.3 l/min and 2.0 l/min/m2 respectively. the peak gradient across the aortic valve was 120 mmhg. the mean gradient was 88 mmhg with calculated =0.4 cm2. 3. no left ventriculogram performed due to elevated filling pressures. technical factors: total time (lidocaine to test complete) = 42 minutes. arterial time = 36 minutes. fluoro time = 17 minutes. contrast: non-ionic low osmolar (isovue, optiray...), vol 65 ml premedications: asa 325 mg p.o. anesthesia: 1% lidocaine subq. anticoagulation: other medication: fentanyl 25 mcg iv midazolam 1 mg iv cardiac cath supplies used: 150cc mallincrodt, optiray 150cc - allegiance, custom sterile pack pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is moderately depressed globally.. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated. the ascending is mildly dilated. the descending thoracic is mildly dilated. there are simple atheroma in the descending thoracic . the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is no pericardial effusion. post-cpb: improved lv systolic fxn. ef=50-55%. good rv systolic fxn. well-seated and functioning aortic valve prosthesis. no leak, no ai. trace - 1+ mr. . other parameters as pre-bypass. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician brief hospital course: admitted and underwent cath with results noted below. avr/maze performed by dr. on and transferred to the csru in condition on neosynephrine, propofol, insulin ad epinephrine drips. ep service consulted for continuing afib and amiodarone started. extubated on pod #1 and transferred to the floor to begin increasing his activity level. chest tubes removed on pod #2 and gentle diuresis continued with beta blockade also started. pacing wires removed on pod #4 and coumadin started. hct 23 and inr 1.5 on discharge on pod #5. pt to be seen in wound clinic in 2 weeks and follow up as per discharge instructions. coumadin dosing/inr to be followed by dr. with first blood draw on . medications on admission: asa 325 ng daily lopid 600 mg atenolol 100 mg daily glipizide xl 5mg daily lovenox on transfer discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours): x 10 days then qd x 2weeks. disp:*70 capsule, sustained release(s)* refills:*0* 3. 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* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 5. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. glipizide 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 7. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): 400mg x1 wk then 400mg qd x1 wk then 200mg qd. disp:*60 tablet(s)* refills:*0* 9. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily) for 1 months. disp:*30 tablet(s)* refills:*0* 10. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day) for 1 months. disp:*60 tablet(s)* refills:*0* 11. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day): x 10 days the qd x 2 weeks. disp:*40 tablet(s)* refills:*0* 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 13. coumadin 1 mg tablet sig: one (1) tablet po as directed: 1mg 6/19&20 then as directed by dr . disp:*100 tablet(s)* refills:*0* discharge disposition: home with service facility: gentiva discharge diagnosis: s/p avr(#23 pericardial)/maze pmh: as, afib, htn, dm2, ^chol, s/p bil ing hernia repair discharge condition: good discharge instructions: keep wounds clean and dry. ok to shower, no bathing or swimming. take all medications as prescribed. call for any fever, redness or drainage from wounds followup instructions: wound clinic in 2 weeks dr in 4 weeks dr in weeks dr in weeks procedure: extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization coronary arteriography using a single catheter excision or destruction of other lesion or tissue of heart, open approach open and other replacement of aortic valve with tissue graft angiocardiography of right heart structures diagnoses: pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation aortic valve disorders 

Answer: The patient is high likely exposed to