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: history of present illness: this is an 82-year-old gentleman with aortic valve replacement (st. ), rheumatic heart disease and mitral stenosis with an ejection fraction of 50%, atrial fibrillation on coumadin, who awoke on the day of admission with substernal chest pain approximately . he presented to the emergency room at an outside hospital where an ekg showed 1- elevations laterally in 1, l, v5 through v6 with concomitant st depressions in the inferior leads. the cardiology service was consulted and while evaluating the patient he was noted to go into polymorphic ventricular fibrillation. cardiopulmonary resuscitation was begun and the patient was shocked at 360 joules. he then became bradycardic, was given atropine 1 mg and an amiodarone drip was started and the patient was taken emergently to the cardiac catheterization laboratory. in the catheterization laboratory the patient was found to have normal left main, normal left anterior descending coronary artery, and a 20% proximal left circumflex coronary artery. of note, there was also an obtuse marginal #1 with very distal thrombotic occlusion with timi 1 flow. the patient had a normal right coronary artery. he was taken to the coronary care unit for monitoring. review of systems: negative for diaphoresis, nausea, vomiting or palpitations. past medical history: 1. aortic valve replacement (st. placed in ). 2. rheumatic heart disease with moderate to severe mitral stenosis. 3. echocardiogram of demonstrating an ejection fraction of 50%. 4. atrial fibrillation on coumadin with previous cardioversion attempts in 06/99 and . the patient had been switched from sotalol to atenolol for the past year. 5. asthma. 6. hcv, chronic. 7. hypertension. 8. hypercholesterolemia. 9. prostate cancer recently diagnosed in . 10. eczema. 11. transient ischemic attacks. allergies: the patient is allergic to amiodarone, reaction unknown. medications on admission: 1. atenolol 25 q.d. 2. lisinopril 30 q.d. 3. procardia xl 30 q.d. 4. coumadin. 5. albuterol two puffs b.i.d. 6. flovent 10 mcg b.i.d. 7. hydrochlorothiazide 25 q.d. social history: remote history of cigarette smoking. no alcohol use, no drug use. the patient is a clerk. family history: significant for a brother with emphysema. physical examination: on admission temperature was 98, blood pressure 137/72, heart rate 68 and regular, respiratory rate 12, breathing at 95% on a shovel mask. general: no apparent distress, lying on back with shovel mask. heent: five cm of jugular venous distension, pupils equal and reactive to light and accommodation. oropharynx was negative. cardiovascular: regular rate with a 2/6 systolic murmur without radiation, nondisplaced point of maximal impulse, no carotid bruits auscultated. pulmonary: clear to auscultation bilaterally. abdomen: soft, nontender, nondistended. extremities: no cyanosis, clubbing or edema, 2+ dorsalis pedis and radial pulses bilaterally. neurological: examination was nonfocal. skin: examination showed a groin incision which was clean, dry and intact without hematoma. laboratory data/studies: echocardiogram in shows an ejection fraction of 50-55% with moderate left ventricular hypertrophy, moderate to severe ms. the white count on admission was 9.1, hematocrit 38.1, platelet count 183, sodium 140, potassium 3.2, chloride 101, bicarbonate 25, bun 31, creatinine 1.3, glucose 143, ck 210, mb 5, troponin less than .01. a repeat echocardiogram showed an ejection fraction of 20%, aortic valve normal, prosthetic mitral valve 1+ mr, left atrium was dilated, left ventricle showed severe hypokinesis, right ventricle was dilated. the catheterization report is as above. the chest x-ray showed congestive heart failure, mild. an ekg showed atrial fibrillation at 65 beats per minute with normal intervals, st elevations in 1, l, v5 through v6, approximately 1-2 mm; st depressions in leads 2 and 3. hospital course: the patient was admitted to the coronary care unit for observation. his cks were cycled. the patient was placed on telemetry and serial ekgs were performed. 1. status post ventricular fibrillation arrest: the patient was continued on an amiodarone drip in the coronary care unit at 1 mg per minute, then decreased to 0.5 mg per minute due to bradycardia (heart rate in the 40s to 50s) and an episode of hypotension with systolic blood pressure in the 80s. on the patient was switched to p.o. amiodarone .i.d. on the patient's amiodarone was discontinued. 2. distal obtuse marginal #1 lesion: the patient's distal obtuse marginal #1 lesion was thought to be embolic in origin secondary to being off of coumadin in anticipation of a prostate biopsy. a transthoracic echocardiogram was performed on which demonstrated an ejection fraction of 35%, mildly dilated left atrium, decreased atrial velocity with a mechanical aortic valve, mitral stenosis, global left ventricular hypokinesis, rheumatic mitral disease with no thrombus. 3. anticoagulation: the patient was anticoagulated in the setting of atrial fibrillation and left ventricular hypokinesis. his coumadin dose was titrated to an inr of . the heparin drip was overlapped with coumadin and was discontinued on the day of discharge at which time the patient's inr was 2.5. 4. post myocardial infarction: the patient was put on a post myocardial infarction regimen of aspirin, beta blockers, statin and ace inhibitor. 5. chronic obstructive pulmonary disease/asthma: the patient's clinical findings of wheezing gradually improved over the course of his hospital stay on metered dose inhalers and nebulizers. the patient's oxygen requirement decreased and on the day of discharge the patient was breathing at 98% on room air and his physical examination was remarkable for the absence of crackles or wheezing. 6. bradycardia: the patient did have any episode of bradycardia to the 40s to 50s, during which time he was symptomatic and resolved spontaneously. 7. cardiac enzymes: the patient's ck dropped from a maximum of 1,412 to 187. condition on discharge: good. discharge status: on the day of discharge the patient's blood pressure is 112/62 with a heart rate of 72, breathing at 98% on room air. the patient was asymptomatic with no events on telemetry. discharge diagnoses: 1. posterior/lateral myocardial infarction. 2. atrial fibrillation. discharge medications: 1. aspirin 325 mg, one p.o. q.d. 2. protonix 40 mg tablets, p.o. q.d. 3. atorvastatin 10 mg, one p.o. q.d. 4. fluticasone propionate 110 mcg aerosolized, two puffs b.i.d. 5. ipratropium bromide 0.2 mg per ml inhalation q. 6. 6. lisinopril 10 mg p.o. q.d. 7. coumadin 2.5 mg alternating with 3.75 mg q.o.d. 8. albuterol 90 mcg aerosolized, 1-2 puffs q. 4-6 hours p.r.n. 9. atenolol 25 mg tablet, one-half of a tablet p.o. q.d. follow-up plans: the patient was discharged home with a visiting nurse. he was advised to take his medications as prescribed and to return to the emergency department or call 911 with fevers, chills, nausea, vomiting, chest discomfort, shortness of breath, bloody stools, worsening cough, or any other concerning symptoms. the patient was advised to make a follow-up appointment with dr. at within one week of discharge. the patient was advised to visit the clinic in the next two to three days. the patient had an appointment arranged with dr. on at 10:50 at , phone number , and with dr. at the center at on at 2:30 pm. the patient was also advised to follow up with dr. regarding possible future electrophysiological testing for risk stratification, including a possible signal averaged ecg. , m.d. dictated by: medquist36 d: 11:45 t: 07:12 job#: procedure: coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart other electric countershock of heart diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified chronic hepatitis c without mention of hepatic coma atrial fibrillation cardiac arrest ventricular fibrillation chronic obstructive asthma, unspecified rheumatic mitral insufficiency acute myocardial infarction of other lateral wall, initial episode of care 

Answer: The patient is high likely exposed to