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: chief complaint and history of present illness: this is a 58- year-old gentleman who was diagnosed with a heart murmur 3 years ago. an echo was done at the time revealing mitral regurgitation. he was treated with lasix and lopressor. he became more symptomatic this past spring with shortness of breath. a repeat echo revealed severe mitral regurgitation with flailed leaflet. he was also diagnosed with atrial fibrillation. he was subsequently referred for surgical procedure. the patient's major surgical procedure at this time is status post mitral valve replacement with a no. 33 st. mechanical valve and coronary artery bypass graft x2, lima to lad and saphenous vein graft to an om. past medical history: consistent with sleep apnea, atrial fibrillation, hypertension, congestive heart failure, nephrolithiasis, gout. clostridium difficile following cath. past surgical history: his past surgical history consists of the following: tonsillectomy as a child, right hernia repair in the 6th grade, lithotripsy for kidney stones. medications at home: 1. coumadin 2.5 mg once daily. 2. lasix 20 mg once daily. 3. digoxin 0.125 mg once daily. 4. lisinopril 5 mg once daily. 5. colchicine 0.6 mg once daily. allergies: no known drug allergies. family history: his father died of coronary artery disease. his mother died of a cerebrovascular accident. he works for a delivery company. he denies tobacco. he lives in , mass, with two other people. his last dental examination was this spring. he infrequently drinks alcohol. physical examination: the patient has lost 30 pounds in the last 6 months intentionally. his head, ears, eyes, nose and throat examination is normal. the patient does wear glasses. his neck is supple. there is no lymphadenopathy. he has full range of motion. he has positive sleep apnea. his chest is otherwise clear to auscultation bilaterally. cardiac examination: he complains of shortness of breath. he has dyspnea on exertion. he also has orthopnea. the patient has an irregularly irregular rate and rhythm. he has 2/6 systolic murmur. his abdomen is obese. he has positive bowel sounds. his extremities are warm and well perfused. he has trace lower extremity edema bilaterally. he also had bilateral venous stasis ulcers. he has varicosities on the left lower extremity that are grossly varicosed on the right. they are more impressive with standing. neurological examination: he is alert, awake, and oriented x3. he has 5/5 strength. he has a steady gait and no focal deficits. his femoral pulses are 2+ bilaterally as are his dorsalis pedis pulses and posterior tibial pulses. he does not have carotid bruits on the right. he has a small left transmitted carotid bruits on the left hand side. brief hospital course: on , the patient was admitted to the cardiac surgery service. he was preop'd for mitral valve replacement and coronary artery bypass graft. his preop laboratory values were the following: his hematocrit was 39.5, his white blood cell count was 7.6, his platelets were 163. his serum sodium was 141, his potassium was 4.4, his chloride was 104, his bicarb was 28, and his bun was 20. his creatinine was 1.1 and glucose was 98. his coags showed pt of 15, ptt was 30, and his inr was 1.6. the patient had a carotid ultrasound. he was started on heparin and repeat coags were checked in the morning prior to surgery. the patient was in hospital for approximately 3 days prior to surgery for preoperative evaluation in order to monitor him and prep him for surgical procedure which he had on . on , the patient underwent a coronary artery bypass graft x2 and a mitral valve replacement. on postoperative day 1, the patient was in the cardiothoracic surgery intensive care unit. he was doing well and promptly transferred to the regular hospital floor. his blood pressure was monitored strictly as were his ins and outs. he had chest tubes that were removed on postoperative day 2. he was transfused a unit of blood on postoperative day 2. his gout was also controlled and colchicine was restarted as per his prior preoperative medications. the patient was maintained on a heparin drip due to previous atrial fibrillation. he was also started on coumadin following his surgery. lopressor was also used to control his blood pressure. the patient had an x- ray of the left hand to rule out a subluxation at the left first digit at the mp joint. the x-ray was negative for any fractures. he had a physical examination by the house officer which revealed a chronic gamekeeper's thumb. the patient was advised that if he wanted to pursue surgery that he could do so and can follow up with the hand surgeon. the patient denied that. the patient was continued on heparin drip and coumadin, however waiting for the patient's coumadin to become therapeutic. on postoperative day 6, the patient was continued on heparin and coumadin. on postoperative day 8, the patient's coumadin was finally therapeutic at 2.2. he was discharged with very strict instructions that he was to follow up at . the patient's previous primary care physician no longer worked at . arrangements were made with a nurse at so that the patient could be followed up within 3 days for adjustment of his inr dosing. he was discharged on 5 of coumadin for 3 days and he also had 2.5 mg tablets of his coumadin. medications: 1. lasix 20 mg po b.i.d. for 7 days. 2. potassium chloride 10 meq po q12 hours for 7 days. 3. colace 100 mg po b.i.d. 4. aspirin 81 mg, delayed release po once daily, 30 tabs, 2 refills. 5. percocet 5/325 mg 1 to 2 tabs po q4 to 6 hours, dispensed 30 tabs. 6. bisacodyl 10 mg suppository daily, dispensed 30. 7. atorvastatin 10 mg po once daily, 30 tabs, 2 refills. 8. colchicine 0.6 mg 1 tab po once daily. 9. metoprolol 25 mg po b.i.d. 10. protonix 40 mg po once daily. 11. coumadin 2.5 mg tablets. the patient was to take 5 mg for the next 3 days and then follow up with his primary care physician at at the clinic for adjustment. discharge diagnoses: 1. atrial fibrillation 2. coronary artery disease. 3. gout. 4. congestive heart failure. discharge disposition: he was stable upon discharge. the patient was told that he may shower but not take baths. he is to use no creams, lotions or ointments to his incisions. he was not allowed to drive for at least 1 month and no lifting over 10 pounds for at least 10 weeks from the day of the surgery. he is to monitor his wounds for infection. he is to follow up with his pcp as previously discussed. he was given instructions to follow up with dr. ; phone no. , within one month. the patient's discharge condition was stable. , m.d. procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery non-invasive mechanical ventilation (aorto)coronary bypass of one coronary artery open and other replacement of mitral valve transfusion of packed cells continuous intra-arterial blood gas monitoring diagnoses: abnormal coagulation profile coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension gout, unspecified atrial fibrillation ostium secundum type atrial septal defect unspecified sleep apnea family history of ischemic heart disease asymptomatic varicose veins laxity of ligament 

Answer: The patient is high likely exposed to