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: increasing shortness of breath major surgical or invasive procedure: mitral valve replacement with a 25-mm st. medical epic tissue valve through a right thoracotomy (3rd time cardiac surgery) history of present illness: 79 year old male s/p coronary artery bypass graft x4 , s/p redo coroanry artery bypass graft x1 (svg to lad)/ aortic valve replacement(pericardial) . he presented to pcp 1 week ago with complaint of shortness of breath x 3 weeks. he had an upper respiratory tract infection which was treated and symptoms improved somewhat. he became acutely short of breath and went to mwmc er on . an echo was done that showed progression from mild mitral regurgitation to wide open severe mitral regurgitation this week with possible torn chords. past medical history: coronary artery disease - s/p cabg x 4 s/p avr and cabg right cataract surgery hypertension elevated cholesterol insulin dependent diabetes mellitus neuropathy tia with moderate bilateral internal carotid artery stenoses ventricular tactycardia colon polyps gerd social history: retired engineer lives with wife 100 pack-year history to smoking, quit 40 years ago etoh denies family history: father died of mi physical exam: skin: dry intact heent: perrla eomi full upper and lower dentures. right hearing aid in place. neck: supple full rom x chest: lungs clear bilaterally heart: rrr s3 murmur iii/vi abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none **********left leg svg incision scar from groin to ankle right groin w/ mynx cloasure device- no hematoma neuro: grossly intact pulses: femoral right: minyx closure left:+2 dp right: +2 left:+2 pt : +2 left:+2 radial right: +2 left:+2 carotid bruit - bruit bilat - vs radiating murmur right: +2 left:+2 pertinent results: 05:45am blood wbc-10.2 rbc-3.52* hgb-9.5* hct-29.6* mcv-84 mch-27.1 mchc-32.2 rdw-14.4 plt ct-160 06:58pm blood wbc-8.5 rbc-4.49*# hgb-12.2* hct-37.4* mcv-83 mch-27.1 mchc-32.5 rdw-14.1 plt ct-151 05:45am blood plt ct-160 06:58pm blood plt ct-151 06:58pm blood pt-14.3* ptt-28.4 inr(pt)-1.2* 05:20pm blood fibrino-208 05:45am blood glucose-81 urean-31* creat-1.2 na-137 k-4.8 cl-101 hco3-29 angap-12 06:58pm blood glucose-129* urean-26* creat-1.1 na-138 k-4.8 cl-101 hco3-31 angap-11 05:45am blood mg-2.1 07:50am blood calcium-9.0 phos-3.7 mg-1.8 06:58pm blood albumin-3.6 mg-2.0 06:58pm blood %hba1c-6.7* 01:39pm blood heparin dependent antibodies- negative echocardiography report , (complete) done at 2:10:48 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 79 m hgt (in): 58 bp (mm hg): / wgt (lb): 196 hr (bpm): bsa (m2): 1.81 m2 indication: intraop mvr evaluate valves, aorta, ventricular function. right thoracotomy approach (h/o 2 previous sternotomies) icd-9 codes: 424.0 test information date/time: at 14:10 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 #: 2010aw1-: machine: aw 5 echocardiographic measurements results measurements normal range left atrium - long axis dimension: *6.0 cm <= 4.0 cm left atrium - four chamber length: 5.0 cm <= 5.2 cm left atrium - peak pulm vein s: 0.0 m/s left atrium - peak pulm vein d: 1.0 m/s left atrium - peak pulm vein a: *0.4 m/s < 0.4 m/s left ventricle - ejection fraction: 50% to 55% >= 55% left ventricle - stroke volume: 156 ml/beat left ventricle - peak resting lvot gradient: 0 mm hg <= 10 mm hg aorta - arch: 2.5 cm <= 3.0 cm aorta - descending thoracic: *2.8 cm <= 2.5 cm aortic valve - peak velocity: 1.5 m/sec <= 2.0 m/sec aortic valve - peak gradient: 9 mm hg < 20 mm hg aortic valve - mean gradient: 4 mm hg aortic valve - lvot vti: 45 aortic valve - lvot diam: 2.1 cm mitral valve - peak velocity: 1.2 m/sec mitral valve - mean gradient: 2 mm hg mitral valve - e wave: 0.8 m/sec mitral valve - a wave: 0.7 m/sec mitral valve - e/a ratio: 1.14 mitral valve - e wave deceleration time: 141 ms 140-250 ms findings left atrium: marked la enlargement. right atrium/interatrial septum: mildly dilated ra. pfo is present. left ventricle: normal lv wall thickness. normal lv cavity size. right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. focal calcifications in ascending aorta. normal aortic arch diameter. complex (>4mm) atheroma in the aortic arch. mildly dilated descending aorta. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: avr well seated, normal leaflet/disc motion and transvalvular gradients. no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. no ms. eccentric mr jet. effective regurgitant orifice is >=0.40cm2. severe (4+) mr. uninterpretable lv inflow pattern due to mr. tricuspid valve: normal tricuspid valve leaflets. normal tricuspid valve supporting structures. no ts. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. no pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. conclusions pre bypass: the left atrium is markedly dilated. a patent foramen ovale is present. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. the right ventricular cavity is mildly dilated with normal free wall contractility. there are complex (>4mm) atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. an eccentric, anteriorly directed jet of the effective regurgitant orifice is >=0.40cm2 severe (4+) mitral regurgitation is seen. there appears to be p2 flail with a torn chordae. post bypass: patient is on phenylepherine and epinepherine infusions, intermittently v paced. a bioprosthetic valve ( #25 tissue valve per surgeons) is insitu and appears well seated. peak gradient 8, mean 4 mm hg, no perivalvular leaks. aortic bioprosthesis appears unchanged with no perivavluar leaks, ai or change in gradients. tr remains mild. aortic contours intact. remaining exam is unchanged. all findings discussed with srugeons at the time of the exam. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 17:57 radiology report chest (pa & lat) study date of 10:15 am , r. csurg fa6a 10:15 am chest (pa & lat) clip # reason: evaluate right lower lobe medical condition: 79 year old man with s/p mvr reason for this examination: evaluate right lower lobe final report chest radiograph indication: status post mitral valve replacement. comparison: . findings: as compared to the previous examination, the pre-existing right basal pleural effusion with subsequent right basal atelectasis are unchanged in extent. also unchanged is the small retrocardiac area of hypoventilation. better visible than on the previous radiograph is a minimal blunting of the left costophrenic sinus, suggesting presence of a minimal left pleural effusion. unchanged size of the cardiac silhouette. no evidence of overt pulmonary edema. unchanged alignment of the sternal wires and the clips. dr. approved: tue 11:02 am brief hospital course: transferred from outside hospital for surgical evaluation for mitral valve. he underwent preoperative workup and discussions about risk and benefits due to previously having two cardiac surgeries. he was brought to the operating for mitral valve replacement. see operative report for further details. he received vancomycin for perioperative antibiotics and was transferred to the intensive care unit for post operative management. in the first twenty four hours he was weaned from sedation, awoke neurologically intact and was extubated without complications. he remained in the intensive care unit for blood pressure management and neurological due to confusion with narcotics, which were stopped. he continued to progress, physical therapy worked with him on strength and mobility. he was transferred to the floor for the remainder of his care. on post operative day three he had prolonged pr interval and lopressor was held. his rhythm was monitored and lopressor was resumed in smaller dose with pr interval stable. he continued to progress and was ready for discharge to rehab on post operative day six. right thoracotomy with skin tears, ecchymosis, and edema upper lip of incision, but continues to improve. medications on admission: plavix (tia) 75 mg daily, amlodipine 5mg daily, metoprolol 50mg , atorvastatin 80mg daily, asa 81 daily, flomax .4 daily, lantus 55 units, novolg sliding scale, protonix 40mg daily 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. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. acetaminophen 325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain/fever. 5. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 6. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 7. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 8. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks. 9. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 2 weeks. 10. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 11. outpatient lab work labs: please check cr and potassium thrusday and call results to c at cardiac surgery office 12. insulin glargine 100 unit/ml solution sig: fifty five (55) units subcutaneous once a day: in am . 13. humalog 100 unit/ml solution sig: sliding scale subcutaneous before each meal and bedtime : glucose insulin dose insulin dose insulin dose insulin dose 0-70 mg/dl proceed with hypoglycemia protocol proceed with hypoglycemia protocol proceed with hypoglycemia protocol proceed with hypoglycemia protocol 71-90 mg/dl 0 units 0 units 0 units 0 units 91-120 mg/dl 3 units 3 units 3 units 0 units 121-150 mg/dl 6 units 6 units 6 units 0 units 151-190 mg/dl 9 units 9 units 9 units 2 units 191-230 mg/dl 12 units 12 units 12 units 4 units 231-280 mg/dl 15 units 15 units 15 units 6 units > 280 mg/dl . 14. sliding scale insulin - humalog breakfast lunch dinner bedtime 71-90 mg/dl 0 units 0 units 0 units 0 units 91-120 mg/dl 3 units 3 units 3 units 0 units 121-150 mg/dl 6 units 6 units 6 units 0 units 151-190 mg/dl 9 units 9 units 9 units 2 units 191-230 mg/dl 12 units 12 units 12 units 4 units 231-280 mg/dl 15 units 15 units 15 units 6 units 15. motrin 400 mg tablet sig: one (1) tablet po every 6-8 hours as needed for pain. discharge disposition: extended care facility: healthcare center - discharge diagnosis: mitral regurgitation s/p mitral valve replacement via right thoracotomy due to s/p cabg and s/p avr via sternotomy hypertension hyperlipidemia diabetes mellitus type 2 neuropathy tia with moderate bilateral internal carotid artery stenosis ventricular tachycardia colon polyps gastric esophageal reflux disease discharge condition: alert and oriented x3 nonfocal except decreased rom right arm d/t surgery ambulating, gait steady right thoracotomy pain managed with tylenol and motrin prn discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your 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 followup instructions: dr. in 3 weeks at heart center for wound check and post-op follow-up : 9:30am dr. at heart center 10am please call to schedule dr. in 2 weeks labs: please check cr and potassium thrusday and call results to c at cardiac surgery office procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft other operations on lung diagnoses: esophageal reflux mitral valve disorders unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status other and unspecified hyperlipidemia long-term (current) use of insulin pressure ulcer, lower back personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits drug-induced delirium pleurisy without mention of effusion or current tuberculosis long-term (current) use of aspirin pressure ulcer, stage i other specified analgesics and antipyretics causing adverse effects in therapeutic use rupture of chordae tendineae 

Answer: The patient is high likely exposed to