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: no known allergies / adverse drug reactions attending: chief complaint: shortness of breath with exertion major surgical or invasive procedure: patch clousre of right sinus of valsalva aneurysm history of present illness: 56 year old male with known right sinus of valsalva aneurysm and mildly dilated aortic root and minimally dilated ascending aorta. followed with serial echocardiograms and ct scans. the echocardiograms for several years leading up to visit in showed pretty stable aneurysm measuring approximately 5.2cm. recommendation was no surgery and follow-up in 1 year with repeat ct and echo. recently underwent ct scan in but given lack of contrast, it was difficult to assess the sinuses of valsalva. aorta measured 4.0cm at level of main pulmonary artery. he underwent an echo which revealed the aorta at the level of the sinus measured 6.1cm. he was underwent cardiac catheterization in preperation for surgical repair and found to have clean coronaries. he is admitted for surgical repair. past medical history: right sinus of valsalva aneurysm aortic root dilatation copd hypertension rheumatoid arthritis seizures (last one over 10 years ago)possible gout social history: lives with:divorced with four children. one of his sons lives with him occupation:works as a custodian cigarettes: smoked no yes hx:smoked up to 2ppd for about 25 years. he quit 12 years ago other tobacco use:denies etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use:denies family history: premature coronary artery disease- uncle with "heart disease". mother with hypertension physical exam: pulse:74 resp:18 o2 sat:96/ra b/p right: 119/83 left: 117/81 height:5'8" weight:181 lbs general: skin: dry intact macular rash on chest, patchy rash left forearm, left shoulder x several years (eczema) heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema-none varicosities: none neuro: grossly intact pulses: femoral right:2+ left:2+ dp right:2+ left:2+ pt :2+ left:2+ radial right:2+ left:2+ carotid bruit right: left: no bruits pertinent results: echo: pre-bypass: the left atrium is normal in size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. due to suboptimal transgastric technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size and free wall motion are normal. the aortic root is severely dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. there was a 2cm x 2cm aneurysm of the right coronary sinus with a broad neck. no associated vsds seen. dr. was notified in person of the results before surgical incsion. post bypass: preserved biventricular systolic function. lvef 55%. no valvular findings. intact thoracic aorta. the sinus patch appears intact and no flow across. the old aneurysm appears to be excluded from the main flow. 05:10am blood wbc-7.7 rbc-3.23* hgb-10.4* hct-30.8* mcv-95 mch-32.2* mchc-33.8 rdw-13.2 plt ct-315 10:44am blood wbc-16.0*# rbc-2.81*# hgb-9.1*# hct-26.8*# mcv-95 mch-32.5* mchc-34.1 rdw-13.2 plt ct-138* 04:47am blood pt-12.1 ptt-27.1 inr(pt)-1.1 05:10am blood glucose-90 urean-16 creat-0.8 na-137 k-4.0 cl-101 hco3-29 angap-11 11:53am blood urean-17 creat-0.9 na-141 k-4.8 cl-108 hco3-29 angap-9 brief hospital course: as mentioned in the hpi, mr. is 56 year old male with known right sinus of valsalva aneurysm and mildly dilated aortic root and minimally dilated ascending aorta. followed with serial echocardiograms and ct scans. the echocardiograms showed increased aneurysm size and surgerical repair was advised. during the pre-op work up a diagnostic cardiac cath was done on showed non- significant coronary disease. on he was brought to the operating room where he underwent a patch closure of his right sinus of valsalva. please see operative report for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. later that day he was weaned from sedation, awoke neurologically intact and extubated. he was started on lopressor and lasix. chest tubes and temporary pacing wires were removed per protocol. he did develop an ileus. general surgery was consulted. the patient was kept npo on ivf with an ngt. ileus resolved and the patient's diet was advanced as tolerated. additionally, he developed pain in the left foot. xray showed no fracture or bony abnormality detected. he was evaluated by physical therapy for strength and conditioning and cleared for discharge to home on pod#9. all instructions and appointments were advised. medications on admission: preadmission medications listed are correct and complete. information was obtained from webomr. 1. lisinopril 10 mg po daily 2. hydroxychloroquine sulfate 200 mg po bid 3. metoprolol tartrate 100 mg po bid 4. phenytoin sodium extended 400 mg po daily 5. budesonide (nasal) *nf* 2 puff nu discharge medications: 1. aspirin ec 81 mg po daily rx *enteric coated aspirin 81 mg 1 tablet(s) by mouth daily disp #*60 tablet refills:*2 2. metoprolol tartrate 37.5 mg po tid rx *metoprolol tartrate 25 mg 1.5 tablet(s) by mouth three times a day disp #*90 tablet refills:*2 3. hydroxychloroquine sulfate 200 mg po bid rx *hydroxychloroquine 200 mg 1 tablet(s) by mouth twice a day disp #*60 tablet refills:*2 4. docusate sodium 100 mg po bid rx *colace 100 mg 1 capsule(s) by mouth twice a day disp #*60 tablet refills:*2 5. fluticasone-salmeterol diskus (250/50) 1 inh ih rx *advair diskus 250 mcg-50 mcg/dose 1 puff inh twice a day disp #*1 inhaler refills:*1 6. pantoprazole 40 mg po q24h rx *pantoprazole 40 mg 1 tablet(s) by mouth daily disp #*60 tube refills:*2 7. budesonide (nasal) *nf* 2 puff nu rx *budesonide 2 puffs twice a day disp #*1 inhaler refills:*0 8. metoclopramide 10 mg po qidachs duration: 5 days rx *metoclopramide hcl 10 mg 1 tablet(s) by mouth qidachs disp #*20 tablet refills:*2 9. phenytoin sodium extended 400 mg po daily rx *phenytoin sodium extended 200 mg 2 capsule(s) by mouth daily disp #*60 tablet refills:*2 discharge disposition: home with service facility: vna discharge diagnosis: patch clousre of right sinus of valsalva aneurysm right sinus of valsalva aneurysm aortic root dilatation copd hypertension rheumatoid arthritis seizures (last one over 10 years ago)possible gout discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema: trace 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 and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive 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 at 1:30p in the medical office building, . wound check at 10:30am in the medical office building, , please call to schedule appointments with your cardiologist: dr. primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery operations on other structures adjacent to valves of heart diagnoses: unspecified essential hypertension gout, unspecified personal history of tobacco use other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other emphysema paralytic ileus rheumatoid arthritis epilepsy, unspecified, without mention of intractable epilepsy other anomalies of aorta other digestive system complications 

Answer: The patient is high likely exposed to