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: chest pain major surgical or invasive procedure: mv repair with 34 mm ce physio ii ring history of present illness: this 51 year old orthodontist reports a history of mitral valve prolapse that was initially diagnosed around . he has been followed over the years by serial echocardiograms. echocardiogram in showed severe mr prolapse, with dilation of the lv and atrium. this had progressed compared to an echo in . because of the progression in his disease, he is now being referred for mitral valve replacement on with dr. . in terms of symptoms, the patient describes intermittent "weird chest discomfort" that is non exertional and transient, occurring several days a week. he also has intermittent palpitations. he denies fatigue, shortness of breath, lightheadedness, or presyncope. past medical history: mitral valve prolapse/regurgitation, originally diagnosed in psoriasis : right leg fracture, s/p surgery/plate cyst removed from back t&a wisdom teeth extraction social history: last dental exam: every 6 months lives with: wife in occupation: orthodontist cigarettes: smoked no other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use family history: one older sister with mvp, brother with history of bicuspid aortic valve/ aneurysm in his 30's. physical exam: bp: 140/83. heart rate: 72. resp. rate: 16. pain score:0/100 saturation%: 100. height: 74" weight: 200lb general: wdwn in nad skin: warm, dry and intact. no c/c/e heent: ncat, perrla, eomi, sclera anicteric, op benign, teeth in good repair. neck: supple full rom no jvd chest: lungs clear bilaterally heart: rrr, nl s1-s2, iii-iv/vi holosystolic murmur best heard at apex abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused no edema varicosities: right calf with posterior varicosity and spider varicosities noted below knee. left without varicosities. 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 - transmitted murmur pertinent results: echocardiogram findings left atrium: moderate la enlargement. 5.5 cm right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: normal lv wall thickness, cavity size and regional/global systolic function (lvef >55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal diameter of aorta at the sinus, ascending and arch levels. simple atheroma in ascending aorta. simple atheroma in aortic arch. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. partial mitral leaflet flail. severe (4+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. conclusions pre-bypass: the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. there are simple atheroma in the ascending aorta, aortic arch, and in the descending thoracic aorta. there are three aortic valve leaflets. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is p1/p2 mitral leaflet flail. severe (4+) mitral regurgitation is seen with reversal of flow in the pulmonary veins during systole. there is no pericardial effusion. post-bypass: left ventricular function is preserved with an estimated ef>55%. no wall motion abnormalities are present. mitral regurgitation is significantly improved - now trace. there is no mitral leaflet flail or prolapse. there is a good area of mitral valve coaptation. the peak and mean gradient across the mitral valve are 9/4mmhg. the pressure time is 160cm/s. there are no peri-valvular mild ai is unchanged. there is no evidence of aortic dissection s/p decannulation. . 06:00am blood wbc-6.8 rbc-3.52* hgb-10.5* hct-30.4* mcv-86 mch-29.8 mchc-34.5 rdw-12.4 plt ct-294 06:00am blood wbc-7.4 rbc-3.20* hgb-9.7* hct-27.4* mcv-86 mch-30.4 mchc-35.6* rdw-12.2 plt ct-247 06:00am blood pt-12.6* ptt-24.8* inr(pt)-1.2* 03:29am blood pt-12.3 ptt-28.4 inr(pt)-1.1 06:00am blood glucose-91 urean-15 creat-0.9 na-138 k-4.5 cl-103 hco3-29 angap-11 06:00am blood glucose-93 urean-12 creat-0.8 na-137 k-4.3 cl-102 hco3-31 angap-8 07:40am blood glucose-99 urean-12 creat-0.8 na-135 k-4.4 cl-101 hco3-26 angap-12 06:00am blood calcium-8.5 phos-3.3 mg-2.2 06:00am blood mg-2.2 07:40am blood mg-2.2 brief hospital course: the patient was brought to the operating room on where the patient underwent mitral valve repair with 34 mm ce physio ii ring. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. he required epicardial pacing post-op for a junctional bradycardia he has now recovered with a first degree av block. pod 1 found the patient extubated, alert, oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable. beta blockers were held due to his junctional rhythm he was gently diuresed toward his preoperative weight. the patient was transferred to the telemetry floor for further recovery on pod #1. chest tubes discontinued without complication. on pod #3 he was noted to be in atrial fibrillation rate controlled at 50 bpm. an ep consult was obtained suggesting that av nodal blocking agents should be held and no anticogulation except for asprin 81mg daily. he has now been in sinus rhtym with a first degree block since the morning of pod #4. his pacing wires came out on pod 5. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 5 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged home with services in good condition with appropriate follow up instructions. medications on admission: 1. aspirin 81 mg po daily 2. multivitamins 1 tab po daily discharge medications: 1. aspirin 81 mg po daily 2. hydromorphone (dilaudid) 2-4 mg po q4h:prn pain rx *hydromorphone 2 mg tablet(s) by mouth q3h disp #*40 tablet refills:*0 3. ibuprofen 600 mg po q8h:prn pain rx *ibuprofen 600 mg 1 tablet(s) by mouth every six (6) hours disp #*90 tablet refills:*0 4. multivitamins 1 tab po daily discharge disposition: home with service facility: all care vna of greater discharge diagnosis: mitral valve prolapse psoriasis (mild) broken leg from skiing accident - required surgery/plate cyst removed on back tonsillectomy and adenoidectomy wisdom teeth extraction discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage edema: trace discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: follow-up: you are scheduled for the following appointments: wound check at cardiac surgery office, 10:00 surgeon dr. , md phone: date/time: 1:15 cardiologist dr. at 3:15pm please call to schedule an appt. with your pcp, , . , 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 open heart valvuloplasty of mitral valve without replacement diagnoses: mitral valve disorders cardiac complications, not elsewhere classified atrial fibrillation other specified cardiac dysrhythmias surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation other psoriasis first degree atrioventricular block 

Answer: The patient is high likely exposed to