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: heparin agents attending: chief complaint: fatigue major surgical or invasive procedure: mvr ( 29mm st. porcine)/cabg x3 (lima to lad, svg to diag, svg to om) / placement iabp rle thrombectomy/popliteal stent/ant. tibial angioplasty/stent pacemaker placement ( sensia) right fem- bpg right bka percutaneous trach/open j tube/ cholecystostomy tube tunnel line placement in interventional radiology history of present illness: 86 year old male with known coronary artery disease and questionable mitral regurgitation followed by echo, s/p pci and bms in , reports progressive dyspnea on exertion and fatigue over the last month. cardiac catherization revealed coronary artery disease. he was referred to cardiac surgery for coronary artery bypass surgery and possible miral valve replacement. past medical history: s/p bare metal stents coronary artery disease s/p pci atrial fibrillation hypertension hypercholesterolemia ascites chronic renal insufficiency low back pain depression obstructive sleep apnea turp bilateral inguinal hernia repair bilateral carpal tunnel surgery social history: retired. owned wholesale groceries. lives with wife (who has ) and daughter. quit tobacco 48 years ago. (2packs per day x ? years) family history: brother passed away at age 84 from heart attack both parents had a stroke in their 60s-70s. physical exam: physical exam on admission: vss: pulse=57, rr=18, bp: 101/59, ht=5'8", wt:62.7kg general:cachectic, alert and oriented x3 heent: at/nc, eomi, perrl lungs: cta cvs: irregularly irregular abd: benign extr: venous stasis changes bilaterally, warm, 1+ edema bilateral lower extremities pertinent results: 02:32am blood wbc-12.8* rbc-2.59* hgb-8.3* hct-25.0* mcv-97 mch-32.1* mchc-33.2 rdw-20.0* plt ct-150 03:55pm blood wbc-7.8 rbc-3.78* hgb-11.4* hct-33.5* mcv-89 mch-30.1 mchc-33.9 rdw-15.3 plt ct-248 11:38am blood pt-18.9* inr(pt)-1.7* 03:55pm blood pt-19.1* ptt-25.8 inr(pt)-1.8* 03:55pm blood plt ct-248 02:32am blood glucose-77 urean-107* creat-3.1* na-134 k-3.5 cl-101 hco3-21* angap-16 03:55pm blood glucose-100 urean-89* creat-2.0* na-135 k-3.7 cl-89* hco3-36* angap-14 03:06am blood alt-28 ast-59* alkphos-119* amylase-406* totbili-7.8* 03:55pm blood alt-26 ast-43* ck(cpk)-67 alkphos-62 amylase-168* totbili-1.2 03:06am blood lipase-697* 03:55pm blood lipase-119* 02:32am blood calcium-7.3* phos-6.5* mg-3.2* 03:55pm blood albumin-4.1 mg-2.9* 03:55pm blood %hba1c-6.3* 04:14am blood triglyc-15 08:52pm blood ammonia-18 10:41pm blood ammonia-90* 06:59am blood tsh-1.1 02:50am blood tsh-4.3* 10:29am blood type-art po2-90 pco2-43 ph-7.33* caltco2-24 base xs--3 03:53am blood levetiracetam (keppra)-test , m 86 radiology report ct head w/o contrast study date of 11:07 am , r. csurg csru 11:07 am ct head w/o contrast clip # reason: anoxic brain injury medical condition: 86 year old man s/p resp failure reason for this examination: anoxic brain injury contraindications for iv contrast: none. provisional findings impression: jmgw mon 11:49 am no acute abnormality. mri is more sensitive for acute infarct. final report history: 86-year-old man status post respiratory failure. evaluate for anoxic brain injury. comparison: ct head . ct head: contiguous axial imaging was performed through the brain without iv contrast administration. findings: no evidence of hemorrhage, edema, mass effect, or acute territorial infarction. there is prominence of the ventricles and the sulci related to age-related parenchymal atrophy. periventricular white matter hypodensities are present due to small vessel ischemic disease which appear unchanged. minimal maxillary sinus mucosal thickening is present. remaining paranasal sinuses and mastoid air cells are well aerated. impression: 1. no acute intracranial pathology. mri however is more sensitive for detection of acute infarct. , m 86 neurophysiology report eeg study date of object: evaluate brain activity in a non-responsive patient after cardiac arrest. referring doctor: dr. findings: abnormality #1: throughout the recording, the background activity was severely suppressed with only a few bursts of slowing seen during this recording predominantly following noxious stimuli. background: as above. hyperventilation: could not be performed. intermittent photic stimulation: could not be performed. sleep: there were no normal sleep patterns seen in this recording. cardiac monitor: showed a paced rhythm with an average rate of 54 bpm. impression: this is an abnormal portable eeg recording due to the suppressed background with only a few bursts of slowing following stimulation. this abnormality suggests an extreme encephalopathy. there were no lateralized or epileptiform features seen in this recording. interpreted by: , l. , m 86 radiology report chest (portable ap) study date of 7:00 am , r. csurg csru 7:00 am chest (portable ap) clip # reason: eval for effusion, chf, infiltrate medical condition: 86 year old man with trach, increasing vent setting reason for this examination: eval for effusion, chf, infiltrate final report ap chest 7:55 history: increased respiratory insufficiency, on trach. evaluate for effusion and chf. impression: ap chest compared to through : moderate to large bilateral pleural effusion, changed in distribution but not in overall volume since , consistently loculated on the left, newly loculated on the right. opacification of the left lower lobe and leftward mediastinal shift are unchanged indicating left lower lobe collapse. moderate enlargement of the post-operative cardiac silhouette is stable. no pulmonary edema. tracheostomy tube in standard placement. transvenous right ventricular pacer lead continues from the left axillary pacemaker. no pneumothorax. dr. approved: mon 9:55 am echocardiography report , tte (complete) done at 2:45:55 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 86 m hgt (in): 68 bp (mm hg): 132/50 wgt (lb): 137 hr (bpm): 80 bsa (m2): 1.74 m2 indication: left ventricular function. h/o cardiac surgery with bioprosthetic mvr, cabg..evaluate for pericardial effusion icd-9 codes: 402.90, v42.2, 424.0 test information date/time: at 14:45 interpret md: , md test type: tte (complete) son: , rdcs doppler: full doppler and color doppler test location: west echo lab contrast: none tech quality: adequate tape #: 2009w014-0:26 machine: vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.1 cm <= 4.0 cm left atrium - four chamber length: *6.6 cm <= 5.2 cm left atrium - peak pulm vein s: 0.3 m/s left atrium - peak pulm vein d: 0.6 m/s right atrium - four chamber length: *6.4 cm <= 5.0 cm left ventricle - septal wall thickness: *1.9 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.7 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.6 cm <= 5.6 cm left ventricle - systolic dimension: 3.4 cm left ventricle - fractional shortening: *0.26 >= 0.29 left ventricle - ejection fraction: 25% to 30% >= 55% left ventricle - stroke volume: 25 ml/beat left ventricle - cardiac output: 2.01 l/min left ventricle - cardiac index: *1.16 >= 2.0 l/min/m2 aorta - sinus level: 3.5 cm <= 3.6 cm aorta - ascending: 3.0 cm <= 3.4 cm aortic valve - peak velocity: 1.3 m/sec <= 2.0 m/sec aortic valve - lvot pk vel: 0.60 m/sec aortic valve - lvot vti: 8 aortic valve - lvot diam: 2.0 cm mitral valve - peak velocity: 1.5 m/sec mitral valve - mean gradient: 4 mm hg mitral valve - e wave: 1.5 m/sec mitral valve - e wave deceleration time: *252 ms 140-250 ms findings this study was compared to the prior study of . left atrium: moderate la enlargement. right atrium/interatrial septum: moderately dilated ra. a catheter or pacing wire is seen in the ra and extending into the rv. normal interatrial septum. no asd by 2d or color doppler. left ventricle: severe symmetric lvh. normal lv cavity size. moderate-severe global left ventricular hypokinesis. no lv mass/thrombus. no resting lvot gradient. no vsd. right ventricle: moderate global rv free wall hypokinesis. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. aortic valve: mildly thickened aortic valve leaflets (3). no as. mild (1+) ar. mitral valve: bioprosthetic mitral valve prosthesis (mvr). mvr well seated, with normal leaflet/disc motion and transvalvular gradients. trivial mr. tricuspid valve: mildly thickened tricuspid valve leaflets. moderate to severe tr. indeterminate pa systolic pressure. pulmonic valve/pulmonary artery: no ps. pericardium: trivial/physiologic pericardial effusion. conclusions the left atrium is moderately dilated. the right atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is moderate to severe global left ventricular hypokinesis (lvef = 25-30 %). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. with moderate global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. a bioprosthetic mitral valve prosthesis is present. the mitral prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of . lvef has decreased. there is now a bioprosthetic mvr that is in place and well functioning. electronically signed by , md, interpreting physician 16:17 06:14pm report comment: source: line-arterial hepatitis hepatitis b surface antigen negative hepatitis b surface antibody positive hepatitis b virus core antibody negative hepatitis a virus antibody positive hepatitis b core antibody, igm negative hepatitis a virus igm antibody negative hepatitis c serology hepatitis c virus antibody negative brief hospital course: mr. was admitted for preoperative workup for coronary artery bypass surgery and possible mitral valve replacement. he was placed on heparin drip for atrial fibrillation and his coumadin was stopped. ct scan was done to rule out ascites. underwent surgery with dr. on . transferred to the cvicu in critical condition on milrinone, levophed, epinephrine, vasopressin, and amiodarone drips. iabp placed in or. he remained on the ventilator and pressors were slowly weaned. iabp weaned and removed on pod #3.right foot cool and mottled without pulses early am . vascular consult done and iv heparin started. angiogram with thrombectomy, popliteal stent, and anterior tibial angioplasty/stent. heparin was restarted. he was extubated pod # 5. his toes ultimately remained cyanotic over the next few days. he developed complete heart block postop and cardiology was consulted. he was electively reintubated on for pacer placement. on he went back to the or for right fem- bpg for continuing ischemia. which resulted in right bka on . he made very slow progress and on , he required trach/open j tube placement, and a cholecystostomy tube for an incidental finding of gangrenous call bladder. he was fitted for a passy-muir valve on after tolerating a trach collar for 36 hours. he suffered acute respiratory failure with respiratory arrest that progressed to pea on . post resuscitation he required neosynephrine for blood pressure management. tee revealed no tamponade and ef 25%. seizures were noted, and neurology consulted, keppra started, and eeg obtained. eeg done showing cortical dysfunction. treated with iv keppra and ativan. renal consulted for rising creatinine. cvvh started for elevated bun and then stopped to evaluate. he continued to have renal failure and tunnelled line placed for hemodialysis on . neurologically he remains nonresponsive on ventilator. there is currently no infection issues chole tube remains in to gravtiy with follow up in six weeks with dr. . nutritionally he is receiving renal tube feeds via j tube. there have been lengthy discussions with the family (3 daughters) and they would like to proceed with all medical treatment. he was discharged to rehab on pod #39. please see metavision note from for physical exam medications on admission: lasix 80(2) metazolone 2.5 mg every mmon/wed/friday cardia xl 240(1) aspirin 325(1) potassium chloride 40(1) metoprolol 25(2) simvastatin 40(1) plavix 75(1)-last dose 4/20 coumadin-last dose 4/24 discharge medications: 1. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 2. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 3. polyvinyl alcohol-povidone 1.4-0.6 % dropperette : one (1) drop ophthalmic qid (4 times a day). 4. metoprolol tartrate 25 mg tablet : 0.25 tablet po bid (2 times a day): 6.25 mg twice a day. 5. levetiracetam 100 mg/ml solution : five (5) ml po daily (daily). 6. warfarin 1 mg tablet : goal inr 2.0-2.5 tablets po once a day as needed for afib: please give 0.5mg daily and check inr three times a week for dosing with goal 2.0-2.5 received 0.5 mg and no coumadin - check inr prior to next dose 6/10. 7. lorazepam 1-2 mg iv q4h:prn seizure activity lasting > 5min and notify md 8. tunnel line flush sodium citrate 4% 4 ml dwell asdir catheter not in use red - 2.1 ml blue - 2.2 ml 9. calcium carbonate 500 mg tablet, chewable : one (1) tablet, chewable po q 8h (every 8 hours). discharge disposition: extended care facility: northeast - discharge diagnosis: mitral regurgitation s/p mvr coronary artery disease s/p cabg complete heart block s/p ppm chronic renal insufficiency progressed to acute renal failure resulting in hemodialysis respiratory failure s/p tracheostomy nutritional deficit with albumin 2.5 gangrenous gall bladder ischemic right leg with subsequent bka seizures s/p arrest thrombocytopenia s/p respiratory arrest hypertension hypercholesterolemia atrial fibrillation ascites sleep apnea (uses cpap) low back pain depression acute heart failure discharge condition: poor discharge instructions: no lotions, creams or powders on any incision bath daily and pat incisions dry call for fever greater than 101 () followup instructions: please call to schedule appointments dr after discharge from rehab dr. in 4 weeks dr in 6 weeks dr in 4 weeks procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for 96 consecutive hours or more continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries other enterostomy enteral infusion of concentrated nutritional substances hemodialysis angioplasty of other non-coronary vessel(s) angioplasty of other non-coronary vessel(s) arteriography of femoral and other lower extremity arteries arteriography of femoral and other lower extremity arteries other (peripheral) vascular shunt or bypass temporary tracheostomy implant of pulsation balloon open and other replacement of mitral valve with tissue graft insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) other cholecystostomy other amputation below knee initial insertion of transvenous lead [electrode] into ventricle endarterectomy, lower limb arteries initial insertion of single-chamber device, not specified as rate responsive cranial or peripheral nerve graft insertion of one vascular stent transposition of cranial and peripheral nerves insertion of two vascular stents procedure on two vessels procedure on two vessels diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation other convulsions depressive disorder, not elsewhere classified percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia atrioventricular block, complete alkalosis other complications due to other vascular device, implant, and graft mitral valve insufficiency and aortic valve stenosis other ascites acute cholecystitis arterial embolism and thrombosis of lower extremity acute pancreatitis gangrene respiratory arrest other restorative surgery causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation 

Answer: The patient is high likely exposed to