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: dicloxacillin / sulfa (sulfonamides) / morphine attending: chief complaint: cardiogenic shock major surgical or invasive procedure: aortic valve replacement(27mm mosaic porcine), mitral valve replacement(27mm mosaic porcine), replacement of ascending aorta(28mm gelweave graft), and four vessel coronary artery bypass grafting(left internal mammary to left anterior descending, vein grafts to diagonal, obtuse marginal and posterior descending artery). repair of right common femoral artery pseudoaneurysm. cardiac catheterization with successful angioplasty of an acutely occluded diagonal branch without stenting. history of present illness: this is a 70 year old male transferred from in cardiogenic shock after undergoing cardiac catheterization which revealed an occlusion in his left anterior descending artery. patient became hypotensive and bradycardic requiring intubation and placement of an iabp for hemodynamic support. he was placed on intravenous heparin and nitroglycerin. mr. was also significant for mitral regurgitation, aortic insufficiency, and dilated ascending aorta. an echocardiogram on showed mild aortic insufficiency, mild aortic stenosis, severe mitral regurgitation and dilated ascending aortic aneurysm. his lvef was estimated at 60-65%. he was admitted directly to the csru, intubated and sedated, for further evaluation and treatment. past medical history: coronary artery disease, ascending aortic aneurysm, mitral regurgitation, aortic insufficiency, recent myocardial infarction, history of mitral valve endocarditis with emboli to brain, kidney, colon, and extremities, history of renal insufficiency, insulin-dependent diabetes mellitus, hypertension, atrial fibrillation, cerebrovascular disease - prior cva, hypercholesterolemia, chronic obstructive pulmonary disease, history of deep venous thrombosis - s/p ivc filter, gout, osteoarthritis, history of ischemic colitis and gi bleed - s/p subtotal colectomy, history of tracheostomy, s/p left hip replacement social history: quit tobaccco 40 years ago. no history of excessive etoh. currently lives with his wife. family history: no history of premature coronary artery disease. physical exam: admission: vitals: bp 132/90, hr 112, rr 22, sat 95%(psv - 50% - - tv 420 to 560) general: intubated, sedated, moderatly agitated, iabp in place heent: oropharynx benign, perrl, sclera anicteric neck: supple, no jvd, heart: irregular rate, blowing systolic murmur lungs: clear bilaterally abdomen: soft, nontender, normoactive bowel sounds, well healed incisions ext: warm, no edema, no varicosities pulses: decreased distally neuro: once sedation stopped - nonfocal,moved all extremities and followed commands discharge: vs: t 98 hr 81sr bp 130/60 rr 18 o2sat 94%ra weight preop 107k d/c 105.8k gen: nad neuro: a&ox3, nonfocal exam pulm: coarse rhonchi cv: rrr, sternum stable-incision cdi abdm: soft/nt/nd/nabs ext: warm, 2+ pedal edema bilat. lle with multiple incisions. calf/serous drainage, thigh w/minimal erythema and tenderness. bilat groin incisions w/staples cdi pertinent results: 01:31pm blood wbc-10.7 rbc-4.02* hgb-11.9* hct-35.0* mcv-87 mch-29.5 mchc-33.9 rdw-15.9* plt ct-247 03:59pm blood pt-14.6* ptt-57.1* inr(pt)-1.3* 02:48pm blood fact v-90 fact x-56 02:48pm blood at iii-76 11:16pm blood glucose-158* urean-16 creat-0.8 na-138 k-4.2 cl-100 hco3-30 angap-12 11:16pm blood alt-53* ast-260* ld(ldh)-690* ck(cpk)-2570* alkphos-103 totbili-0.9 11:16pm blood ck-mb-210* mb indx-8.2* ctropnt-9.02* 11:16pm blood %hba1c-6.8* -done -done 02:48pm blood homocys-5.1 wbc 14.3 hct 33.9 plt 350k k+ 3.6 bun 17 cr 0.8 inr 1.9 carotid ultrasound: suboptimal study given the presence of the balloon counterpulsation, however, there does not appear to be any significant stenosis bilaterally. likely no stenosis of the right carotid and less than 40% stenosis of the left carotid. cardiac catheterization: selective left coronary angiography revealed essentially no change from the diagnostic angiogram performed prior to transfer except the notable complete occlusion of the first diagonal branch which was poorly on outside films. the 70% mid lad and 90% proximal lcx stenoses were unchanged. the rca was not injected. the 100% occluded diagonal branch was crossed with a choice pt xs wire and dilated with a 2.0mm balloon. the wire was exchanged for a forte wire through the balloon. the lesion was then dilated again with a 2.5x12mm balloon to a maximum of 10atm with very good poba results. there remained a 30% residual with normal flow and no dissection. echocardiogram: the left atrium is dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are moderately thickened. there is no significant aortic valve stenosis but aortic valve velocities/gradient may have been underestimated. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is severe mitral annular calcification with moderate mitral inflow gradient. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is no pericardial effusion. groin ultrasound: there is a large fairly anechoic hematoma in the right groin, with a pseudoaneurysm which is poorly organized and extending over several centimeters. tee, pre-bypass: the left atrium is markedly dilated. no atrial septal defect. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is moderately dilated. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis. mild aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. moderate to severe (3+) mitral regurgitation is seen. tee, post-bypass: biventricular systolic function remains preserved in the setting of inotropes. there is a well seated, well functioning bioprosthesis in the mitral position. no significant mr . there is a well seated bioprostheis in the aortic position. it is not well however no significant ai is present. the is a tube graft in the ascending aorta. remaining study is unchanged from prebypass. brief hospital course: transferred to after cardiac catheterization arrest and subsequent resuscitation. cardiac cath revealed 3vd w/occluded lad. pt was intubated and intra-aortic balloon pump placed during arrest. after arrival at pt sedation stopped, weaned from ventilator and extubated, pt then found to have continuing angina and was to the cath lab at for angioplasty of lad(please see report for details)following which the angina was resolved. the following day patient had an echo that showed preserved cardiac function and the balloon pump was weaned and removed. the patient was then transferred to the floors to allow him time to recover from his intra-cath mi. during this period he had hematology, infectious disease, vascular surgery, podiatry, and cardiology consults. on hospital day 5 the patient was noted to have an expanding hematoma at the catheterization site and vascular surgery was again consulted. the patient had a repair of the right femoral pseudoaneurysm by dr (please see or note for details). on hospital day 7 the patient was brought to the operating room with dr at which time he had avr-tissue/mvr-tissue/asc ao r e p lacement-gelweave/cabgx4(lima-lad,svg-om,svg-diag,svg-rca)please see or note for details. he was transferred to the icu on amiodarone/dobutamine/neosynephrine/propofol and insulin. on pod1 he was extubated and over the next several days the pressors and inotropes were weaned. on pod4 he was transferred to the step down floor for continued post-op care/recovery. over the next several days the patient was diuresed, his anticoagulation reinstated, his activity level advanced and on pod9 it was decided he was stable and ready for discharge to home. he is to be discharged with visiting nurses, follow-up with dr in weeks with dr in weeks and with dr in weeks. he is also to have an inr check by the visiting nurse on with the results called to dr who will monitor his inr. medications on admission: lisinopril 20 qd, lipitor 40 qd, metformin 500 , indocin 25 , nexium 40 qd, metoprolol 25 , zantac, aspirin 81 qd, warfarin, levofloxacin 250 qod, lasix, iv heparin, iv nitro discharge medications: 1. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* 2. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 5. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*100 tablet, delayed release (e.c.)(s)* refills:*2* 6. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). disp:*1 mdi* refills:*2* 7. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours) as needed. disp:*1 mdi* refills:*2* 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 9. glucosamine chondroitin maxstr oral 10. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 11. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 12. furosemide 40 mg tablet sig: one (1) tablet po tid (3 times a day): 40mg tid x10 days then 40mg x10 days then 40mg qd. disp:*60 tablet(s)* refills:*0* 13. levofloxacin 500 mg tablet sig: one (1) tablet po q mon-wed-fri. disp:*12 tablet(s)* refills:*0* 14. potassium chloride 20 meq packet sig: two (2) packet po q12h (every 12 hours). disp:*60 packet(s)* refills:*0* 15. psyllium packet sig: one (1) packet po bid (2 times a day). 16. warfarin 5 mg tablet sig: as directed tablet po once a day: 5mg q t-th-s-s 7.5mg q m-w-f target inr 2-2.5. disp:*45 tablet(s)* refills:*0* discharge disposition: home with service facility: tba discharge diagnosis: coronary artery disease, ascending aortic aneurysm, mitral regurgitation, aortic insufficiency, recent myocardial infarction - s/p avr, mvr, cabg and replacement of ascending aorta; rupture of right femoral artery pseudoaneurysm - s/p repair; history of mitral valve endocarditis with emboli to brain, kidney, colon, and extremities; history of renal insufficiency; insulin-dependent diabetes mellitus; hypertension; atrial fibrillation; cerebrovascular disease; hypercholesterolemia; chronic obstructive pulmonary disease; history of deep venous thrombosis - s/p ivc filter; gout; osteoarthritis; history of ischemic colitis and gi bleed - s/p subtotal colectomy; history of tracheostomy; s/p left hip replacement discharge condition: good discharge instructions: patient may shower, no baths. no creams, lotions or ointments to incisions. no driving for at least one month. no lifting more than 10 lbs for at least 10 weeks from the date of surgery. monitor wounds for signs of infection. please call with any concerns or questions. patient should have pt/inr checked within 48 hours of discharge. dr. **** will monitor and manage warfarin as an outpatient. goal inr between 2.0 - 3.0. followup instructions: cardiac surgeon, dr. in weeks - call for appt. local pcp, . in weeks - call for appt. local cardiologist, dr. or in weeks - call for appt. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery left heart cardiac catheterization coronary arteriography using a single catheter open and other replacement of aortic valve with tissue graft open and other replacement of mitral valve with tissue graft other repair of aneurysm resection of vessel with replacement, aorta, abdominal transfusion of packed cells nonoperative removal of heart assist system continuous intra-arterial blood gas monitoring excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute myocardial infarction of other anterior wall, initial episode of care thoracic aneurysm without mention of rupture chronic airway obstruction, not elsewhere classified gout, unspecified atrial fibrillation hematoma complicating a procedure personal history of tobacco use pressure ulcer, other site multiple involvement of mitral and aortic valves hip joint replacement aneurysm of artery of lower extremity personal history of other diseases of digestive system 

Answer: The patient is high likely exposed to