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: amitriptyline attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement (21 mm ce pericardial magne ease) resection of left atrial appendage history of present illness: 57 year old male with bicuspid aortic valve. aortic stenosis has been followed by echocardiogram. he has recently experienced progressive doe and now admitted post cardiac catheterization for aortic valve surgery. past medical history: childs a cirrhosis- followed by hepatology h/o esophageal varices atrial fibrillation osa (does not use cpap) copd/emphysema cri (baseline cr 1.4) non-hodgkins lymphoma 5yrs. ago s/p rituximab and chop hepatitis c cirrhosis gerd chronic abdominal pain syndrome appendectomy social history: lives with: mother and dog, has daughter in hcp is occupation: medical leave x 6 yrs. was a plumber tobacco: quit 4 yrs. ago etoh: none for 10 years family history: non contributory physical exam: pulse: 60 resp: 20 o2 sat: 100%ra b/p right: left: 125/93 height: weight: general: nad skin: dry intact heent: perrla eomi pupils fixed 4mm neck: supple full rom chest: lungs clear bilaterally audible wheezing heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + , distended extremities: warm , well-perfused edema 1+ varicosities: none neuro: grossly intact x pulses: femoral right: left: dp right: 1+ left: 1+ pt : left: np edema radial right: 1+ left: 1+ carotid bruit right: left: no bruits appreciated pertinent results: cardiac catheterization 1. selective coronary angiography in this right dominant system revealed no angiographically significant coronary artery disease. 2. resting hemodynamics revealed significant respiratory variation in all intracardiac and pulmonary pressure recordings. the mean ra pressure was elevated at 16mmhg. there was moderate pulmonary artery hypertension (52/31 mmhg with a mean of 38mmhg). the pcw was elevated at a mean of 21mmhg. final diagnosis: 1. coronary arteries are normal. 2. elevated left and right heart filling pressures. 3. moderate pulmonary artery hypertension echo right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: moderate symmetric lvh. normal lv cavity size. normal regional lv systolic function. overall normal lvef (>55%). right ventricle: mildly dilated rv cavity. normal rv systolic function. aorta: simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). trace ar. mitral valve: moderately thickened mitral valve leaflets. moderate mitral annular calcification. moderate thickening of mitral valve chordae. mild valvular ms (mva 1.5-2.0cm2). mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. physiologic (normal) pr. prebypass no atrial septal defect is seen by 2d or color doppler. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is mildly dilated with normal free wall contractility. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area 0.6 cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate thickening of the mitral valve chordae. there is mild valvular mitral stenosis (area 1.9cm2). mild (1+) mitral regurgitation is seen. biventricular systolic function is preserved. there is a well seated, well functioning bioprosthesis in the aortic position. no ai is visualized. the remaining study is unchanged from prebypass. 08:50am blood wbc-8.2 rbc-3.37* hgb-10.4* hct-31.1* mcv-92 mch-31.0 mchc-33.6 rdw-17.0* plt ct-177 08:50am blood pt-21.9* ptt-41.5* inr(pt)-2.0* 08:50am blood glucose-120* urean-41* creat-1.4* na-138 k-4.3 cl-100 hco3-26 angap-16 08:50am blood alt-17 ast-38 alkphos-151* amylase-85 totbili-1.5 08:50am blood lipase-82* brief hospital course: presented for cardiac catheterization that revealed normal coronary arteries and was admitted for preoperative workup. on was brought to the operating room for aortic valve replacement and resection of left atrial appendage. see operative report for further details. he received vancomycin and cefazolin for perioperative antibiotics, and transferred to the intensive care unit for post operative management. that evening he was weaned from sedation, awoke neurologically intact and was extubated without complications. post operative day one he was weaned from pressors. he was transferred to the surgical step down floor. he was restarted on coumadin for chronic atrial fibrillation and his inr quickly became supertherapeutic requiring vitamin k so he was restarted on a reduced dose of coumadin. diltiazem and lopressor was increased for better rate control. chest tubes and pacing wires were removed per cardiac surgery protocol. his pain was controlled with dilaudid and ativan. once on the step down unit he was ambulating with assistance, tolerating a full oral diet and his incisions were healing well. slight erythema was noted at the mediastinal incision so he was started on keflex. while his liver function tests were elevated post-operatively, they were downtrending and near normal by discharge. he was discharged to center. medications on admission: toprol xl 100mg daily colace 100mg zolpidem tartrate 5mg hs insomnia mvi quetiapine fumarate 25 mg po/ng qam and 50 mg po/ng at 4 p.m. and qhs lorazepam 1 mg po/ng :prn anxiety hydromorphone (dilaudid) 6 mg q4hrs prn lactulose 30 ml po/ng albuterol 0.083% neb soln 1 neb ih q2h:prn sob, wheeze, albuterol 0.083% neb soln 1 neb ih q4h, ipratropium bromide neb 1 neb ih q4hrs digoxin 0.125 mg po/ng every other day cyanocobalamin 1000 mcg po/ng daily aspirin 81 mg po daily fluoxetine 40 mg po/ng daily mirtazapine 30 mg po/ng hs omeprazole 20 mg po daily coumadin 2.5mg discharge medications: 1. lorazepam 0.5 mg tablet sig: one (1) tablet po twice a day as needed for anxiety. 2. hydromorphone 2 mg tablet sig: three (3) tablet po q4h (every 4 hours) as needed for pain. 3. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po twice a day. 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation every four (4) hours as needed for wheezes. 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation every four (4) hours. 6. digoxin 125 mcg tablet sig: one (1) tablet po qod (). 7. cyanocobalamin (vitamin b-12) 100 mcg tablet sig: one (1) tablet po daily (daily). 8. aspirin, buffered 81 mg tablet sig: one (1) tablet po once a day. 9. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 10. mirtazapine 15 mg tablet sig: two (2) tablet po hs (at bedtime). 11. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. diltiazem hcl 60 mg tablet sig: one (1) tablet po qid (4 times a day). 15. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 10 days: sternal erythema. 16. quetiapine 25 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 17. quetiapine 25 mg tablet sig: two (2) tablet po daily at 1600 (). 18. quetiapine 25 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 19. rifaximin 550 mg tablet sig: one (1) tablet po bid (2 times a day). 20. lasix 20 mg tablet sig: two (2) tablet po once a day for 10 days. 21. potassium chloride 20 meq tablet, er particles/crystals sig: two (2) tablet, er particles/crystals po once a day for 10 days. 22. warfarin 1 mg tablet sig: 0.5 tablet po once (once) for 1 doses: titrate for inr goal of for afib. check inr . 23. multivitamin tablet sig: one (1) tablet po daily (daily). 24. zolpidem 5 mg tablet sig: one (1) tablet po once a day as needed for insomnia. discharge disposition: extended care facility: rehabilitation and nursing center - discharge diagnosis: aortic stenosis s/p avr atrial fibrillation s/p resection of laa childs a cirrhosis obstructive sleep apnea emphysema chronic renal insufficiency non-hodgkins lymphoma hepatitis c cirrhosis gerd chronic abdominal pain syndrome discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage edema 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 1:00pm cardiologist: dr. at 1:00 pm wound check: , md 1:45 please call to schedule appointments with your 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** labs: pt/inr for coumadin ?????? indication a fib goal inr 2.0-3.0 first draw: rehab to arrange coumadin follow up upon discharge procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters excision or destruction of other lesion or tissue of heart, open approach open and other replacement of aortic valve with tissue graft diagnoses: other chronic pain abdominal pain, unspecified site anemia, unspecified esophageal reflux mitral valve disorders cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma atrial fibrillation aortic valve disorders other chronic pulmonary heart diseases chronic kidney disease, unspecified personal history of other lymphatic and hematopoietic neoplasms other emphysema carrier or suspected carrier of methicillin resistant staphylococcus aureus congenital insufficiency of aortic valve other ill-defined heart diseases 

Answer: The patient is high likely exposed to