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: mitral regurgitation, coronary artery disease major surgical or invasive procedure: mitral valve repair(resection of the middle scallop of the posterior leaflet,mitral valve annuloplasty with a 32-mm st. medical saddle ring) & coronary artery bypass grafting x4 (lima-lad,svg-dg,svg-rca, svg-om) history of present illness: this 55 year old black male was found to have a murmur on a routine check up. further testing showed mitral regurgitation. he had an elective catheterization on that showed significant coronary disease. he was asymptomatic. he denies shortness of breath. past medical history: mitral regurgitation hyperlipidemia emphysema coronary artery disease social history: patient is divorced and has four sons. is a program administrator tobacco: denies etoh: rarely recreational drugs: denies (brother) cell # family history: non contributory physical exam: pe: 97.3, 130/85, 132/84, 73, 16, 100% ra ht: 6 ft 2 inches, wt: 185lbs general:nad, a&ox4 skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ___3/6___ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _n/a____ 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: no left: no pertinent results: echo pre-bypass: 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 thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. an eccentric, posteriorly directed jet of moderate to severe (3+) mitral regurgitation is seen. there is no pericardial effusion. 05:53am blood wbc-10.1 rbc-3.65* hgb-11.5* hct-34.7* mcv-95 mch-31.4 mchc-33.1 rdw-12.1 plt ct-314 04:43pm blood wbc-14.1*# rbc-3.17* hgb-10.0*# hct-31.9* mcv-101* mch-31.7 mchc-31.5 rdw-12.5 plt ct-119* 05:53am blood pt-13.8* inr(pt)-1.3* 01:26am blood pt-12.4 ptt-28.3 inr(pt)-1.1 06:20pm blood pt-13.3* ptt-27.1 inr(pt)-1.2* 05:53am blood urean-16 creat-0.9 05:00am blood glucose-196* urean-17 creat-0.9 na-133 k-5.0 cl-96 hco3-28 angap-14 05:00am blood glucose-196* urean-17 creat-0.9 na-133 k-5.0 cl-96 hco3-28 angap-14 brief hospital course: the patient was admitted to the hospital as a same day admission and brought to the operating room on where he underwent mitral valve repair with a resection of the middle scallop of the posterior leaflet and a mitral valve annuloplasty with a 32-mm st. saddle ring as well as coronary artery bypass grafting x4. see operative note for full details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. on pod 3 night he went into rapid atrial fibrillation which converted to sinus rhythm approximately 8 hours later with iv lopressor and iv amiodarone bolus. oral lopressor was increased for better rate control. the patient was evaluated by the physical therapy service for assistance with strength and mobility. he had nocturnal atrial fibrillation on two other occasions and was therefor begun on coumadin. at discharge on pod 6 he was in in rate controlled atrial fibrillation, was ambulating freely, the wounds were healing and pain was controlled with oral analgesics. the patient was discharged home with vna services in good condition with appropriate follow up instructions. coumadin will be regulated by his cardiologist, dr. . medications on admission: simvastatin - 20 mg tablet - 1 tablet(s) by mouth at bedtime discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pai/fever/ha. 3. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 5. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. amiodarone 200 mg tablet sig: as directed tablet po twice a day: 400mg (two tablets) twice daily for two weeks, then 200mg (one tablet) twice daily for two eeks, then 200mg (one tablet) until directed to discontinue. disp:*100 tablet(s)* refills:*2* 8. coumadin 2.5 mg tablet sig: as directed tablet po once a day: take daily at 4pm as directed by dr. . disp:*100 tablet(s)* refills:*2* 9. outpatient lab work inr on & 9, then prn. please fax results to dr. 10. ativan 0.5 mg tablet sig: one (1) tablet po every eight (8) hours as needed for anxiety for 2 weeks. disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: severe mitral regurgitation coronary artery disease s/p coronary artery bypass grafts x4 & mitral valve repair discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema- trace alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with percocet incisions: sternal - healing well, no erythema or drainage leg left - 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 1:30 pm cardiologist: dr. on at 3 pm clinic in 2a on at 10 am please call to schedule appointments with: 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** coumadin to be managed by dr. (fax ) indication: atrial fibrillation goal inr 2-2.5 first inr fax results to above procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery excision or destruction of other lesion or tissue of heart, open approach open heart valvuloplasty of mitral valve without replacement diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders hyposmolality and/or hyponatremia atrial fibrillation other and unspecified hyperlipidemia other emphysema 

Answer: The patient is high likely exposed to