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: exertional dyspnea major surgical or invasive procedure: aortic valve replacement (23mm st. regent mechanical valve) history of present illness: 69 year old gentleman with a complex past medical history who has known coronary artery disease status post angioplasty and aortic stenosis followed by serial echocardiogram. he has recently noticed increased dyspnea on exertion. echo earlier this year showed severe aortic stenosis with 0.76cm2. he was referred for a cardiac catheterization which revealed no significant coronary disease and mild aortic stenosis. he presents now to see if his dyspnea is related to his aortic valve disease and if he should proceed with surgery. of note, pulmonary function testing and a chest ct scan were not suggestive of any disease process which may be responsible for his exertional dyspnea. past medical history: aortic stenosis hypertension dyslipidemia diabetes type 2 paroxysmal atrial fibrillation - cardioversion x2 b cell lymphoma, chemo and xrt prostate ca herpes zoster lung ca bursitis urinary incontinence s/p artificial sphincter spinal stenosis s/p right lower lobectomy s/p fatty tumor removal from his back prostate cancer, s/p resection and radiation; remission s/p resected bronchial carcinoid s/p left knee arthroscopy s/p bilateral rotator cuff repair x 2 social history: race: caucasian last dental exam: yesterday lives with: wife contact: phone # occupation: semi-retired, real estate cigarettes: smoked no yes last cigarette hx: other tobacco use: denies etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: denies family history: no premature coronary artery disease-father died suddenly of an mi at age 83 physical exam: pulse: 71 resp: 16 o2 sat: 100% b/p right: 125/74 left: 125/75 height: 5' weight: 220 general: well-developed male in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema/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: - left: - pertinent results: echo: pre-bypass: the left atrium is dilated. 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. 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. overall left ventricular systolic function is low normal (lvef 50-55%). the remaining left ventricular segments contract normally. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results on this patient before surgical incision. post-bypass: intact thoracic aorta. normal rv systolic function. lvef 50%. no oovious wall motion abnormalities withl imited midesophageal suboptimal views. the aortic valve is stable in position, both leaflets open and the residual mean gradient is 8 mm of hg. brief hospital course: mr. was admitted the day before surgery for pre-operative work-up and to be started on heparin for history of atrial fibrillation. on the following day he was brought to the operating room where he underwent an aortic valve replacement. please see operative note for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. later this day he was weaned from sedation, awoke neurologically intact and extubated. he was started on betablockers, statin therapy, asa and ace-inhibitor and diuresed toward his pre-operative weight. he was transferred tot he stepdown unit for ongoing post-operative care. his chest tubes and temporary pacing wires were removed per protocol. his couamdin therapy was resumed for atrial fibrillation. on pod#5 he was cleared for discharge to home and all appointments and instructions were advised. medications on admission: atenolol 100mg amlodipine 10mg daily folic acid 2mg daily lasix 20mg daily novolog 11 units with breakfast, 20 units with dinner levemir 55 units at bedtime lisinopril 20mg daiy simvastatin 40mg daily coumadin 2.5mg alternating with 5mg aspirin 325mg daily vitamin d3 daily discharge medications: 1. aspirin ec 81 mg po daily rx *adult low dose aspirin 81 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*1 2. simvastatin 40 mg po daily 3. warfarin 2.5 mg po daily16 3 day cycles: 2.5mg, x 2 days, then 5mg x 1 day, then repeat rx *warfarin 2.5 mg tablet(s) by mouth once a day disp #*60 tablet refills:*1 4. acetaminophen 650 mg po q4h:prn pain/fever 5. novolog *nf* (insulin aspart) 100 unit/ml subcutaneous tid 11 units with breakfast 11 units with lunch 17 units with dinner 6. multivitamins 1 tab po daily 7. levemir *nf* (insulin detemir) 100 unit/ml subcutaneous hs 55 units hs 8. metoprolol tartrate 75 mg po tid hold for hr < 55 or sbp < 90 and call medical provider. *metoprolol tartrate 25 mg 3 tablet(s) by mouth every eight (8) hours disp #*90 tablet refills:*1 9. oxycodone-acetaminophen (5mg-325mg) tab po q4h:prn pain rx *oxycodone-acetaminophen 5 mg-325 mg tablet(s) by mouth every four (4) hours disp #*65 tablet refills:*0 10. milk of magnesia 30 ml po hs:prn constipation 11. folic acid 2 mg po daily 12. vitamin d 400 unit po daily 13. lisinopril 5 mg po daily rx *lisinopril 5 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*1 14. furosemide 20 mg po bid duration: 7 days then decrease to 20mg daily ongoing rx *furosemide 20 mg 1 tablet(s) by mouth twice a day disp #*37 tablet refills:*1 15. potassium chloride 20 meq po q12h duration: 7 doses then decrease to once daily rx *k-tab 10 meq 2 (two) tablets by mouth twice a day disp #*42 tablet refills:*1 discharge disposition: home with service facility: vna discharge diagnosis: aortic stenosis s/p aortic valve replacement past medical history: hypertension dyslipidemia diabetes type 2 paroxysmal atrial fibrillation - cardioversion x2 b cell lymphoma, chemo and xrt prostate ca herpes zoster lung ca bursitis urinary incontinence s/p artificial sphincter spinal stenosis s/p right lower lobectomy s/p fatty tumor removal from his back prostate cancer, s/p resection and radiation; remission s/p resected bronchial carcinoid s/p left knee arthroscopy s/p bilateral rotator cuff repair x 2 discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema: 1+ lower extremity edema (left > right-chronically) 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 females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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 1:15pm in the medical office building, , wound check with cardiac surgery on 10am in the medical office building, , cardiologist: dr. on at 8:45am 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 mechican aortic valve replacement goal inr 2.5-3.0 first draw results to dr. phone ; fax procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: other iatrogenic hypotension unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation personal history of malignant neoplasm of bronchus and lung aortic valve disorders other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia other malignant lymphomas, unspecified site, extranodal and solid organ sites long-term (current) use of insulin malignant neoplasm of prostate 

Answer: The patient is high likely exposed to