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: fatigue major surgical or invasive procedure: mitral valve repair utilizing a 30mm ce physio ii ring history of present illness: this is a 53 year old male who was found to have a newly diagnosed heart murmur during his annual physical. relatively asymptomatic besides fatigue and very occassional chest pain. work-up revealed severe mitral regurgitation. given the severeity of his disease, he was referred for surgical intervention. past medical history: hypertension hyperlipidemia (not on medications) prior fractured ribs s/p vasectomy social history: lives with: married with 3 children occupation: construction tobacco: one cigarette/day etoh: 3-4 beers every evening family history: denies premature coronary disease physical exam: pulse: 59 resp: 18 o2 sat: 98% b/p right: 132/93 left: 125/87 height: 6'4" weight: 225 lbs 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 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: 04:25am blood wbc-8.8 rbc-3.54* hgb-11.8* hct-32.7* mcv-92 mch-33.4* mchc-36.3* rdw-13.1 plt ct-147* 12:40pm blood wbc-11.8*# rbc-3.38*# hgb-11.1*# hct-30.5*# mcv-90 mch-32.7* mchc-36.3* rdw-12.9 plt ct-150 01:42pm blood pt-13.8* ptt-25.5 inr(pt)-1.2* 04:25am blood glucose-95 urean-19 creat-1.0 na-136 k-4.0 cl-102 hco3-26 angap-12 echocardiography report , (complete) done at 1:32:04 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 54 m hgt (in): 76 bp (mm hg): / wgt (lb): 225 hr (bpm): bsa (m2): 2.33 m2 indication: intraoperative tee for mitral valve repair versus replacement icd-9 codes: 424.0 test information date/time: at 13:32 interpret md: , md test type: tee (complete) 3d imaging. son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2011aw6-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *6.9 cm <= 4.0 cm left ventricle - inferolateral thickness: 0.8 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.6 cm <= 5.6 cm left ventricle - ejection fraction: 45% to 50% >= 55% aorta - sinus level: 3.0 cm <= 3.6 cm aorta - sinotubular ridge: 2.5 cm <= 3.0 cm aorta - ascending: 3.4 cm <= 3.4 cm aorta - descending thoracic: 2.1 cm <= 2.5 cm aortic valve - lvot diam: 2.2 cm findings multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: mild spontaneous echo contrast in the body of the la. no mass/thrombus in the laa. right atrium/interatrial septum: 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: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness. top normal/borderline dilated lv cavity size. normal regional lv systolic function. mild global lv hypokinesis. right ventricle: mild global rv free wall hypokinesis. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. normal ascending aorta diameter. normal aortic arch diameter. normal descending aorta diameter. simple atheroma in descending aorta. focal calcifications in descending aorta. aortic valve: mildly thickened aortic valve leaflets (3). no as. trace ar. mitral valve: mildly thickened mitral valve leaflets. no ms. eccentric mr jet. moderate to severe (3+) mr. to the eccentric mr jet, its severity may be underestimated (coanda effect). tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. conclusions pre bypass mild spontaneous echo contrast is seen in the body of the left atrium. no mass/thrombus is seen in the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is top normal/borderline dilated. regional left ventricular wall motion is normal. there is mild global left ventricular hypokinesis (lvef = 45-50 %). the right ventricle displays mild global free wall hypokinesis. there are simple atheroma in the descending thoracic aorta. 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, anteriorly directed jet of moderate to severe (3+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). there is no pericardial effusion. dr. was notified in person of the results in the operating room at the time of the procedure. post bypass there is mild to moderate global left ventricular hypokinesis with an ejection fraction of about 35-40%. the right ventricle displays borderline normal systolic function. the mitral valve is s/p repair - a mitral valve annuloplasty ring is seen in situ. it appears well seated. no mitral regurgitation is seen. the maximum gradient across the mitral valve was 8 mm hg with a mean of 4 mmhg at a cardiac output of about 7 liters/minute. the thoracic aorta appears intact after decannulation. no other significant changes from pre-bypass are noted. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 15:13 ?????? caregroup is. all rights reserved. brief hospital course: on mr. was admitted and underwent mitral valve repair (#30 mm ring) by dr. . for surgical details, please see operative note. following the operation, he was brought to the intensive care unit for invasive monitoring. within 24 hours, he awoke neurologically intact and was extubated without incident. he was weaned off pressors and beta-blocker, aspirin and diuresis were initiated. his intensive care course was uneventful, and he transferred to the step down unit on postoperative day one for further monitoring. physical therapy was consulted for evaluation of strength and mobility. the remainder of his hospital course was essentially uneventful. scant drainage was noted from the superior pole of his sternotomy and keflex was started for 10 days. on postoperative day 4, he was cleared for discharge to home with vna. all follow up instructions were advised. medications on admission: lisinopril 5mg daily discharge medications: 1. 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* 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*90 tablet, delayed release (e.c.)(s)* refills:*2* 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 5. lisinopril 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: hospice program discharge diagnosis: mitral regurgitation s/p mitral valve repair hypertension dyslipidemia discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema, slight drianage at superior pole. edema trace discharge instructions: 1) 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 2) please no lotions, cream, powder, or ointments to incisions 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart 4) no driving for approximately one month and while taking narcotics 5) no lifting more than 10 pounds for 10 weeks 6) keflex 500mg four times daily for 10 days. 7) 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. ( 1:15pm cardiologist: in 3 weeks. please call for appointment. ( please come next thursday at 10:30am for wound check. medical building . 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** procedure: extracorporeal circulation auxiliary to open heart surgery open heart valvuloplasty of mitral valve without replacement diagnoses: mitral valve disorders unspecified essential hypertension personal history of tobacco use 

Answer: The patient is high likely exposed to