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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: mini-maze procedure with ligation of left atrial appendage chest tube insertion chest tube insertion history of present illness: mr. is a 47 year old male with history of atrial fibrillation. he underwent cardioversion approximately 6 months prior with concomitant treatment with sotalol. since that time, he has re-developed atrial fibrillation(chronically) with associated symptoms of dyspnea on exertion and decreased exercise tolerance. a prior echocardiogram from showed only mild mitral regurgitation with trace tricuspid regurgitation and no aortic insufficiency. there was evidence of left atrial enlargement and his lvef was estimated at 60-65%. based upon the above, he was referred for surgical intervention. prior to maze procedure, he underwent cardiac mri for pulmonary vein isolation/mapping. past medical history: atrial fibrillation - s/p cardioversion hypertension hypercholesterolemia diabetes mellitus type ii right shoulder surgery social history: quit smoking in , but admits to 30-50 pack year history of tobacco. he denies etoh. married, lives in . employed as a dental tech. family history: strong family history of diabetes. denies premature cad. physical exam: pre admit vitals: bp 112/62, hr 86, rr 12 general: well developed male in no acute distress heent: oropharynx benign, neck: supple, no jvd, no carotid bruits heart: irregular rate, normal s1s2, no murmur or rub lungs: clear bilaterally abdomen: soft, nontender, normoactive bowel sounds ext: warm, no edema, no varicosities pulses: 2+ distally neuro: nonfocal discharge vitals: bp 100/62, hr 68, rr 18 wt 107.9 general: well developed male in no acute distress heart: rrr, normal s1s2, no murmur or rub lungs: clear bilaterally, sq emphysema in left chest into neck and small amt mid chest abdomen: soft, nontender, normoactive bowel sounds ext: warm, trace edema neuro: nonfocal, a/o x3 incision l/r mini thoracotomy healing no drainage/erythema old ct sites with occlusive dressing pertinent results: 06:40am blood wbc-4.6 rbc-3.92* hgb-12.3* hct-36.2* mcv-92 mch-31.4 mchc-34.0 rdw-14.2 plt ct-273 09:01am blood wbc-3.9* rbc-4.02* hgb-12.5* hct-37.2* mcv-93 mch-31.0 mchc-33.5 rdw-13.8 plt ct-239 06:40am blood plt ct-273 06:40am blood pt-11.7 inr(pt)-1.0 06:45am blood pt-11.6 ptt-20.5* inr(pt)-1.0 06:40am blood urean-15 creat-1.1 k-4.4 06:55am blood glucose-84 urean-21* creat-1.0 na-139 k-4.0 cl-102 hco3-29 angap-12 02:12pm blood urean-17 creat-1.2 cl-104 hco3-25 radiology final report chest (pa & lat) 8:53 am chest (pa & lat) reason: re-eval bilat ptx medical condition: 47 year old man with paf s/p mini maze reason for this examination: re-eval bilat ptx history: 47-year-old man with paroxysmal atrial fibrillation status post mini maze procedure. comparison: . chest, pa and lateral: cardiac, mediastinal, and hilar contours are stable. pulmonary vasculature is unremarkable. small opacities in the left lung fields near the chest tubes are unchanged. tiny apical pneumothoraces are unchanged. bilateral chest tubes are in stable position. the degree of subcutaneous emphysema has slightly decreased on the right. impression: stable radiographic appearance of the chest with tiny apical pneumothoraces. the study and the report were reviewed by the staff radiologist. dr. tham dr. approved: tue 7:27 pm cardiology report echo study date of patient/test information: indication: maze ablation status: inpatient date/time: at 10:37 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw-1: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. measurements: left ventricle - septal wall thickness: 0.9 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 0.9 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.6 cm (nl <= 5.6 cm) left ventricle - ejection fraction: 50% to 55% (nl >=55%) aorta - ascending: 2.4 cm (nl <= 3.4 cm) interpretation: findings: left atrium: no spontaneous echo contrast is seen in the laa. right atrium/interatrial septum: normal interatrial septum. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thicknesses and cavity size. lv wall motion: basal anterior - normal; mid anterior - normal; basal anteroseptal - normal; mid anteroseptal - normal; basal inferoseptal - normal; mid inferoseptal - normal; basal inferior - normal; mid inferior - normal; basal inferolateral - normal; mid inferolateral - normal; basal anterolateral - normal; mid anterolateral - normal; anterior apex - normal; septal apex - normal; inferior apex - normal; lateral apex - normal; apex - normal; right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets with trivial mr. tricuspid valve: mild tr. pulmonic valve/pulmonary artery: 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. no tee related complications. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. the patient was under general anesthesia throughout the procedure. conclusions: no spontaneous echo contrast is seen in the left atrial appendage. left ventricular wall thicknesses and cavity size are normal. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. laa shown to have been ligated. electronically signed by , md on 13:29. physician cardiology report ecg study date of 3:38:46 pm sinus rhythm. low qrs voltage. diffuse non-diagnostic repolarization abnormalities. compared to previous tracing of cardiac rhythm now sinus mechanism. read by: , intervals axes rate pr qrs qt/qtc p qrs t 75 172 108 384/412.57 72 76 71 brief hospital course: mr. was admitted and underwent mini-maze procedure with ligation of left atrial appendage. for surgical details, please see separate dictated operative note. following the operation, he was brought to the csru for invasive monitoring. he had additional chest tube inserted for pneumothorax with subcutaneous emphysema on the left side without difficulty. within 24 hours, he awoke neurologically intact and was extubated without incident. postoperatively, he was in a normal sinus rhythm and was maintained on amiodarone. routine chest x-rays were notable for a persistent left apical pneumothorax and continued with subcutaneous emphysema. serial chest x-rays were performed. due to persistent pneumothorax and gradual worsening of subcutaneous emphysema, a third left sided chest tube was placed. he otherwise maintained stable hemodynamics with satisfactory oxygen saturations, and transferred to the sdu for further care recovery. he continued to progress and all chest tubes except the left apical were removed pod 4. he did well for 24 hours and last chest tube was removed on pod 5. he was ready for discharge home with plan for follow up chest xray and wound check on 2. plan for coumadin with results to heart center coumadin clinic. medications on admission: warfarin, zetia 10 qd, glyburide 2.5 , avandia 4 , metformin 100 , toprol xl 50 qd, tricor 145 qd discharge medications: 1. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. glyburide 2.5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 3. avandia 4 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*0* 4. metformin 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*0* 5. toprol xl 50 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po once a day. disp:*45 tablet sustained release 24 hr(s)* refills:*0* 6. ibuprofen 400 mg tablet sig: two (2) tablet po q8h (every 8 hours) for 6 weeks. disp:*360 tablet(s)* refills:*0* 7. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): take two tablets twice a day until then decrease to 2 tablets once daily for 7 days then decrease to one tablet once a day and follow up with dr . disp:*120 tablet(s)* refills:*0* 8. fenofibrate micronized 145 mg tablet sig: one (1) tablet po qd (). disp:*30 tablet(s)* refills:*0* 9. hydromorphone 2 mg tablet sig: 1-3 tablets po q3h as needed. disp:*60 tablet(s)* refills:*0* 10. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 13. outpatient work pt/inr as needed coumadin dosing - indication atrial fibrillation s/p maze goal inr 2.0-2.5 with results to coumadin clinic heart center #( first draw 14. warfarin 3 mg tablet sig: one (1) tablet po once a day: please take 3mg and with draw for further dosing . disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: vna, discharge diagnosis: atrial fibrillation - s/p maze procedure postoperative pneumothorax subcutaneous emphysema history of cardioversion hypertension hypercholesterolemia diabetes mellitus type ii right shoulder surgery discharge condition: good discharge instructions: dressing on chest tube site to remained sealed until pm then remove and leave open to air shortness of breath or difficulty breathing please seek emergency assistance patient should shower daily after when chest ube dressing removed, no baths or swimming. no creams, lotions or ointments to incisions. no driving while taking pain medication and until seen by cardiologist no lifting more than 10 lbs for at least 4 weeks from the date of surgery. monitor wounds for signs of infection, redness, drainage, swelling. please call cardiac surgeon if start to experience fevers, sternal drainage and/or wound erythema. followup instructions: dr. in weeks, call for appt dr. in weeks, call for appt dr. in weeks, call for appt follow up chest xray please go to clinical center for xray then to 2 for wound check labs: pt/inr for coumadin dosing - indication atrial fibrillation s/p maze goal inr 2.0-2.5 with results to coumadin clinic heart center # ( first draw procedure: insertion of intercostal catheter for drainage excision or destruction of other lesion or tissue of heart, open approach diagnoses: pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation iatrogenic pneumothorax other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation emphysema (subcutaneous) (surgical) resulting from procedure 

Answer: The patient is high likely exposed to