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: dyspnea on exertion major surgical or invasive procedure: - 1. coronary artery bypass graft x2; left internal mammary artery to the left anterior descending artery and saphenous vein graft to diagonal artery.2. endoscopic harvesting of the long saphenous vein.3. complex mitral valve repair with -tex suture and size 28 annuloplasty ring. history of present illness: as you recall, he is a 62-year-old gentleman with known mitral regurgitation. approximately one year ago, he required hospitalization for an acute episode of congestive heart failure secondary to community-acquired pneumonia. since that time, he has been doing relatively well on medical therapy. however, recently, he admits to worsening shortness of breath on exertion. he denies chest pain or orthopnea as well as lower extremity edema. however, his shortness of breath does limit his routine adls at this time. his most recent echocardiogram is from , which showed an ejection fraction of 60-65% with 4+ mitral regurgitation. there was of note a small vegetation on the mitral valve. the aortic valve was normal. there was 1+ tricuspid regurgitation and his right-sided heart pressures were elevated. his pasp was estimated at 38 mmhg. given that his serial echocardiograms have shown worsening mr and increasing pa pressures, he was referred to me for cardiac surgical evaluation. past medical history: mitral regurgitation, history of acute congestive heart failure, hypertension, dyslipidemia, history of non-st elevation myocardial infarction in , and history of pneumonia in , hypertension, hyperlipidemia. social history: lives at home w/ his wife. in retail. denies tobacco ever, no drug use. currently drinks 1 beer/night but does have history of etoh abuse. family history: denies early heart disease. physical exam: physical examination in my office today revealed a pulse of 58, respirations of 14, and blood pressure of 158/79, saturation 97% on room air. in general, he was a well-developed and well-nourished male in no acute distress. his skin was unremarkable. oropharynx was benign. his teeth were in poor repair. neck was supple with full range of motion. there was no jvd. lungs were clear to auscultation bilaterally. heart had a regular rate and rhythm, normal s1 and s2 with a iii/vi systolic murmur best heard at the left lower sternal border. abdomen was benign. extremities were warm and well perfused without edema. he had no varicosities of the greater saphenous vein. neurologically, he was alert and oriented x3. cranial nerves ii through xii were grossly intact. he had 5 out 5 strength and no focal deficits were appreciated. he had 2+ distal pulses and there was a question of a right-sided carotid bruit. pertinent results: echopre-bypass: the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%), although the lvef may be overestimated in the face of severe mr. there is moderate symmetric lvh. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. 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. an eccentric, posteriorly directed jet of severe (4+) mitral regurgitation is seen. there is prolapse of the anterior mitral leaflet and a chordal remnant is visible in the left atrium during systole., and it appears to be the a3 segment. there is no pericardial effusion. post-bypass: the patient is av paced and on an infusion of phenylephrine. biventricular function is preserved. the aorta is intact. the swan ganz catheter is in the proximal right pa. the mitral valve has been repaired and an annuloplasty ring placed. no chordal remnant is visible , although a long suture is visible along the sewing ring near the anterior portion of the left atrium. there is no mr and no paravalvular leak. no mitral stenosis is evident. the remainder of the examination is unchanged. 06:35am blood wbc-17.8* rbc-2.35* hgb-7.4* hct-21.7* mcv-93 mch-31.7 mchc-34.2 rdw-12.8 plt ct-168 07:15am blood wbc-11.9* rbc-2.55* hgb-7.8* hct-23.1* mcv-91 mch-30.8 mchc-33.9 rdw-14.8 plt ct-205 06:50am blood wbc-8.6 rbc-2.46* hgb-7.7* hct-22.4* mcv-91 mch-31.2 mchc-34.2 rdw-14.1 plt ct-259 06:35am blood glucose-125* urean-28* creat-1.0 na-135 k-4.1 cl-101 hco3-26 angap-12 06:50am blood glucose-103 urean-16 creat-0.9 na-134 k-4.0 cl-101 hco3-28 angap-9 06:50am blood mg-2.2 brief hospital course: mr. was admitted to the on for elective surgical management of his mitral regurgitation and coronary artery disease. he was taken to the operating room where he underwent coronary artery bypass grafting and a complex mitral valve repair. please see operative note for surgical details. postoperatively he was taken to the intensive care unit for invasive monitoring. within 24 hours, he awoke neurologically intact and was extubated without incident. beta blockade was initially withheld for transient complete heart block. pacing wires were kept in and his rhythm was observed. over several days, his heart rate and rhythm improved. low dose beta blockade was slowly introduced, and no further heart block was noted. given nstemi and postoperative hypertension, ace inhibitor was resumed. also received several units of packed red blood cells for a postoperative anemia. also started on a 3 day course of ciprofloxacin for a positive urinalysis. his icu course was otherwise uneventful and he transferred to the sdu on postoperative day two. beta blockade was slowly advanced and anti-hypertensives were titrated accordingly. given persistent hypertension, he was eventually started on clonidine patch. he remained in a normal sinus rhythm and no further heart block was noted on telemetry. given prior history of etoh, he was started on multivitamins and anxiolytics. the remainder of his hospital course was uneventful and he was discharged to home on postoperative day five. medications on admission: aspirin 81 mg daily, aldactazide 50/50 tablets one daily, amlodipine 10 mg daily, lisinopril 40 mg twice daily, simvastatin 20 mg daily, catapres patch 0.3 mg over 24 hours every weekly, toprol xl 100 mg daily. discharge medications: 1. 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* 2. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. lisinopril 40 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 7. clonidine 0.1 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qtues (every tuesday). disp:*30 patch weekly(s)* refills:*2* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. lorazepam 0.5 mg tablet sig: one (1) tablet po every hours as needed for anxiety. disp:*30 tablet(s)* refills:*0* 10. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 7 days: take 1 tab(40mg) for 7 days then discontinue - please take with kcl. disp:*7 tablet(s)* refills:*0* 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 7 days: take 1 tab(20meq) for 7 days then discontinue - please take with lasix. disp:*7 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: mitral regurgitation/coronary artery disease - s/p cabg/mv repair history of acute congestive heart failure non-st elevation myocardial infarction transient postop complete heart block postop anemia postop urinary tract infection hyperlipidemia hypertension history of etoh abuse discharge condition: good discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks from date of surgery. 6) no driving for 1 month or while taking narcotics for pain. 7) call with any questions or concerns. followup instructions: please follow-up with dr. in 1 month ( please follow-up with dr. in 2 weeks. please follow-up with dr. in weeks. scheduled appointments: provider: , md phone: date/time: 9:20 md procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open heart valvuloplasty of mitral valve without replacement operations on chordae tendineae diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension cardiac complications, not elsewhere classified alcohol abuse, unspecified other and unspecified hyperlipidemia atrioventricular block, complete surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation old myocardial infarction rupture of chordae tendineae 

Answer: The patient is high likely exposed to