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: percutaneous aortic valvuloplasty placement of a bare metal stent in the saphenous vein graft history of present illness: this is an 86 yo male with a history of cad (s/p cabg), chronic afib, chf, critical as who was transferred to for evaluation for aortic valvular repair. in early , he was at for an acute chf exacerbation, where he ruled in for an mi by enzymes. at on , he underwent catheterization which showed 85% stenosis of his svg-om1, but a patent lima-lad. he was transferred to the for aortic valve replacement. . in preparation for surgery, he was being followed by nephrology for chronic kidney disease. it was felt that the patient had a 20% chance of needing dialysis following cabg. he was also being followed by heme-onc for chronically elevated inr, which was felt to be secondary to chronic warfarin use. . on the morning of admission, he became tachypneic, the rate of his afib increased and he developed substernal chest pain. his o2 requirement increased to 92% on 2l (98% ra yesterday). over the past few days, he has been on a decreased dose of lasix, only receiving 40 po daily when his home regimen was 40mg po bid. . on transfer to the ccu he converted to sinus rhythm after receiving lasix, metazolone, and metoprolol 7.5 mg iv. he reported improved sob and cp after converting. . past medical history: cad - mi & cabg chf -- systolic dysfunction (ef 35 - 40%) chronic afib critical as nsvt s/p aicd htn dm lbbb cri tia & cva social history: social history is significant for the absence of current tobacco use. there is no history of alcohol abuse. patient is a former barber. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: admission physical exam . vs: t: 96.7 , bp: 91/61 , hr: 110s (afib) -> 80s , rr:20 , o2 94% on 3l nc . gen: wdwn elderly male with obvious respiratory distress with some difficulty speaking. pleasant. heent: ncat. sclera anicteric. op clear. neck: supple with jvp to mid neck with bed at 45%. cv: irregularly irregular. murmurs difficult to appreciate. chest: poor air movement ~ 1/3 up bases. no wheezing. abd: obese, soft, ntnd, no hsm or tenderness. no abdominial bruits. ext: 2+ pretibial edema. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: admission labs: 04:50pm blood wbc-8.4 rbc-3.45* hgb-10.4* hct-30.9* mcv-90 mch-30.0 mchc-33.5 rdw-14.0 plt ct-164 04:50pm blood pt-17.7* ptt-75.8* inr(pt)-1.6* 04:50pm blood plt ct-164 04:50pm blood glucose-160* urean-84* creat-3.2* na-136 k-4.8 cl-97 hco3-30 angap-14 04:50pm blood alt-33 ast-28 ld(ldh)-300* alkphos-95 amylase-83 totbili-0.5 04:50pm blood albumin-3.2* 07:30am blood calcium-9.1 phos-5.0* mg-3.0* 04:50pm blood %hba1c-6.9* . imaging: admission cxr-- pa & lateral mild atelectasis at the left lung base with moderate cardiomegaly . cardiac catheterization (see cath report for further details) 1. three vessel coronary artery disease. patent lima. svg->om/pda stenosis. 2. pulmonary edema. 3. critical aortic stenosis. 4. successful stenting of the svg-om/pda with a bare metal stent. 5. successful aortic valvuloplasty. brief hospital course: aortic stenosis on admission, mr. ef was ~35-40% with moderate mitral regurgitation and critical aortic stenosis (valve area of 0.6 and mean gradient of 58). surgical aortic valve replacement was deferred on this admission because of the patient's worsening renal function and multiple comorbidities, placing him at high risk for complications with an open heart surgery. a percutaneous aortic valvuloplasty was performed on without complication. atrial fibrillation he has known chronic atrial fibrillation, with a baseline lbbb. upon arrival to the ccu, mr. was found to be in afib with a rapid ventricular rate, which induced hypoxia and chest pain. after intravenous furosemide and metoprolol, the patient quickly returned to his baseline rhythm of atrial fibrillation with a rate in the 70's, and his shortness of breath and chest pain improved. a chest x ray showed pulmonary edema, which slowly improved over the hospital course with continued diruesis. he was kept on heparin throught the admission for anticoagulation and was bridged to coumadin at the end of his hospital stay. coronary artery disease mr. had a cabg in with svg to the om1 and lima to the lad. his cath on showed patent lad and 85% stenosis of the svg; thus, a bare metal stent was placed in the svg to om1. he was continued on aspirin and plavix for anti-platelet therapy. hypertension he was continued on metoprolol succinate and amlodipine with good control of his blood pressure. his home ace inhibitor was held in the setting of arf. acute on chronic renal failure although his baseline cr is unknown, his cr was 3.2 on admission, elevated from the 2.2 - 2.4 that he was running at the outside hospital prior to transfer. the aucte on ckd was likely secondary to contrast nephropathy and a pre-renal state. the renal service was consulted and felt there was no indication for acute dialysis. his kidney function improved somewhat by the time of discharge with management of his chf and volume status (see above). his home ace inhibitor was held in the setting of arf. urinary tract infection mr. was found to have klebsiella in is urine cultures from , which was treated with cirpofloxacin. repeat urine culture on grew klebsiella and enterococcus; he was again treated with ciprofloxacin (shown to be sensitive on culture). the foley catheter was pulled on prior to discharge. medications on admission: medications pateint was on prior to admission to : toprol xl 100mg lisinopril 40mg daily glyburide 10mg daily hydralazine 20mg tid furosemide 40mg norvasc 5mg daily doxazosin 4mg daily asa 81mg daily warfarin 5mg daily hectorol 0.5mcg daily . medications on transfer to icu: -metoprolol xl 100mg daily -doxasozin 4mh qhs -doxercalciferol 0.5mcg dialy -colace 100mg -lasix 40mg po daily -insulin ss - glipizide 10mg -epoietin alpha 4000u sc mwf -iv heparin -diltiazem 30mg po qid -ipratropium q6hr discharge medications: 1. doxercalciferol 0.5 mcg capsule sig: one (1) capsule po daily (daily). 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever, headache, pain. 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 5. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 6. glipizide 5 mg tablet sig: one (1) tablet po bid (2 times a day). 7. warfarin 2 mg tablet sig: one (1) tablet po daily (daily): dosage to be adjusted according to inr (goal 2.0 - 3.0). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 9. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days: continue through . 10. epoetin alfa 4,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 11. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 12. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 13. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed. 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). 16. insulin lispro 100 unit/ml solution subcutaneous 17. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day): dosage will need to be adjusted according to daily weights to keep his weight even. discharge disposition: extended care facility: - discharge diagnosis: primary diagnoses: aortic stenosis, s/p percutaneous valvuloplasty systolic congestive heart failure atrial fibrillation acute on chronic renal failure urinary tract infection secondary diagnoses: hypertension diabetes coronary artery disease discharge condition: stable-- patient less short of breath than on admission; still with some fatigue but also improved. patient deconditioned from prolonged hospital stay, but able to work with physical therapy and being discharged to a rehab facility. discharge instructions: please follow the rehabilitation program at the rehab facility that you are going to after your discharge from the hospital. you should call your primary care doctor if you develop fever, pain with urination, worsening shortness of breath, or fluid retention. your fluid levels need to be closely monitored while you are at the rehab facility and then later when you go home. they should adjust your lasix dosage so that you do not gain weight and do not become short of breath. subcutaneous insulin dosage to be adjusted according fingerstick glucose. followup instructions: please see your cardiologist and primary care doctors within the next 1 - 2 weeks for follow-up of your heart problems. procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters left heart cardiac catheterization percutaneous balloon valvuloplasty cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified coronary atherosclerosis of autologous vein bypass graft hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortic valve disorders chronic kidney disease, unspecified systolic heart failure, unspecified 

Answer: The patient is high likely exposed to