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: dyspnea on exertion major surgical or invasive procedure: coronary artery bypass grafts x4,aortic valve replacement(25 tissue) history of present illness: 75 year old male with history of hyperlipidemia and aortic stenosis. he reports being able to walk about 30 minutes on flat ground without symptoms. he does reports shortness of breath after climbing stairs or walking up inclines relieved with rest. he also reports that symptoms have improved over the past several months, however, he has limited his activity. his most recent echo is from revealing a normal lv wall thickness, cavity size and regional/global systolic function with an lvef of 55%, severely thickened and deformed aortic valve leaflets with critical aortic valve stenosis noting a valve area of <0.8 cm2, mild to moderate + aortic regurgitation as well as trivial mitral regurgitation. he was referred for right and left heart catheterization. he is now being referred to cardiac surgery for an aortic valve replacement and revascularization. past medical history: critical aortic stenosis mild to moderate aortic insufficiency hyperlipidemia hypertension atrial tachycardia s/p ablation colon cancer s/p chemo/xrt and surgery now with colostomy glaucoma past cardiac procedures: none psh: lar ileostomy takedown social history: race:caucasian last dental exam:5 months ago, will call dentist and have dental clearance faxed to office lives with:wife contact: (wife) phone #. occupation:retired teacher cigarettes: smoked no yes other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use family history: family history:premature coronary artery disease- father died of mi at age 76 physical exam: physical exam pulse:53 resp:13 o2 sat:97/ra b/p right:138/60 left:140/62 height:5'" weight:205 lbs general: dry awake alert oriented skin: intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr harsh 5/6 systolic ejection murmur; with radiation to r carotid abdomen: soft non-distended non-tender + bowel sounds extremities: warm , well-perfused no edema no varicosities 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: harsh murmur left: + bruit pertinent results: abd/pelvis ct 1. stable bilateral pleural effusions and atelectasis. 2. small pericardial effusion. 3. diminished volume of intraperitoneal free air likely related to recent surgery. 4. no bowel obstruction. 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. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results before surgical incision. post-bypass: normal rv systolic function. lvef 55%. the aortic bioprosthesis is intact, functioning well with a residual mean gradient of 5 mm of hg. intact thoracic aorta. minimal mr. 04:21am blood wbc-6.5 rbc-2.94* hgb-9.1* hct-27.6* mcv-94 mch-30.8 mchc-32.8 rdw-14.8 plt ct-239 05:29am blood wbc-5.7 rbc-2.93* hgb-9.2* hct-27.5* mcv-94 mch-31.3 mchc-33.4 rdw-14.8 plt ct-213 05:44am blood pt-15.6* inr(pt)-1.4* 04:21am blood plt ct-239 05:29am blood pt-18.9* inr(pt)-1.7* 05:44am blood urean-16 creat-0.9 na-139 k-4.3 cl-106 04:21am blood glucose-103* urean-11 creat-0.8 na-137 k-4.2 cl-106 hco3-24 angap-11 05:29am blood glucose-94 urean-9 creat-0.7 na-140 k-3.9 cl-107 hco3-24 angap-13 brief hospital course: the patient was brought to the operating room on where the patient underwent aortic valve replacement with size 25-mm st. epic tissue valve and coronary artery bypass graft x4: left internal mammary artery to left anterior descending artery and saphenous vein grafts to distal left anterior descending artery, obtuse marginal and posterior descending arteries. see operative note for full details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. pt did have minimal bowel sounds with nausea and vomiting with a history of a post operative ileus. a kub revealed an ileus. pt was made npo. a nasogastric tube was placed and general surgery was consulted when the patient had a prolonged ileus. an abdominal ct was performed and revealed no bowel obstruction. the patient's diet was slowly advanced with good tolerance and ng tube was removed. he regained his bowel sounds and his diet was advanced to regular. on discharge he was tolerating a regular oral diet well and his stoma was putting out stool. pt also went into a rapid atrial fibrillation, he was given a bolus of amiodarone and given a drip for 24 hours and lopressor was titrated up for better rate control. when the patients bowel sounds returned, he was started on po amiodarone. he went into paroxysmal atrial fibrillation (rapid at times to 130's) but he was in rate controlled sinus rhythm at the time of discharge. due to his repeated atrial fibrillation, he was started on coumadin. inr goal 2.0-2.5 - coumadin follow up was arranged with pcp. patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod #12 the patient was ambulating with assistance, the wound was healing well and pain was controlled with oral analgesics. he was discharged home with vna and pt services. all appropriate follow up instructions and appointments were given. medications on admission: brimonidine 0.2 % drops one drop right eye , dorzolamide 2 % drops one drop right eye , metoprolol tartrate 25 mg , simvastatin 20 mg daily, timolol 0.5 % drops one drop right eye , aspirin 81 mg daily discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temperature >38.0. 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 4. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): please tape, 200 x 7 days, then 200 mg po qd untill f/u with pcp. :*44 tablet(s)* refills:*2* 5. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 7. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 8. dorzolamide-timolol 2-0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 9. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). :*30 tablet, chewable(s)* refills:*2* 10. insulin sliding scale & fixed dose fingerstick qachs insulin sc fixed dose orders breakfast glargine 25 units insulin sc sliding scale breakfast lunch dinner bedtime humalog glucose insulin dose 0-70 mg/dl proceed with hypoglycemia protocol 71-119 mg/dl 0 units 0 units 0 units 0 units 120-159 mg/dl 2 units 2 units 2 units 0 units 160-199 mg/dl 4 units 4 units 4 units 2 units 200-239 mg/dl 6 units 6 units 6 units 4 units 240-280 mg/dl 8 units 8 units 8 units 6 units > 280 mg/dl notify m.d. 11. outpatient lab work coumadin for afib goal inr 2-2.5 first draw then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. results to phone (fax ) 12. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). :*90 tablet(s)* refills:*2* 13. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 14. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily): home dose while on amiodarone. :*30 tablet(s)* refills:*2* 15. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po daily (daily) for 7 days. :*14 tablet extended release(s)* refills:*0* 16. warfarin 1 mg tablet sig: 2.5 tablets po daily (daily): dose based on inr for afib goal 2.0-2.5. :*80 tablet(s)* refills:*2* 17. lasix 20 mg tablet sig: one (1) tablet po once a day for 7 days. :*7 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: critical aortic stenosis mild to moderate aortic insufficiency hyperlipidemia hypertension atrial tachycardia- s/p ablation, colon cancer (s/p chemo/xrt and surgery now with colostomy) glaucoma discharge condition: alert and oriented x3 ,nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema 1+ to knees bilaterally 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 **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:wound care nurse phone: date/time: 10:45 in the medical office building . cardiologist: dr. () on at 1:20pm **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr coumadin for afib goal inr 2-2.5 first draw then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. results to phone (fax ) md procedure: (aorto)coronary bypass of three coronary arteries single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery parenteral infusion of concentrated nutritional substances open and other replacement of aortic valve with tissue graft diagnoses: acidosis other iatrogenic hypotension coronary atherosclerosis of native coronary artery unspecified pleural effusion unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders other and unspecified hyperlipidemia long-term (current) use of anticoagulants paralytic ileus personal history of malignant neoplasm of large intestine colostomy status other digestive system complications 

Answer: The patient is high likely exposed to