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: zocor / lipitor attending: chief complaint: worsening shortness of breath for 5-6 months. critical as. major surgical or invasive procedure: core valve placement endotracheal intubation cardioversion history of present illness: mr. is a a very articulate year old man who has been in good health until the past two years when his activity level has diminished. over the past three months, he had increasing dyspnea with exertion. he does not have chest pain or syncope-presyncope but is limited to a few stairs or walking across the room. his dyspnea resolves rapidly with rest. he has not had pnd, orthopnea, or other cardiovascular symptoms. as part of assessment for percutaneous aortic valve therapy he was found to have iliofemoral peripheral vascular disease. he underwent stenting (x2 bare metal stents) of his right iliac artery on , with excellent result. he was discharged home on with vna and has been doing well since. he did complain of back pain to the vna who sent a u/a via his pcp. was positive for a uti (unknown bacteria) and pt is on day of cephalexin. able to ambulate only 20 steps before has doe causing him to rest. also has incontinance at baseline, uses pads at home. on review of systems, he denies any prior history of deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. he does have doe after 20 ft. he has had tia s/p stenting of left cartotid artery . past medical history: 1. hypercholesterolemia 2. recurrent utis ( foley catheters), urinary incontinence 3. left carotid stenting in due to a tia with mild left eye droop 4. bilat total hip replacement 5. stage iii chronic kidney disease 6. essential thrombocytopenia 7. stage 3 ckd 8. aortic valve stenosis with valve area 0.5 cm2 9. hypertension 10. nyha class iii chf social history: he lives with his wife in ma. he has much support at home including daily nursing and home health aide from vna of . one son lives next door and is frequently over to see him several times a day; another son is also in to visit several times a day. he uses a cane and has not had any falls. he does not have lifeline in the home but son states there is almost someone there during the day but not at night. he will be accompanied by his son (cell) . uses a walker at home. no history of falls. -tobacco history: none -etoh: none -illicit drugs: none average daily living: live independently yes no bathing independent dependent dressing independent dependent toileting independent dependent transferring independent dependent continence independent dependent feeding independent dependent family history: there is no history of hypertension, diabetes,stroke and premature coronary artery disease. his mother and father both died at age 85 of natural causes. physical exam: on admission: pulse: 50-57 sr b/p: right 136/73 left 131/63 resp: 18 o2 sat: 99% ra temp: 98.4 height: 68 inches weight: 76.8 kg general: alert, comfortable, sitting in bed. skin: no open areas, warm, dry heent: supple, jvd 1/2 up bilat. perla, eom's intact. mm moist. sclera non-icteric. chest: ctab posteriorly heart: regular, 3/6 systolic murmur across precordium, no radiation to carotids. abdomen: soft, nt, nd extremities: trace peripheral edema, bilat at ankles and feet. no bruits. neuro: a/o hoh, appropriate. . on admission to ccu: bp 130/74 (on .5 neo), hr 70, rr 18, o2 sat 100% on 500/16, 60%, peep 5, t 34.9 general: initially intubated, sedated, paralyzed. later, still intubated but awake and following commands heent: intubated, jvd difficult to visualized, moist mucosa chest: clear anteriorly heart: regular with frequent premature beats, very faint systolic murmur abdomen: soft, nontender, nondistended groin: bilateral bandages in place, no evidence of swelling or tenderness (r hip firm, which seems to be his baseline thr). no bruit. extremities: trace peripheral edema bilaterally, pulses dopplerable faintly at pt (obtained by one examiner and not another), warm but slightly mottled feet bilaterally neuro: after withdrawal of sedation, patient able to squeeze hands, blink eyes to command. perrl . on discharge: gen: alert, oriented x2 heent: supple, cv: rrr, no m/r/g resp: at bases, no crackles or wheezes abd: soft, nt, pos bs, had bm extr: left groin with large resolving hematoma, no bruit noted. right groin wtih pos bruit. no tenderness neuro: alert, conversant, less confused. oriented x 2 extremeties: no edema pulses: right: dp 1+ pt 1+ left: dp 2+ pt 1+ skin: intact pertinent results: admission labs: 12:40pm wbc-6.7 rbc-3.56* hgb-11.7* hct-33.8* mcv-95 mch-33.0* mchc-34.7 rdw-15.3 12:40pm plt count-191 12:40pm neuts-66.0 lymphs-20.0 monos-6.4 eos-6.4* basos-1.1 12:40pm pt-14.5* ptt-32.5 inr(pt)-1.2* 12:40pm glucose-99 urea n-32* creat-2.2* sodium-139 potassium-4.7 chloride-106 total co2-23 anion gap-15 12:40pm albumin-4.1 calcium-9.8 phosphate-3.6 magnesium-2.3 12:40pm alt(sgpt)-17 ast(sgot)-28 ld(ldh)-252* ck(cpk)-56 alk phos-133* tot bili-0.4 12:40pm ck-mb-4 . discharge labs: 06:50am blood wbc-9.8 rbc-2.93* hgb-9.4* hct-29.0* mcv-99* mch-32.2* mchc-32.6 rdw-19.0* plt ct-217 06:50am blood pt-44.0* inr(pt)-4.6* 06:50am blood glucose-91 urean-51* creat-2.7* na-138 k-4.6 cl-106 hco3-19* angap-18 03:25pm blood ld(ldh)-362* ck(cpk)-185 totbili-1.5 . echo (): the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). with mild global free wall hypokinesis. the aortic valve leaflets are severely thickened/deformed. mild (1+) aortic regurgitation is seen.there is severe aortic stenosis. moderate (2+) mitral regurgitation is seen, with a restricted posterior leaflet.there is also a mitraal valve cleft bettween p1 and p2. moderate tricuspid regurgitation is seen. there is no pericardial effusion. post tavi there is 2+ aortic regurgitation.the regurgitation is parvalvular, 2+ mitral regurgitation similar to preprocedure no pericardial effusion is seen lv function is preserved . echo (): the left atrium is mildly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). the right ventricular cavity is dilated with mild global free wall hypokinesis. the aortic root is mildly dilated at the sinus level. an aortic corevalve prosthesis is present. the prosthetic aortic valve leaflets appear normal. the transaortic gradient is normal for this prosthesis. there are two small paravalvular aortic regurgitation jets, together constituting no more than mild (1+) aortic regurgitation is seen. moderate (2+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normally-functioning corevalve aortic prosthesis. symmetric lvh with normal global and regional systolic function. severe pulmonary hypertension with dilated right ventricle and mild global systolic dysfunction and moderate to severe functional tricuspid regurgitation. . ekg (): sinus bradycardia with first degree atrio-ventricular conduction delay. low qrs voltage in limb leads. inferior wall myocardial infarction of indeterminate age. lateral myocardial infarction of indeterminate age. compared to the previous tracing of multiple abnormalities persist without major change. . brief hospital course: yom with nyha class 3 chf and severe as, now s/p corevalve with post-procedure course complicated by hemodynamic instability and new onset af with rvr. . # aortic stenosis: corevalve procedure was without complications. he was extubated immediately post-op. subsequent ttes showed appropriate positioning and functioning of the valve. aspirin and plavix were continued. . # hypotension: in the immediate post-procedure period, he was recurrently hypotensive, and did several hours after the procedure, lose his pulse briefly. he regained blood pressure and consciousness after 1 round of cpr. however, over the next 48 hours he had 3 more episodes of sudden, profound hypotension to the 40s systolic with loss of consciousness. each time he regained consciousness within seconds without intervention. this was all thought to be due to profound systemic dilatation in the setting of the sudden relief of his outflow tract obstruction he required intermittent neosynephrine in the first 48 hours post-procedure. echo showed a collapsed lv and outflow tract obstruction, prompting fluid resuscitation. his blood pressures improved, but subsequently decreased due to atrial fibrillation. his blood pressures again stabilized with rate, and eventually rhythm control. . # atrial fibrillation. new diagnosis of afib. on amio loaded and anticoagulation started with hep ggt. he was cardioverted on and continued on amiodarone and coumadin. he remained in sinus bradycardia with stable blood pressures. the decision was made to discontinue coumadin on given bleeding risk and interaction with amio. amiodarone was changed to 200 mg daily. . # thrombocytopenia. patient with 191 -> 83 drop in platelets in the several days post-procedure. d-dimer and fdp were elevated but fibrinogen was not low and no evidence of hemolysis. rbc morphology did not demonstrated schistocyes. hit was thought to be unlikely. platelets returned to baseline over the next week. . # anemia: hct stable after 2u of prbc on . ct showed left pelvic hematoma with layering blood in the pelvis and a small amount of peri-hepatic hemoperitoneum. no retroperitoneal hematoma. repeat b/l le duplex - normal appearance to right cfa, and cfv pseudoaneurysm no longer seen. hct stabilized and no further transfusions were required. . # acute on chronic diastolic chf: after core-valve procedure patient was hypotensive and very pre-load dependent with bedside echo demonstrating low filling. was treated with ivf boluses. bp??????s subsequently stabilized and patient was los balance positive upto 5l. subsequently appeared clinically fluid overloaded with crackles and wheezing on lung auscultation and congested appearance of chest x ray, this prompted diuresis with boluses of 10mg iv lasix. he was approximately euvolemic upon discharge. . # delirium. patient developed confusion and disorientation during hospitalization, which was likely secondary to prolonged icu course. he had no signs of active infection. he was given seroquel prn and daily ecg was followed to monitor for qtc prolongation. seroquel was discontinued on discharge due to sedation. . # coronaries: no history of cad. asa and pravastatin were continued. . # peripheral vascular disase: s/p bms to right iliac artery. pulse exam was stable - pt pulses dopplerable, dp very faint on doppler . # ckd, stage 3: creatinine increased to 2.7 from baseline 2.2. believed to be pre-renal given feurea <25%. he was given 1 liter ns bolus on the day of discharge. he will require daily cr checks. . # dyslipidemia: pravastatin was continued . code: full . comm: : , . . pt is illiterate. . transitions of care: - daily cr checks medications on admission: confirmed with son and list 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. pravastatin 10 mg tablet sig: one (1) tablet po hs (at bedtime). 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 6. lumigan 0.01 % drops sig: two (2) drops ophthalmic at bedtime. 7. cephalexin 500 mg po qid, day #5 of 7 for uti 8. tylenol 500 mg po bid for back pain discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. pravastatin 10 mg tablet sig: one (1) tablet po once a day. 4. multivitamin tablet sig: one (1) tablet po daily (daily). 5. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 6. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 7. acetaminophen 325 mg tablet sig: two (2) tablet po bid (2 times a day). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 10. polyethylene glycol 3350 17 gram/dose powder sig: one (1) packet po daily (daily) as needed for constipation. 11. outpatient lab work please check daily cr, until begins trending down to baseline 2.2. 12. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: cape regency, a healthcare center - discharge diagnosis: severe arotic stenosis s/p corevalve placement delerium atrial fibrillation acute on chronic kidney disease chronic thrombocytopenia and anemia acute on chronic diastolic congestive heart failure discharge condition: mental status: confused - always. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you had a naortic corevalve placed that has fixed your severe aortic stenosis. the procedure went well but you had some complications that include bleeding at the right and left groin site, delerium and atrial fibrillation. your groin sites have been stable with no evidence of bleeding at present. the atrial fibrillation was converted to a normal rhythm via a cardioversion procedure and you were started on a medicine called amiodarone to keep you in a normal rhythm. you will need to have your thyroid, liver and lung function followed regularly while you are on this medicine. you thyroid and liver function tests were ok here in the hospital. you were also started on coumadin to prevent a blood clot from the atrial fibrillation. your coumadin level is high now, probably from the interaction with the amiodarone. this level will be followed closely from now on. you were confused from being in the hospital and this is clearing slowly. weigh yourself every morning, call dr. if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. . we made the following changes to your medicines: 1. start amiodarone to keep you in a normal rhythm 2. start senna, colace and miralax to treat your constipation followup instructions: department: cardiac services when: friday at 12:20 pm with: , md building: sc clinical ctr campus: east best parking: garage department: cardiac services when: friday at 11:00 am with: echocardiogram building: sc clinical ctr campus: east best parking: garage procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters open and other replacement of aortic valve atrial cardioversion percutaneous balloon valvuloplasty diagnoses: acidosis thrombocytopenia, unspecified pure hypercholesterolemia urinary tract infection, site not specified congestive heart failure, unspecified cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation acute on chronic diastolic heart failure aortic valve disorders other chronic pulmonary heart diseases chronic kidney disease, stage iii (moderate) other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits nontraumatic hematoma of soft tissue atherosclerosis of native arteries of the extremities, unspecified delirium due to conditions classified elsewhere hip joint replacement chronic total occlusion of artery of the extremities 

Answer: The patient is high likely exposed to