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: aortic valve replacement(19 tissue) history of present illness: 64 year old female who has been followed with serial echocardiograms by his pcp for aortic stenosis. most recent echo in showed severe aortic stenosis. she recently underwent a cardiac cath which revealed clean coronaries and again showed severe as. she is complaining of mild dyspnea on exertion and was referred for an aortic valve replacement. she was seen in clinic by dr. and presents for preadmission testing. past medical history: past medical history: aortic stenosis diabetes mellitus hypertension hypercholesterolemia anxiety past surgical history: s/p left carpal tunnel surgery social history: race: caucaisn last dental exam: lives with: husband occupation: at cigarettes: smoked yes last cigarette _____ hx: 1ppd x 50yr other tobacco use: denies etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: denies family history: family history:premature coronary artery disease. mother had cabg x 3 in her 70's father mi < 55 mother < 65 physical exam: pulse: 80 resp: 16 o2 sat: 100% b/p right: 128/60 left: 124/64 height: 61" weight: 134lbs general: well-developed female in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular systolic murmur grade abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema/varicosities: none 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: - left: - pertinent results: pre-op labs 07:37am freeca-1.11* 07:37am hgb-10.6* calchct-32 07:37am glucose-205* lactate-1.1 na+-138 k+-3.8 cl--106 10:14am pt-12.2 ptt-20.3* inr(pt)-1.1 10:14am wbc-11.2* rbc-2.78* hgb-8.5*# hct-26.4* mcv-95 mch-30.7 mchc-32.3 rdw-14.0 11:17am urea n-16 creat-0.5 sodium-142 potassium-3.7 chloride-112* total co2-23 anion gap-11 echocardiography report results measurements normal range aortic valve - peak gradient: *70 mm hg < 20 mm hg aortic valve - mean gradient: 40 mm hg aortic valve - valve area: *0.5 cm2 >= 3.0 cm2 findings left atrium: no spontaneous echo contrast is seen in the laa. right atrium/interatrial septum: normal interatrial septum. left ventricle: overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). mild to moderate (+) ar. mitral valve: mildly thickened mitral valve leaflets. trivial mr. tricuspid valve: physiologic 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. the patient was under general anesthesia throughout the procedure. no tee related complications. conclusions pre-cpb: no spontaneous echo contrast is seen in the left atrial appendage. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. posr-cpb: there is a prosthetic aortic valve with no leak and no ai. mean gradient is 15 mmhg. preserved biventriculary systolic fxn. no mr. . aorta intact. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician ?????? caregroup is. all rights reserved. brief hospital course: the patient was brought to the operating room on where the patient underwent avr (19mm tissue) with dr. . 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. transfer to the telemetry floor was delayed due to issues with hyperglycemia requiring insulin drip for management. once glycemic conrol was achieved, she was transferred to the telemtry floor for ongoing care and recovery. was consulted for assistance with glucose management and ms. was started on lantus. 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 #6 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to home in good condition with appropriate follow up instructions. medications on admission: medications at home: citalopram 40mg daily glyburide 10mg hctz 12.5mg daily lisinopril 40mg daily metformin 1000mg niacin er 500mg daily crestor 10mg daily aspirin 81mg daily mvi daily discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*75 tablet(s)* refills:*0* 2. 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:*2* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 5. metformin 500 mg tablet sig: two (2) tablet po bid (2 times a day). 6. glyburide 5 mg tablet sig: two (2) tablet po bid (2 times a day). 7. lisinopril 10 mg tablet sig: three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* 8. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 7 days: after 7 days, resume your hydrochlorothyazide. disp:*7 tablet(s)* refills:*0* 9. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 10. potassium chloride 10 meq tablet extended release sig: one (1) tablet extended release po once a day for 7 days. disp:*7 tablet extended release(s)* refills:*0* 11. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 2-4 puffs inhalation q4h (every 4 hours) as needed for wheezing/sob. disp:*1 mdi* refills:*1* 12. rosuvastatin 20 mg tablet sig: 0.5 tablet po daily (daily). 13. niacin 500 mg capsule, extended release sig: one (1) capsule, extended release po daily (daily). 14. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 weeks. disp:*28 tablet(s)* refills:*0* 15. nicotine 7 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*14 patch 24 hr(s)* refills:*2* 16. lantus solostar 100 unit/ml (3 ml) insulin pen sig: thirty (30) units subcutaneous every morning at breakfast. disp:*3 pens* refills:*2* 17. glucose test strips- one touch test glucose before meals and at bedtime and record values 18. glucose monitor one touch glucose monitor discharge disposition: home with service facility: vna, discharge diagnosis: s/p avr(19 tissue) past medical history: aortic stenosis diabetes mellitus hypertension hypercholesterolemia anxiety past surgical history: s/p left carpal tunnel surgery discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema trace 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 one month or while taking narcotics. driving will be discussed at follow up appointment with surgeon. no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **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 wound check 10:15 in the medical office building, . surgeon: dr on 1:00 in the medical office building, . cardiologist: dr. at 9:45 please call to schedule appointments with your primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: pure hypercholesterolemia unspecified essential hypertension aortic valve disorders personal history of tobacco use diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled long-term (current) use of insulin insulins and antidiabetic agents causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to