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: shortness of breath major surgical or invasive procedure: aortic valve replacement, . medical mechanical regent valve history of present illness: 54 year old female with 20 year history of a "heart murmur" who has been complaining of progressive shortness of breath and fatigue. recent echocardiogram in revealed critical aortic stenosis. of note, she has no prior echocardiogram and never been told she has aortic valve disease. she presents today for surgical evaluation. prior to surgical consultation, she underwent cardiac catheterization which showed normal coronary arteries. she also admits to exertional chest tightness and "heart burn" symptoms. she denies orthopnea, pnd, palpitations and pedal edema. past medical history: aortic stenosis, history of syncope 15 years ago anxiety s/p c-section social history: race: caucasian last dental exam: extraction 3-4 months ago lives with: parents occupation: unemployed cigarettes: denies etoh: 1-2 beers per night illicit drug use: denies family history: denies premature coronary artery disease. both parents still alive. mother underwent cabg in her early 70's. physical exam: pulse: 84 resp: 16 o2 sat: 100% room air b/p right: 123/83 left: 119/79 height: 59" weight: 102 lbs general: wdwn female in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular grade 4/6 sem radiating to carotids abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: none varicosities: none neuro: grossly intact pulses: femoral right: 2 left: 2 dp right: 1 left: 1 pt : 1 left: 1 radial right: 1 left: decreased carotid bruit: transmitted murmurs pertinent results: tte prebypass: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. and there is effacement of the sinotubular junction. no thoracic aortic dissection is seen. the aortic valve is bicuspid. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. normal coronary sinus. no clot in laa. the pv is not well seen. postbyass: normally functioning mechanical av. normal lv function. no dissection seen after ao cannula removed. otherwise unchanged. 10:39am blood wbc-13.5*# rbc-2.61*# hgb-8.0*# hct-22.2*# mcv-85 mch-30.6 mchc-36.0* rdw-13.2 plt ct-128*# 05:30am blood wbc-12.3* rbc-3.40* hgb-10.4* hct-29.8* mcv-88 mch-30.6 mchc-34.9 rdw-13.5 plt ct-428# 10:39am blood pt-16.7* ptt-34.1 inr(pt)-1.6* 04:06am blood pt-19.6* ptt-29.2 inr(pt)-1.9* 08:10am blood pt-24.2* inr(pt)-2.3* 01:34pm blood pt-26.8* inr(pt)-2.6* 05:30am blood pt-17.2* ptt-41.8* inr(pt)-1.6* 04:45am blood pt-23.7* ptt-108.7* inr(pt)-2.3* 11:53am blood urean-9 creat-0.5 na-141 k-3.7 cl-112* hco3-21* angap-12 04:45am blood urean-10 creat-0.6 na-130* k-4.1 cl-87* 04:50am blood calcium-8.1* phos-2.7 mg-2.1 brief hospital course: mrs. was a same day admit after undergoing pre-operative work-up as an outpatient. on she was brought directly to the operating room where she underwent an aortic valve replacement. please see operative note for surgical details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. within 24 hours she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was started on beta-blockers and diuretics and gently diuresed towards her pre-op weight. later on this day she was transferred to the telemetry floor for further care. chest tubes and epicardial pacing wires were removed per protocol. coumadin was initiated for mechanical aortic valve. this was titrated for goal inr. she worked with physical therapy for strength and mobility. on post-op day three inr jumped to 3.7 and coumadin was held. subsequent day the inr was 1.6. coumadin was again given along with heparin drip. she was ready for discharge home and just waiting for inr to be at therapeutic level. on post-op day six she was finally discharged home with vna services and the appropriate medications and follow-up appointments. her pcp, . , follow her coumadin and inr. medications on admission: centrum silver daily, calcium carbonate 500mg daily, tylenol prn discharge medications: 1. 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* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 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). disp:*60 capsule(s)* refills:*2* 4. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 5. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 6. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po q12h (every 12 hours) for 10 days. disp:*40 tablet extended release(s)* refills:*0* 7. furosemide 40 mg tablet sig: one (1) tablet po once a day for 10 days. disp:*10 tablet(s)* refills:*0* 8. coumadin 1 mg tablet sig: 0.5 tablet po once a day: please take for mechanical aortic valve. goal inr 2.5-3.5. dose will change according to inr and instructions regarding dose will be given be pcp, . . disp:*30 tablet(s)* refills:*2* 9. outpatient lab work inr daily d/t sensitivity to coumadin. once stable, inr draw can be according to pcp. discharge disposition: home with service facility: discharge diagnosis: critical symptomatic aortic stenosis history of syncope 15 years ago anxiety discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage trace edema bilateral lower extremities 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 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 surgeon: dr on at 1:30pm cardiologist: dr. on at 1:30pm wound check at on at 11:00am 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** labs: pt/inr for coumadin ?????? indication aortic valve replacement goal inr 2.5-3.5 first draw results to phone dr procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: acute posthemorrhagic anemia hyposmolality and/or hyponatremia aortic valve disorders anxiety state, unspecified long-term (current) use of anticoagulants 

Answer: The patient is high likely exposed to