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: dyspnea on exertion major surgical or invasive procedure: s/p aortic valve replacement (21 mm porcine) history of present illness: 68 year old female with history of aortic stenosis with dyspnea on exertion, exercise intolerance, and fatigue. she underwent cardiac catherization on for preoperative evaluation which revealed 40% lad stenosis, with otherwise clean coronaries. past medical history: 1. htn, diagnosed in her 40s, usual bp in 180s 2. dm, diagnosed in 30s, does not take insulin 3. hyperlipidemia, diagnosed in 50s 4. dvt as a young adult when on ocps 5. aortic stenosis 6. 4 svd pregnancies 7. cva 8. anemia 9. pvd 10. diverticulosis social history: works as electronic assembler tobacco denies stopped drinking 7 years ago lives with daughter family history: mother died of stroke in her 70s physical exam: general nad hr 70, b/p 138/68, wt 150 ht 62" skin warm dry heent ncat, perrla, eomi, op benign, edentulous neck supple, full rom + rt bruit no jvd chest cta bilat heart rrr 4/6 blowing systolic murmur abdomen soft nd, nt +bs ext warm well perfused trace le edema varicosities none neuro a/o x3 nonfocal, gait steady, 5/5 strength pertinent results: 12:50pm blood wbc-9.1 rbc-3.20* hgb-9.4* hct-27.5* mcv-86 mch-29.5 mchc-34.3 rdw-14.1 plt ct-451*# 10:05am blood wbc-7.6 rbc-2.07*# hgb-6.0*# hct-18.0*# mcv-87 mch-28.7 mchc-33.1 rdw-14.1 plt ct-171# 12:50pm blood plt ct-451*# 10:05am blood pt-15.8* ptt-43.7* inr(pt)-1.4* 10:05am blood fibrino-166 12:50pm blood glucose-115* urean-11 creat-0.8 na-143 k-4.2 cl-103 hco3-27 angap-17 12:27pm blood urean-15 creat-0.5 cl-119* hco3-23 12:50pm blood mg-1.6 03:10am blood mg-1.7 echocardiography report , (complete) done at 9:00:11 am final referring physician information , r. division of cardiothoracic , status: inpatient dob: age (years): 68 f hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: abnormal ecg. aortic valve disease. hypertension. shortness of breath. icd-9 codes: 402.90, 786.05, 440.0, 424.1 test information date/time: at 09:00 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2008aw1-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.5 cm <= 4.0 cm left ventricle - septal wall thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - ejection fraction: 50% to 55% >= 55% aorta - ascending: 3.1 cm <= 3.4 cm aortic valve - peak velocity: *3.8 m/sec <= 2.0 m/sec aortic valve - peak gradient: *62 mm hg < 20 mm hg aortic valve - mean gradient: 42 mm hg aortic valve - valve area: *0.9 cm2 >= 3.0 cm2 findings left atrium: moderate la enlargement. no spontaneous echo contrast in the body of the laa. good (>20 cm/s) laa ejection velocity. no thrombus in the laa. right atrium/interatrial septum: normal ra size. no spontaneous echo contrast in the raa. left ventricle: moderate symmetric lvh. normal lv cavity size. normal regional lv systolic function. no lv mass/thrombus. low normal lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. simple atheroma in aortic root. normal ascending aorta diameter. simple atheroma in ascending aorta. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. focal calcifications in descending aorta. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. no masses or vegetations on aortic valve. moderate-severe as (area 0.8-1.0cm2). mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. no mass or vegetation on mitral valve. mild mitral annular calcification. no ms. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. 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. the patient received antibiotic prophylaxis. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. patient. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions pre-cpb:1. the left atrium is moderately dilated. no spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. no thrombus is seen in the left atrial appendage. there is no asd by color or 2-d. 2. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. no masses or thrombi are seen in the left ventricle. overall left ventricular systolic function is low normal (lvef 50-55%). 3. right ventricular chamber size and free wall motion are normal. 4. there are simple atheroma in the aortic root. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. no masses or vegetations are seen on the aortic valve. there is moderate to severe aortic valve stenosis (area 0.8-1.0cm2). mild (1+) aortic regurgitation is seen. 6. the mitral valve leaflets are moderately thickened. no mass or vegetation is seen on the mitral valve. mild (1+) mitral regurgitation is seen. dr. was notified in person of the results. post-cpb: on infusion of phenylephrine. well-seated bioprosthetic valve in the aortic position. no paravalvular leak. trivial ai. flow seen in lmca and rca. preserved biventricular systolic gfunction. mild mr from preop. the aortic contour is normal post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 10:17 , m f 68 cardiology report ecg study date of 12:47:02 pm baseline artifact. sinus rhythm. possible st-t wave abnormalities with mild q-t interval prolongation. since the previous tracing of the qrs voltage has decreased. the axis is more leftward. clinical correlation is suggested. read by: , a. intervals axes rate pr qrs qt/qtc p qrs t 81 112 90 418/454 45 -24 36 brief hospital course: admitted same day surgery and underwent aortic valve replacement, see operative report for further details. was transferred to the intensive care unit for hemodynamic monitoring. in the first twenty four hours she was weaned from sedation, awoke neurologically intact and was extubated without complications. she was started on beta blockers for rate control and lasix for gentle diuresis. physical therapy worked with her on strength and mobility. chest tubes were discontinued on pod #2 without complication. her wires were removed on the following day. with ambulation, incentive sprirometry, lasix, and pulmonary toilet her breathing improved. she continued to progress and was ready for discharge to rehab on pod 6. medications on admission: plavix 75mg daily actos 15mg daily norvasc 10mg daily lipitor 80mg daily lasix 40mg alternating with 20mg daily metformin 1000 mg nph 20 units qhs glyburide 10 mg toprol xl 200 mg daily zetia 10 mg daily mavik 8 mg daily verapamil 240 mg daily asa 81 mg daily discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 4. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 7. metformin 500 mg tablet sig: two (2) tablet po bid (2 times a day). 8. lasix 40 mg tablet sig: one (1) tablet po twice a day: please evaluate weight and edema. 9. pioglitazone 15 mg tablet sig: one (1) tablet po daily (daily). 10. glyburide 5 mg tablet sig: two (2) tablet po twice a day. 11. acetaminophen 500 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. 12. insulin ss humalog insulin sc sliding scale breakfast lunch dinner bedtime humalog humalog humalog humalog glucose insulin dose insulin dose insulin dose insulin dose 0-60 mg/dl 4 oz. juice 4 oz. juice 4 oz. juice 4 oz. juice 61-109 mg/dl 0 units 0 units 0 units 0 units 110-130 mg/dl 2 units 2 units 2 units 0 units 131-150 mg/dl 4 units 4 units 4 units 0 units 151-180 mg/dl 6 units 6 units 6 units 0 units 181-210 mg/dl 8 units 8 units 8 units 2 units 211-240 mg/dl 10 units 10 units 10 units 4 units 13. insulin nph human recomb 100 unit/ml suspension sig: twenty (20) units subcutaneous at bedtime. 14. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day): total - 75mg twice a day. discharge disposition: extended care facility: health care discharge diagnosis: aortic stenosis s/p avr hyperlipidemia hypertension peripheral vascular disease anemia diverticulosis diabetes mellitus cva h/o deep vein thrombosis discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: please call to schedule all appointments dr in 4 weeks () dr in 1 week () dr in weeks wound check appointment 6 as instructed by nurse () procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft diagnoses: anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders atherosclerosis of native arteries of the extremities, unspecified epistaxis 

Answer: The patient is high likely exposed to