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: mild dyspnea on exertion/fatigue major surgical or invasive procedure: aortic valve replacement (21mm st. epic bioprosthetic) cardiac cath history of present illness: 78 year old female with history of aortic stenosis which has been followed with serial echocardiograms for the past several years. she has been told she has a heart murmur for several decades. this past she developed congestive heart failure requiring admission to the intensive care unit and diuresis. her most recent echocardiogram revealed severe aortic stenosis with increased gradients across her valve and a reduced ejection fraction. she denies any symptoms however when pressed and with the assistance of her family will admit to mild dyspnea on exertion and fatigue. she is not very active though. given the severity of her disease, she was referred for surgical management. she denies any changes in her health since last seen in cardiac surgery clinic. past medical history: - chronic systolic and diastolic heart failure with history of pulmonary edema in - aortic stenosis - hyperlipidemia - depression - morbid obesity - severe knee and back arthritis, requires percocet daily - recurrent uti - diabetes - hyperglobulinemia - cystoscopy and removal of bladder mass (thought to be reactive/inflammatory on pathology) - cholecystectomy social history: race: caucasian last dental exam: edentulous lives with: son contact: phone # occupation: retired hairdresser cigarettes: smoked no yes hx: other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: none family history: no premature coronary artery disease brother died of pancreatic cancer. parents died of "old age." physical exam: pulse: 74 resp: 18 o2 sat:97% ra b/p right: 113/78 height: 63" weight: 180 general: a&o x3.nad skin: warm dry intact heent: ncat perrla eomi sclera anicteric. edentulous with full dentures/ neck: supple full rom jvd chest: lungs clear bilaterally heart: rrr. iv/vi high pitched sem abdomen: soft non-distended non-tender bowel sounds + obese abdomen extremities: warm , well-perfused trace edema, bilateral groin erythema/left breast erythema appears to be a yeast infection varicosities: no gross varicosities of the gsv tract noted on standing. spider varicosity noted above left knee. neuro: grossly intact pulses: femoral right:2 left:2 dp right:1 left:1 pt :1 left:1 radial right:2 left:2 carotid bruit transmitted vs. bruit pertinent results: cardiac cath: right dominant,lmca: no angiographically-apparent cad. lad: moderate calcification with mild luminal irregularities. 2.0 mm diagonal has proximal 60% stenosis. lcx: no angiographically-apparent cad. rca: ostial 30% stenosis . carotid u/s: no evidence of significant carotid artery stenosis bilaterally, unchanged from prior study from . . echo: pre-cpb: the left atrium is moderately dilated. 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 moderately depressed (lvef= 35 %). right ventricular chamber size and free wall motion are normal. no thoracic aortic dissection is seen. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. 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. post-cpb: a bioprosthetic valve is seen in the aortic position. the valve is well-seated and the leaflets are normally mobile. there are thin, filamentous echodense masses seen on the prosthetic leaflets which do not affect valvular function or hemodynamics. there are no paralvular leaks. there is no ai. the peak gradient across the aortic valve is 23mmhg, the mean gradient is 8mmhg with co of 4.5l/min. the left ventricular systolic function remains moderately depressed. estimated ef=35%. right ventricular systolic function remains normal. other valvular function remain unchanged. there is no evidence of dissection. dr. was notified in person of the results at time of study brief hospital course: mrs. has known aortic stenosis and was admitted for cardaic cath and found to have non-significant coronary disease and was takentot he operating on for replacement of her aortic valve (#21mm st. ). see operative note for details. post-operatively she arrived to the cvicu from the operating room intubated and sedated. she awoke neurologically intact and was weaned and extubated. on pod#1 she was started on betablockade, lasix and statin therapy. she was noted to be in a junctional rhythm and her betablocker was stopped. she returned to sinus rhythm within 24 hrs. she developed brief non-sustained runs of afib and low dose betablockade was resumed and well tolerated. at that point her temporary pacing wires were removed as were her chest tubes. lisinopril was resumed for chronic systolic and diastolic heart failure. throughout her hospital stay she experienced urinary incontinence which had been a problem pre-operatively as well. she was evaluated by physical therapy for strength and conditioning and was cleared for discharge to home. on pod#4 she was discharged to home to live with her sons. appointments and instructions were advised. medications on admission: - metformin 500mg once daily - metoprolol succinate 50mg once daily - methenamine hippurate 1gram tablet twice daily - simvastatin 40mg once daily - lisinopril 2.5mg once daily - percocet 5-325mg as needed - prozac 10mg once daily - aspirin 81mg once daily - omega 3 fish oil 1000mg once daily - vitamins b, c and d - multivitamin - centrum silver - canberry concentrate discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. lisinopril 10 mg tablet sig: 1.5 tablets po daily (daily). disp:*60 tablet(s)* refills:*2* 4. omega-3 fatty acids capsule sig: one (1) capsule po daily (daily). 5. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). disp:*45 tablet(s)* refills:*2* 7. multivitamin tablet sig: one (1) tablet po daily (daily). 8. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 9. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*65 tablet(s)* refills:*0* 10. methenamine hippurate 1 gram tablet sig: one (1) tablet po bid (2 times a day). 11. fluoxetine 10 mg capsule sig: one (1) capsule po daily (daily). 12. 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* discharge disposition: home with service facility: discharge diagnosis: aortic stenosis s/p aortic valve replacement past medical history: - chronic systolic and diastolic heart failure with history of pulmonary edema in - hyperlipidemia - depression - morbid obesity - severe knee and back arthritis, requires percocet daily - recurrent uti - diabetes - hyperglobulinemia - cystoscopy and removal of bladder mass (thought to be reactive/inflammatory on pathology) - cholecystectomy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with percocet 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 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. phone: date/time: 1:00 in the medical office building , wound check at 10:30am in the medical office building , cardiologist: dr. at 1pm 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 coronary arteriography using two catheters left heart cardiac catheterization open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation aortic valve disorders depressive disorder, not elsewhere classified other and unspecified hyperlipidemia morbid obesity urinary incontinence, unspecified chronic combined systolic and diastolic heart failure arthropathy, unspecified, multiple sites body mass index 31.0-31.9, adult 

Answer: The patient is high likely exposed to