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: ibuprofen attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement (. epic porcine), reduction aortoplasty cardiac cath history of present illness: 68 year old female with coronary artery disease status post myocardial infraction with angioplasty in and known aortic stenosis who has been followed by serial echocardiograms. over the past year, she has noted progressive dyspnea on exertion, fatigue and mild peripheral edema. he most recent echocardiogram revealed severe aortic stenosis with a mean gradient of 36mmhg. given the progression of her symptoms and the severity of her aortic stenosis, she had been referred for surgical management. admitted today s/p cardiac catherization as preop for avr with dr in the morning. past medical history: aortic stenosis coronary artery disease s/p angioplasty myocardial infarction hypertension dyslipidemia diabetes mellitus type 2 pancreatitis developiong diabetes after gerd anemia bilateral shoulder fractures (left , right ) past surgical history: cholecystectomy with drainage of pancreatic cyst incisional hernia repair ganglionic cyst of wrist surgical excised social history: race: caucasian last dental exam: 6 months ago - clearance obtained. lives with: alone, son and in law live upstairs in 2 family house (husband recently passed away from pancreatic cancer). occupation: retired tobacco: quit . 48 year pack history etoh: denies family history: sister with cabg at age 70. uncle died of mi at age 21. mother with angina. father with fatal mi at age 74. physical exam: pulse: resp:20 o2 sat: 97% ra b/p right:91/58 left: height: 4'" weight: 181 general: aao x 3 in nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally distant breath sounds heart: rrr irregular murmur iii/vi sem abdomen: soft non-distended non-tender bowel sounds + obese extremities: warm , well-perfused edema - trace 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: transmitted murmur vs bruit b/l pertinent results: cardiac cath: 1. no angiographically-apparent flow-limiting cad. 2. normal pulmonary capillary wedge pressure. 3. mild pulmonary arterial hypertension. 4. low normal systemic systolic arterial pressure with occasional hypotension. 5. sheaths to be removed. 6. additional plans per dr. . admit to csurg. 7. reinforce primary preventative measures against cad. 8. follow-up with dr. . carotid u/s: 1. no evidence of internal carotid artery stenosis on either side. 2. reversal of flow in the right vertebral artery, which is usually associated with subclavian steal. brief hospital course: as mentioned in the hpi, mrs. was admitted following her cardiac cath and underwent pre-operative work-up. on she was brought 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 beta blockers and diuretics were started and she was diuresed towards her pre-op weight. later on this day she was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. during her post-op course she worked with physical therapy. on post-op day five she appeared ready for discharge home with vna services and the appropriate medications and follow-up appointments. she will take lasix for 2 weeks and then resume her spirinolactone if instructed by dr. . medications on admission: aspirin 81mg daily cardizem cd 240mg daily cozaar 50mg twice daily spirinolactone 25mg daily zocor 40mg daily zetia 10mg daily glucophage 1000mg twice daily humalog sliding scale 10-15 units tid lantus 50units daily amitriptyline 10mg daily calcium 600mg daily vitamin d 2000units daily multivitamins mobic 15mg daily omeprazole 20mg daily ativan 0.5 mg po qhs discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. amitriptyline 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. 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* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 7. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 9. mobic 15 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. furosemide 40 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 2 weeks. disp:*14 tab sust.rel. particle/crystal(s)* refills:*0* 12. glucophage 1,000 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 13. insulin glargine 100 unit/ml cartridge sig: please refer to provided instruction sheet for daily dose and sliding scale subcutaneous as instructed. discharge disposition: home with service facility: all care vna of greater discharge diagnosis: aortic stenosis s/p aortic valve replacement past medical history: coronary artery disease s/p angioplasty myocardial infarction hypertension dyslipidemia diabetes mellitus type 2 pancreatitis developiong diabetes after gastresophageal reflux disease anemia bilateral shoulder fractures (left , right ) past surgical history: cholecystectomy with drainage of pancreatic cyst incisional hernia repair ganglionic cyst of wrist surgical excised angioplasty discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema: trace discharge instructions: 1) 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 2) please no lotions, cream, powder, or ointments to incisions 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 6) no lifting more than 10 pounds for 10 weeks 7) take lasix and potassium daily in the morning for 14 days then stop. you may then resume your spirinolactone if instructed by dr. . 8) you may resume your insulin sliding scale and night time lantus 20 units. please refer to dosage sheet provided. 9) please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge 10_ you may resume your at home vitamins. **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. at 1:15pm cardiologist: dr. on at 10:45am 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 combined right and left heart cardiac catheterization coronary arteriography using two catheters open and other replacement of aortic valve with tissue graft diagnoses: unspecified pleural effusion unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia old myocardial infarction 

Answer: The patient is high likely exposed to