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: aortic valve replacement (21mm pericardial)/maze/left atrial ligation tee history of present illness: 78 year old white female has known aortic stenosis and paroxsymal atrial fibrillation with worsening dyspnea on exertion. her most recent echo and cath have shown severe aortic stenosis with no coronary artery disease. she was referred for aortic valve surgery. past medical history: severe aortic stenosis paroxysmal atrial fibrillation hypertension hyperlipidemia diabetes mellitus-diet controlled spinal surgery uterine polypectomy bladder cancer removed cataract surgery tonisellectomy social history: lives with her husband : caucasian tobacco: denies etoh: denies family history: noncontributory physical exam: pulse: 61 resp: 16 o2 sat: 96% ra b/p right: 134/66 left: 122/63 height: 5'1" weight: 200lbs general: well-developed, well-nourished female in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 2/6 sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right/left: 2+ dp right/left: 1+ pt /left: 1+ radial right/left: 2+ carotid bruit right/left: none pertinent results: , fa6a 9:09 am chest (portable ap) clip # reason: (r) apical ptx medical condition: 78 year old woman s/p avr/maze reason for this examination: (r) apical ptx final report indication: 78-year-old woman, status post avr/maze with right pneumothorax, for followup. comparison: ; . portable upright chest radiograph: again seen is a small left apical pneumothorax. sternal wires are intact. avr is noted. cardiomegaly and mediastinal contours unchanged. low lung volumes limit assessment. there is no pulmonary edema. persistent retrocardiac opacification suggests atelectasis/left lower lobe collapse. haziness at the left base suggests persistent small left pleural effusion. the study and the report were reviewed by the staff radiologist. dr. dr. approved: tue 11:11 am echocardiography report , (complete) done at 11:02:18 am final referring physician information , c. , status: inpatient dob: age (years): 78 f hgt (in): 61 bp (mm hg): 134/78 wgt (lb): 200 hr (bpm): 56 bsa (m2): 1.89 m2 indication: intraoperative tee for avr, maze and left atrial ligation. aortic valve disease. atrial fibrillation. chest pain. left ventricular function. mitral valve disease. preoperative assessment. right ventricular function. icd-9 codes: 427.31, 786.05, 799.02, 440.0, 424.1, 424.0, 424.2 test information date/time: at 11:02 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 #: 2009aw1-: machine: aw5 echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - ejection fraction: 55% >= 55% aorta - ascending: 2.8 cm <= 3.4 cm aortic valve - peak velocity: *3.8 m/sec <= 2.0 m/sec aortic valve - peak gradient: *59 mm hg < 20 mm hg aortic valve - mean gradient: 29 mm hg aortic valve - valve area: *0.9 cm2 >= 3.0 cm2 mitral valve - e wave: 0.6 m/sec mitral valve - a wave: 0.6 m/sec mitral valve - e/a ratio: 1.00 findings left atrium: no mass/thrombus in the laa. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: mild symmetric lvh. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. simple atheroma in ascending aorta. simple atheroma in aortic arch. simple atheroma in descending aorta. aortic valve: severely thickened/deformed aortic valve leaflets. severe as (area 0.8-1.0cm2). mild to moderate (+) ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. mild (1+) mr. tricuspid valve: mild tr. 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. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. conclusions prebypass no mass/thrombus is seen in the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. 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 ascending aorta. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (valve area 0.8-1.0cm2). mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results on at 830am. post bypass patient is av paced and receiving an infusion of phenylephrine. biventricular systolic function is unchanged. bioprosthetic valve seen in the aortic position. the valve appears well seated and the leaflets move well. there is no aortic insufficiency. the mean gradient across the valve is 10 mm hg. mild mitral regurgitation persists. the left atrial appendage has been ligated. aorta is intact post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 15:06 complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 07:45am 8.2 3.22* 9.5* 28.2* 88 29.4 33.6 14.3 252# basic coagulation (pt, ptt, plt, inr) pt ptt plt smr plt ct inr(pt) 07:45am 19.1* 1.7* renal & glucose glucose urean creat na k cl hco3 angap 07:45am 123* 18 0.8 138 4.2 102 24 16 brief hospital course: she was admitted prior to surgery for heparin bridge and pre-operative work-up on . on she had a tee to rule out for clot and evaluate aortic stenosis. she was cleared for surgery and brought to the operating room on where she underwent an aortic valve replacement and maze procedure with left atrial appendage ligation. please see operative report for surgical details. she received vancomycin for perioperative antibiotics. following surgery she was transferred from the cvicu for hemodynamic monitoring. within 24 hours she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was doing well and transferred to the telemetry floor for further care. chest tubes and epicardial pacing wires were removed on post-op day two and chest x-ray after removal showed small right apical pneumothorax. coumadin was resumed for her history of paroxysmal atrial fibrillation. on post-op day three she required blood transfusion since she had a hematocrit of 23.5. she otherwise appeared to be recovering well and worked with physical therapy for strength and mobility. on post-op day six she was discharged to rehab facility with the appropriate medications and follow-up appointments. medications on admission: lipitor 10mg qd, citalopram 40mg qd, clonazepam 0.5mg prn qd, cardizem cd 180mg qd, cardura 4mg qd, monopril 20mg , lasix 40mg qd, isosorbide mononitrate 30mg qd, lopressor 100mg , nitrol 0.4mg sl prn, coumadin as directed, aspirin 81mg qd, vitamin d3 1,000 units qd, mvi qd, fish oil discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 6. furosemide 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). tablet(s) 7. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours). 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 9. warfarin 5 mg tablet sig: one (1) tablet po once a day: goal inr 2.5. 10. metoprolol tartrate 100 mg tablet sig: one (1) tablet po bid (2 times a day). tablet(s) 11. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 12. lisinopril 20 mg tablet sig: one (1) tablet po bid (2 times a day). 13. doxazosin 4 mg tablet sig: one (1) tablet po once (once). 14. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day). 15. doxazosin 4 mg tablet sig: one (1) tablet po once (once) for 1 doses. 16. amiodarone 200 mg tablet sig: two (2) tablet po twice a day for 7 days: give 3 tabs at 10 pm on , then 400 mg for 7 days. after 7 days, give 400 mg po daily for 7 days, then decrease to 200 mg po daily. discharge disposition: extended care facility: nursing home discharge diagnosis: aortic stenosis s/p aortic valve replacement atrial fibrillation s/p maze and ligation of left atrial appendage hypertension hyperlipidemia diabetes type 2 depression s/p resection of bladder cancer s/p tonsillectomy s/p uterine polypectomy s/p spinal surgery s/p cataract surgery discharge condition: alert and oriented x3 ambulating short distance with assistance discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming monitor wounds for infection and report any redness, warmth, swelling, tenderness or drainage please take temperature each evening and report any fever 100.5 or greater 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 until follow up 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 followup instructions: please call to schedule appointments surgeon dr in 2 weeks cardiologist dr in 4 weeks primary care dr in 6 weeks procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: anemia, unspecified unspecified essential hypertension 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 iatrogenic pneumothorax personal history of malignant neoplasm of bladder surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation obesity, unspecified 

Answer: The patient is high likely exposed to