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: phenobarbital / codeine / iodine containing agents classifier / quinapril attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement (19mm st. epic porcine) history of present illness: 75 year old female with history of rheumatic heart disease and known aortic stenosis with mild progression of dyspnea on exertion. cardiac catheterization revealed no significant coronary artery disease and referred for aortic valve replacement. past medical history: hypertension hyperlipidemia diabetes mellitus type 2 rheumatic heart disease aortic stenosis/aortic insufficiency non-sustained ventricular tachycardia possible colitis per recent ct scan- needs f/u colonoscopy hypothyroidism seizure disorder-none in 20 years, depakote discontinued gastroesophageal reflux disease social history: lives with:alone occupation:works for tobacco: few cigs/week x 5 yrs as a teenager etoh:occasional family history: father died of mi age 57, brother died from aortic dissection age 60, another brother and sister s/p avr physical exam: pulse: 81reg resp: 18 o2 sat: 100%ra b/p right:148/64 left: height:4'9" weight: 151lb general: elderly female in nad skin: dry intact heent: perrla eomi - full dentures neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur - 3/6 systolic murmur which radiated to carotids and precordium. soft diastolic murmur also noted at left lower sternal border. abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema - 1+ankles varicosities: superficial varicosities noted, did not stand neuro: grossly intact pulses: dp right: 2+ left: 2+ pt : 1+ left: 1+ radial right: 2+ left: 2+ carotid bruit transmitted murmur pertinent results: 06:10am blood wbc-11.8* rbc-3.32* hgb-9.7* hct-29.4* mcv-89 mch-29.2 mchc-32.9 rdw-14.0 plt ct-124* 02:30pm blood wbc-14.0*# rbc-2.94*# hgb-8.6*# hct-25.9*# mcv-88 mch-29.1 mchc-33.0 rdw-13.9 plt ct-140* 03:40pm blood pt-14.3* ptt-42.3* inr(pt)-1.2* 02:30pm blood pt-14.8* ptt-36.1* inr(pt)-1.3* 06:10am blood glucose-119* urean-21* creat-0.6 na-135 k-4.3 cl-98 hco3-31 angap-10 03:40pm blood urean-12 creat-0.5 cl-114* hco3-23 06:10am blood mg-2.2 05:55am blood tsh-1.6 echocardiography report , (complete) done at 2:37:01 pm final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 75 f hgt (in): 57 bp (mm hg): / wgt (lb): 151 hr (bpm): bsa (m2): 1.60 m2 indication: aortic valve replacement icd-9 codes: 424.1, 424.0 test information date/time: at 14:37 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 #: 2010aw03-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.5 cm <= 4.0 cm left atrium - four chamber length: 4.5 cm <= 5.2 cm left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.0 cm <= 5.6 cm left ventricle - ejection fraction: 55% >= 55% aorta - sinus level: 3.2 cm <= 3.6 cm aorta - ascending: 3.2 cm <= 3.4 cm aortic valve - peak velocity: *5.0 m/sec <= 2.0 m/sec aortic valve - peak gradient: *100 mm hg < 20 mm hg aortic valve - mean gradient: 60 mm hg aortic valve - lvot diam: 1.9 cm aortic valve - valve area: *0.5 cm2 >= 3.0 cm2 findings left atrium: dilated la. no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. right atrium/interatrial septum: normal ra size. no asd by 2d or color doppler. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. normal ascending aorta diameter. focal calcifications in ascending aorta. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: severely thickened/deformed aortic valve leaflets. critical as (area <0.8cm2). mild to moderate (+) ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. 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. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. the patient appears to be in sinus rhythm. patient. see conclusions for post-bypass data conclusions pre-bypass: the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). 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 mr. before surgical incision post-bypass: preserved biventricular systolic function. lvef 55%. there is a bioprosthesis in the native aortic valve position and is stable. the residual peak and mean gradients are 20 and 15 mm of hg. the thoracic aorta is intact. mild mr . i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 14:42 cardiology report ecg study date of 3:32:50 pm sinus rhythm. left axis deviation. prominent qrs voltage but does not meet criteria for left ventricular hypertrophy. however, there are marked st-t wave abnormalities. since the previous tracing of voltage in limb leads is less prominent. st-t wave abnormality pattern is somewhat different with longer q-t interval. clinical correlation is suggested. read by: , a. intervals axes rate pr qrs qt/qtc p qrs t 75 170 116 446/472 79 -51 99 brief hospital course: same day admission and underwent aortic valve replacement with dr. . see operative report for further details. she received cefazolin for perioperative antibiotics and transferred to the intensive care unit for post operative management. in the first twenty four hours she was weaned from sedation, awoke, and was extubated without complications. on post operative day one she was transferred to the floor for the remainder of her care. physical therapy worked with her on strength and mobility. her beta blockers were titrated for heart rate and she was gently diuresed with lasix. she was ready for discharge to rehab on post operative day four. medications on admission: atenolol 100mg po daily furosemide 20mg po daily imdur 15mg po daily levothyroxine 100mcg po daily no substitution cozaar 100mg po daily metformin 500mg po qam omeprazole 20mg po bid potassium chloride 30 meq po daily simvastatin 20mg po daily asa 81mg po daily centrum silver 1 tab po daily vitamin e 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. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 5. metformin 500 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 6. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 7. furosemide 40 mg tablet sig: one (1) tablet po once a day. 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po bid (2 times a day). 9. metoprolol tartrate 50 mg tablet sig: 1.5 tablets po tid (3 times a day). 10. please consider resuming cozaar when blood pressure will tolerate discharge disposition: extended care facility: - discharge diagnosis: aortic stenosis s/p aortic valve replacement hypertension hyperlipidemia diabetes mellitus type 2 rheumatic heart disease hypothyroidism seizure disorder-none in 20 years, depakote discontinued gastroesophageal reflux disease s/p tonsillectomy s/p cholecystectomy s/p left trigger finger release discharge condition: alert and oriented x3, nonfocal ambulating with assistance sternal pain managed with tylenol prn discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions 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 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 please monitor your blood glucose, it is important to prevent infection and with wound healing for your blood glucose to be controlled followup instructions: you have an appointment with surgeon dr. in 4 weeks () on at 1pm please call to schedule appointments primary care dr after discharge from rehab - cardiologist dr after discharge from rehab- procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism other and unspecified hyperlipidemia rheumatic heart disease, unspecified rheumatic aortic stenosis with insufficiency 

Answer: The patient is high likely exposed to