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 major surgical or invasive procedure: mitral valve repair (#34 ce physio ring), pfo closure, maze history of present illness: 56 year old female with known heart murmur who developed palpitations this past winter. she was found to have paroxysmal atrial fibrillation and was referred to dr. for evaluation. anticoagulation was started with coumadin. initial echocardiogram suggested significant mitral regurgitation. a transesophageal echocardiogram was then obtained which revealed moderate to severe mitral valve regurgitation and prolapse with severe left atrial enlargement. over the past month, she reports progressive dyspnea on exertion and pnd. given the severity of her disease, she has been referred for surgical evaluation for a mitral valve repair vs. replacement with a maze procedure. she admits today for heparin bridge with plans for or in the am. past medical history: atrial fibrillation hypertension mitral regurgitation primary pulmonary hypertension pancreatitis lyme's disease past surgical history: 1. appendectomy 2. abdominal surgery, ?pancreatic pseudocyst removal social history: lives with: husband in contact:, phone #. no cell phones. occupation: gardener cigarettes: smoked no yes last cigarette _____ hx: other tobacco use: etoh: < 1 drink/week drinks/week >8 drinks/week illicit drug use: denies. 2-3 beers/week. family history: no premature coronary artery disease. sister and mother with mvp. physical exam: t 97.7 bp 136/98 hr 72 af r 18 98% ra ht: 5'6" wt 115# general: aao x 3 in nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade iv/vi sem abdomen: soft non-distended non-tender bowel sounds + . well healed abdominal scar. extremities: warm , well-perfused edema - none varicosities: significant bilateral lower extremitiy varicosities. 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 - negative pertinent results: tee conclusions prebypass the left atrium is dilated. a left-to-right shunt across the interatrial septum is seen at rest. a small secundum atrial septal defect is present. there is mild lvh. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are myxomatous. there is moderate/severe bileaflet leaflet mitral valve prolapse. severe (4+) mitral regurgitation is seen. dr. was notified in person of the results on at 1330. post bypass patient is in sinus rhythm and receiving an infusion of phenylephrine. annuloplasty ring seen in the mitral position. it appears well seated and there is no mitral regurgitation. mean gradient across the mitral valve is 3 mm hg. lvef= 45%. aorta is intact post decannulation. rest of examination is unchanged. . 05:26am blood wbc-6.2 rbc-3.25* hgb-9.9* hct-30.3* mcv-93 mch-30.4 mchc-32.6 rdw-12.9 plt ct-134*# 04:34am blood wbc-4.6 rbc-2.75* hgb-8.8* hct-25.7* mcv-94 mch-32.0 mchc-34.2 rdw-13.3 plt ct-78* 05:26am blood pt-12.0 inr(pt)-1.1 04:34am blood pt-11.7 inr(pt)-1.1 08:00am blood pt-11.3 inr(pt)-1.0 06:20am blood pt-11.5 ptt-30.3 inr(pt)-1.1 04:55am blood urean-13 creat-0.6 na-136 k-4.1 cl-96 04:45pm blood na-135 k-3.5 cl-93* 05:26am blood glucose-110* urean-15 creat-0.7 na-136 k-3.8 cl-97 hco3-33* angap-10 brief hospital course: the patient was brought to the operating room on where the patient underwent mitral valve repair, pfo closure, maze with dr. . overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. thrombocytopenia developed and coumadin was held. platelet count rose and coumadin was resumed. the patient was transferred to the telemetry floor for further recovery. pacing wires were discontinued. when chest tubes were placed to waterseal, she developed moderate bilateral pneumothoraces. tubes were placed back to suction and progressed more slowly. eventually chest tubes were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod 5 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged home in good condition with appropriate follow up instructions. medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. metoprolol succinate xl 50 mg po daily 2. warfarin 7.5 mg po daily stopped for surgery 3. vitamin d 3000 unit po daily 4. ultra inflamx plus 360 *nf* (nut. tx., met.dis.,mvi, min #4) scoops oral daily discharge medications: 1. outpatient lab work labs: pt/inr coumadin for afib goal inr first draw then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. fax: 2. warfarin 7.5 mg po daily stopped for surgery rx *coumadin 2 mg daily disp #*60 tablet refills:*2 3. aspirin ec 81 mg po daily 4. folic acid 1 mg po daily rx *folic acid 1 mg daily disp #*30 tablet refills:*0 5. hydromorphone (dilaudid) 2-4 mg po q3h:prn pain rx *dilaudid 2 mg q3h disp #*40 tablet refills:*0 6. lactulose 30 ml po tid:prn constipation rx *generlac 10 gram/15 ml daiily disp #*1 bottle refills:*0 7. lorazepam 0.25 mg po q8h:prn anxiety rx *ativan 0.5 mg every eight (8) hours disp #*20 tablet refills:*0 8. metoprolol tartrate 12.5 mg po bid hold for hr<60, sbp<90 rx *metoprolol tartrate 25 mg twice a day disp #*60 tablet refills:*0 9. pantoprazole 40 mg po q24h rx *pantoprazole 40 mg daily disp #*30 tablet refills:*0 10. polyethylene glycol 17 g po daily:prn constipation rx *polyethylene glycol 3350 17 gram/dose daily disp #*1 bottle refills:*0 11. thiamine 100 mg po daily rx *thiamine hcl 100 mg daily disp #*30 tablet refills:*0 12. tramadol (ultram) 50 mg po q4h:prn pain rx *tramadol 50 mg every four (4) hours disp #*40 tablet refills:*0 13. ultra inflamx plus 360 *nf* (nut. tx., met.dis.,mvi, min #4) scoops oral daily 14. vitamin d 3000 unit po daily 15. amlodipine 10 mg po daily rx *amlodipine 10 mg daily disp #*30 tablet refills:*0 discharge disposition: home with service facility: smms visiting nurses discharge diagnosis: atrial fibrillation hypertension mitral regurgitation primary pulmonary hypertension pancreatitis lyme's disease past surgical history: 1. appendectomy 2. abdominal surgery, ?pancreatic pseudocyst removal discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage trace edema 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 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 **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments: surgeon dr. , md phone:, 1:30 cardiologist dr. , at 2:20p please call to schedule the following: primary care dr. , c in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr coumadin for afib goal inr first draw then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. fax: procedure: extracorporeal circulation auxiliary to open heart surgery excision or destruction of other lesion or tissue of heart, open approach annuloplasty other and unspecified repair of atrial septal defect open heart valvuloplasty of mitral valve without replacement diagnoses: other iatrogenic hypotension anemia, unspecified mitral valve disorders unspecified essential hypertension atrial fibrillation other chronic pulmonary heart diseases ostium secundum type atrial septal defect rupture of chordae tendineae other secondary thrombocytopenia 

Answer: The patient is high likely exposed to