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: increasing dyspnea on exertion with her daily activities major surgical or invasive procedure: aortic valve replacement (#21mm st. regent mechanical) history of present illness: 53 year old female with known aortic stenosis back in . she has not had any follow up for her as since that time. she presented earlier this fall with complaints of dyspnea on exertion which has been progressively worse. underwent echocardiogram which showed worsening cardiac function and referred for cardiac cath for evaluation for surgery. past medical history: aortic stenosis anemia social history: lives with husband and her 2 boys (also has 2 girls who live close by) -tobacco history: quit 10 years ago, smoked for 15years cigarettes per day -etoh: very occ. -illicit drugs: denies family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; father had lung cancer, died at age 45 (was a smoker), mother is in good health currently age 70. physical exam: admission physical exam pulse: 104 resp:16 o2 sat: 97% b/p right:149/102 left: 149/104 height:5'3" weight:207 lbs general: no acute distress pleasant interactive skin: dry rash mid back non raised red with scabs from scratching heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + no palpable masses extremities: warm , well-perfused edema none varicosities: none neuro: grossly intact pulses: femoral right: +2 left: +2 dp right: +1 left: +1 pt : +2 left: +2 radial right: +2 left: +2 carotid bruit right: murmur left: murmur pertinent results: intraop tee pre-cpb: 1. the left atrium is moderately dilated. the left atrial appendage emptying velocity is depressed (<0.2m/s). no thrombus is seen in the left atrial appendage. 2. no atrial septal defect is seen by 2d or color doppler. 3. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is severely dilated. overall left ventricular systolic function is severely depressed (lvef= 15 %). after an epinephrine infusion was started, the ef increased to 20 %. 4. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. 5. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. there are simple atheroma in the descending thoracic aorta. 6. the aortic valve is bicuspid. 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. 7. there is mild valvular mitral stenosis (area 1.5-2.0cm2). mild (1+) mitral regurgitation is seen. 8. moderate tricuspid regurgitation is seen. 9. there is a small pericardial effusion. 10. there are small bilateral pleural effusions. post-cpb: on infusions of phenylephrine, epi. av pacing. well-seated valve in the aortic position. no ai. preserved systolic function from pre cpb on inotropic support. aortic contour is normal post decannulation. wbc-7.5 rbc-3.55* hgb-9.9* hct-30.3* rdw-14.5 plt ct-347 wbc-7.2 rbc-3.62* hgb-10.2* hct-30.9* rdw-14.4 plt ct-235 pt-26.6* inr(pt)-2.6* pt-27.0* inr(pt)-2.6* pt-25.2* ptt-33.0 inr(pt)-2.4* pt-24.7* inr(pt)-2.4* pt-21.0* ptt-71.0* inr(pt)-2.0* glucose-85 urean-12 creat-0.7 na-134 k-4.3 cl-96 hco3-31 angap-11 glucose-79 urean-10 creat-0.7 na-133 k-4.6 cl-97 hco3-32 angap-9 glucose-82 urean-10 creat-0.6 na-131* k-6.4* cl-94* hco3-28 glucose-120* urean-11 creat-0.6 na-134 k-4.3 cl-95* hco3-33 alt-112* ast-41* ld(ldh)-372* alkphos-87 amylase-49 totbili-0.4 alt-141* ast-65* ld(ldh)-556* alkphos-91 amylase-50 totbili-0.4 alt-140* ast-67* ld(ldh)-554* alkphos-89 amylase-50 totbili-0.4 alt-176* ast-53* ld(ldh)-434* alkphos-88 amylase-48 totbili-0.5 brief hospital course: ms. was taken to the operating room and underwent aortic valve replacement (#. regent mechanical valve replacement) with dr. . please refer to operative report for further details. she tolerated the procedure well and was transferred to the cvicu intubated and sedated requiring inotropic and pressor support. she awoke neurologically intact and was extubated without difficulty. she transferred to the floor on in stable condition. on she was transferred back to the cvicu for hypotension, hyperkalemia and cre 1.5. pa line, foley and low-dose milrinone started. echocardiogram revealed ef 20-25%, no tamponade, avr well seated, with moderate tr/mr. over the next few days she titrated off inotropes, tolerated low-dose ace and beta-blockers. she was transferred back to the floor on . respiratory: aggressive pulmonary toilet, nebs, incentive spirometer and ambulation she titrated off oxygen with saturations of 97% ra. cardiac: beta-blockers were titrated. she remained in sinus rhythm. ace was started on , transfer to cvicu on . on episode of atrial fibrillation 140's amiodarone bolus and beta-blockers iv converted to sinus rhythm. inotropes was titrated off, carvediolol and ace were titrated. gi: h2 blockers and bowel regimen nutrition; tolerated a regular diet renal: atn briefly secondary to hypotension and hyperkalemia, peak cre 1.8 base 0.9-1.0 resolved once hemodynamics improved. she was gentley diuresed with good urine output. electrolytes were repleted as needed. heme: heparin bridge to coumadin was started for mechanical aortic valve replacement with inr goal 2.5 - 3.0. inr was followed daily. iv access: right brachial picc placed . pain: iv pain medications converted to po with good control disposition: followed by pt who deemed her safe for home. she was discharged on and will follow-up with dr. , her cardiologist and pcp for further coumadin management. medications on admission: aspirin - (prescribed by other provider) - 325 mg tablet - 1 (one) tablet(s) by mouth once a day mvi flaxseed oil garlic oil vitamin e calcium discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 2. 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:*0* 3. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 5. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. carvedilol 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 7. lasix 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 8. warfarin 5 mg tablet sig: goal inr 2.5-3.0 tablets po once a day: dose to be adjusted for goal inr 2.5-3.0 . disp:*90 tablet(s)* refills:*2* 9. warfarin 2 mg tablet sig: goal inr 2.5-3.0 tablets po once a day: dose to be adjusted based on inr . disp:*90 tablet(s)* refills:*2* 10. coumadin/warfarin you have received prescriptions for two doses of coumadin so that the dose can be adjusted based on your lab results please take 7.5 mg - then inr will be checked and coumadin clinic at will call you with further instructions on what dose to take discharge disposition: home with service facility: rehab & skilled nursing center - discharge diagnosis: aortic stenosis s/p aortic valve replacement acute on chronic systolic heart failure anemia discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage edema +1 bilateral lower extremity 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 date/time: 2:30 cardiologist: dr @ 10:40am please call to schedule appointments with your pcp dr 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 for coumadin ?????? indication mechanical avr goal inr 2.5-3.0 first draw wednesday results to phone fax please check inr monday, wednesday, and friday for 2 weeks then as directed by dr procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve arterial catheterization pulmonary artery wedge monitoring central venous catheter placement with guidance diagnoses: other primary cardiomyopathies hyperpotassemia anemia, unspecified acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified atrial fibrillation aortic valve disorders other chronic pulmonary heart diseases surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation congenital insufficiency of aortic valve acute on chronic systolic heart failure 

Answer: The patient is high likely exposed to