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: history of present illness: this is a 52 year old woman status post aortic valve replacement on who presents with a subtherapeutic inr of 1.8. the patient had a longstanding aortic stenosis of uncertain etiology, which became symptomatic in . on , she received a mechanical aortic valve transplant. the patient tolerated the procedure well, and was coumadinized after surgery with a goal inr of 2.5 to 3. ms was discharged on to home with coming to check her inr frequently. her last inr before discharge on was 3.6. her discharge dose of warfarin was 2 mg q.d. on this dose, the patient's inr drifted downward following discharge to 1.8 on , at which time she was referred to emergency department for management of her anticoagulation. since her discharge from the hospital on , the patient has experienced no fever or chills, no nausea or vomiting, no shortness of breath. her only complaint is of some pain in her chest wall near the surgical incision site. past medical history: 1. history of aortic stenosis (severe) of unknown etiology, status post aortic valve replacement on ; 2. asthma, no history of systemic steroids, no intubation for asthma; 3. thyroiditis; 4. status post right oophorectomy. medications on admission: lasix 40 mg p.o. b.i.d. times two weeks (day 8 of course on admission) potassium chloride 20 meq p.o. b.i.d. times two weeks (day 8 of course on admission) atenolol 75 mg p.o. q.d. flovent metered dose inhaler, 2 puffs t.i.d. atrovent 2 puffs b.i.d. albuterol metered dose inhaler, 2 puffs q. 4-6 hours prn percocet 5/325 one to two tablets p.o. q. 4 hours prn pain colace 100 mg p.o. b.i.d. coumadin (target inr 2.5 to 3) allergies: vioxx, rash social history: widowed, lives with brother and grandson in . reports they had been taking care of her "very well" since surgery. employed as clean-up until late 70s when she became a homemaker. no smoking history. no alcohol. no intravenous drug abuse. family history: two sibling with coronary artery disease. physical examination: vital signs, temperature 99.0, pulse 73, blood pressure 134/87, respiratory rate 18, oxygen saturation 98% on room air. general: lying comfortably, in no apparent distress, alert and oriented times three. head, eyes, ears, nose and throat: normocephalic, atraumatic. pupils equal, round and reactive to light, extraocular muscles intact, no jugulovenous distension noted, no lymphadenopathy. chest: clear to auscultation and percussion bilaterally, no wheezes, no rales, no rhonchi. cardiovascular: regular rate and rhythm, click on s2, particularly along the right upper sternal border. no murmurs, rubs or gallops appreciated. surgical scar, healing well. abdomen: soft, obese, nontender, normoactive bowel sounds. extremities: no edema bilaterally. no clubbing, no cyanosis. laboratory data: pertinent laboratory studies on admission revealed white blood cells 12.6, hematocrit 31.4, platelets 652. pt 17.5, ptt 26.6, inr 2.0. sodium 137, potassium 4.9, chloride 99, bicarbonate 28, bun 15, creatinine 0.7, glucose 102. chest x-ray: cardiomegaly, no consolidations, no congestive heart failure. hospital course: 1. anticoagulation - the patient received a mechanical valve, therefore inr is 2.5 to 3.5. inr measured on admission was 2.0. the patient was given a warfarin loading dose of 8 mg on the night of admission, and given 4 mg warfarin per day afterwards. on the morning after admission the patient's inr was 2.5, and stayed within the therapeutic range for 24 hours, so the patient was discharged on . the patient was discharged on warfarin 4 mg q.d. and asked to have her inr checked the day after discharge. on admission before the inr was in target range, the heparin intravenous drip was started based on weight-based dosing. the patient reached target ptt between 60 and 80 by the night of admission and stayed within that range until the day of discharge, when heparin drip was discontinued. 2. pain control - the patient complained of pain in her chest near the surgical incision along the left lower sternal border. pain appeared to be positional, and was not associated with any symptoms that suggested it was cardiac in origin. there was no erythema, induration, or drainage of the wound. the patient reports that the pain has been slowly decreasing since her surgery. it seemed extremely likely that the pain was normal post surgical pain. for pain control, the patient was given percocet two tablets q. 4 hours, and ibuprofen 600 mg q. 6 hours prn. 3. cardiovascular - during her hospital stay, the patient had no symptoms or signs of cardiac ischemia or failure. she had no shortness of breath, no fevers or chills, no nausea or vomiting. as mentioned earlier, the chest pain that she had did not appear to be cardiac in nature. the patient was maintained on her preadmission cardiac regimen of lasix, potassium chloride and atenolol. 4. asthma - the patient was not wheezing on examination, and did not complain of shortness of breath during her hospital admission. she continued on her preadmission regimen of flovent, atrovent and albuterol. 5. prophylaxis - the patient was given colace because of her narcotic pain medications. condition on discharge: the patient's condition on discharge was good. she was discharged to home with services. discharge diagnosis: 1. subtherapeutic anticoagulation 2. status post aortic valve replacement 3. asthma discharge medications: 1. lasix 40 mg p.o. b.i.d. times four days 2. potassium chloride 8 meq p.o. b.i.d. times four days 3. atenolol 75 mg p.o. q.d. 4. flovent metered dose inhaler 2 puffs b.i.d. 5. atrovent 2 puffs b.i.d. 6. albuterol metered dose inhaler 2 puffs q. 4-6 hours prn 7. percocet 5/325 1 to 2 tablets q. 4 hours prn 8. colace 100 mg p.o. b.i.d. while on percocet 9. coumadin 4 mg p.o. q.d. (target inr 2.5 to 3.5) discharge instructions: the patient was discharged to home with services. was to check inr the day after discharge, three days after discharge and five days after discharge. the inr results would be monitored by her primary care physician, . . after one week, the patient was to have her inr checked at . the patient was instructed to make an appointment with her primary care physician, . one week after discharge. dr., 02-248 dictated by: medquist36 d: 22:48 t: 07:37 job#: procedure: pericardiotomy cardiopulmonary resuscitation, not otherwise specified diagnoses: abnormal coagulation profile acute and subacute necrosis of liver atrial fibrillation asthma, unspecified type, unspecified other chronic pulmonary heart diseases unspecified disease of pericardium cardiac arrest long-term (current) use of anticoagulants disruption of external operation (surgical) wound 

Answer: The patient is high likely exposed to