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: sulfa (sulfonamide antibiotics) / penicillins / latex / codeine attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: - 1. mitral valve replacement with a . medical biocor tissue valve. 2. coronary artery bypass grafting x2 with a left internal mammary artery graft to left anterior descending and reverse saphenous vein graft diagonal branch. history of present illness: 84 year old female with a well known history of mitral valve regurgitation followed by serial echocardiogram. she was evaluated for a cough in early and was noted to be in mild congestive heart failure. she was prescribed cipro for possible pneumonia. symptoms include dyspnea on exertion such as climbing stairs, or carrying a laundry basket. as she began to develop a dilated left ventricle last year, the recommendation for surgery had already been made however she was reluctant to proceed. given her severe mitral regurgitation, she has been referred for surgical management. past medical history: past medical history: mitral valve prolapse with mitral regurgitation arthritis mild emphysema/copd chronic right bundle branch block pneumonia recurrent uti's hyperthyroidism gerd/barrett's esophagitis lumbar disc disease past surgical history: right total hip replacement left total hip replacement cholecystectomy remotely social history: last dental exam: 3 weeks ago lives with: alone. widowed 32 years ago. occupation: retired tobacco: quit 30 years ago. etoh: 1 glass of wine daily. family history: hypertension/mvp mother died of cancer, father died with tuberculosis physical exam: pulse: 94 resp: 16 o2 sat: 95 b/p right: 112/65 left: 104/62 height: 5'4" weight: 167lb general: nad, wgwn, elderly white female skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur 3/6 systolic, loudest at apex abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema- trace varicosities: none early venous stasis changes neuro: grossly intact x pulses: femoral right: 2+ left:2+ dp right: 2+ left:2+ pt : 2+ left:2+ radial right: 2+ left:2+ carotid bruit right: left: no bruits pertinent results: echo pre-bypass: the left atrium is moderately dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate/severe anteriorly directd leaflet mitral valve prolapse. there is partial p2 mitral leaflet flail. severe (4+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). there is no pericardial effusion. post: 1. preserved -ventricular systolic function with backgrounf\d inotropic support 2. bioprosthetic valve in aortic position. well seated and stable with good leaflet excursion. trace valvular regurgitation. mean gradient = 7 mm hg 3. intact aorta 4. no other change day surgery labs: 07:56am hgb-10.2* calchct-31 07:56am glucose-110* lactate-1.7 na+-137 k+-4.0 cl--100 12:35pm fibrinoge-170 12:35pm pt-15.1* ptt-56.4* inr(pt)-1.3* 12:35pm plt count-157 12:35pm wbc-14.5*# rbc-2.70* hgb-8.2* hct-24.4* mcv-91 mch-30.4 mchc-33.5 rdw-14.3 12:52pm glucose-78 lactate-2.1* na+-144 k+-1.8* cl--132* 02:15pm urea n-20 creat-0.6 sodium-139 potassium-3.3 chloride-109* total co2-24 anion gap-9 discharge labs: 04:28am blood wbc-8.2 rbc-3.56* hgb-10.9* hct-32.5* mcv-91 mch-30.6 mchc-33.5 rdw-15.2 plt ct-228 04:28am blood plt ct-228 04:28am blood pt-18.6* ptt-33.1 inr(pt)-1.7* 04:28am blood glucose-100 urean-17 creat-0.7 na-140 k-4.4 cl-96 hco3-36* angap-12 brief hospital course: ms. was admitted to the on for surgical management of her mitral regurgitaion and coronary artery disease. she was taken directly to the operating room where she underwent coronary artery bypass grafting to two vessels and a mitral valve replacement. please see operative note for details. in summary she had: 1. mitral valve replacement with a . medical biocor tissue valve. 2. coronary artery bypass grafting x2 with a left internal mammary artery graft to left anterior descending and reverse saphenous vein graft diagonal branch. her bypass time was 93 minutes with a crossclamp of 80 minutes. she tolerated the operation well and postoperatively she was taken to the intensive care unit for monitoring. on postoperative day one, ms. neurologically intact and was extubated without incident. she was slowly weaned off pressors over the next several days. all lines and drains were discontinued per cardiac surgery protocol. she was gently diuresed towards her preoperative weight. she continued to progress and was transferred to the step down unit on pod4 for further monitoring. the physical therapy service was consulted for assistance with her postoperative strength and mobility. she developed post-operative atrial fibrillation which was treated with beta blockade and amiodarone as well as anticoagulation with coumadin. the remainder of her postoperative course was essentially uneventful. on pod7 she was discharged to newbridge on the rehabilitation. all follow up appointments were advised. medications on admission: nexium 40', lasix 40', vicodin prn, avapro 75', levothyroxine 200', sunday 400, toprol 25', nasonex 50 mcg', mupirocin, temazepam 15-30 prn hs, trimethoprim 100', mvi discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 3. levothyroxine 100 mcg tablet sig: two (2) tablet po 6x/week (mo,tu,we,th,fr,sa). 4. levothyroxine 100 mcg tablet sig: four (4) tablet po qsunday (). 5. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed for dry nares . 6. trimethoprim 100 mg tablet sig: one (1) tablet po q24h (every 24 hours). 7. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours). 10. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 11. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 12. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 13. amiodarone 400 mg tablet sig: one (1) tablet po daily: 400mg qd x7 days then 200 mg qd. 14. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day: no substitutions. 15. warfarin 1 mg tablet sig: as directed to keep inr 2-2.5 tablets po daily (daily): afib- target inr 2-2.5. 16. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 17. warfarin 2 mg tablet sig: one (1) tablet po once for 1 doses: dose is 2mg. 18. lasix 80 mg tablet sig: one (1) tablet po twice a day. discharge disposition: extended care facility: newbridge on the - discharge diagnosis: mitral valve prolapse with mitral regurgitation coronary artery disease postoperative atrial fibrillation arthritis mild emphysema/copd chronic right bundle branch block pneumonia recurrent uti's hyperthyroidism gerd/barrett's esophagitis lumbar disc disease discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) 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. () on at 1:15pm cardiologist: dr. () on at 10:30am please call to schedule appointments with your primary care 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: postoperative atrial fibrillation goal inr: first draw: procedure: venous catheterization, not elsewhere classified single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open and other replacement of mitral valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux mitral valve disorders cardiac complications, not elsewhere classified atrial fibrillation thyrotoxicosis without mention of goiter or other cause, and without mention of thyrotoxic crisis or storm right bundle branch block other emphysema barrett's esophagus hip joint replacement 

Answer: The patient is high likely exposed to