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: corevalve placement major surgical or invasive procedure: corevalve placement repeat right and left heart catheterization temporary pacemaker placement history of present illness: -year-old caucasian female with cad, nstemi pulmonary htn, and known critical aortic stenosis (aova = 0.6cm2, ef 40%) now symptomatic with increasing chest pain, sob, and dizziness. patient had been seen in and declined surgical intervention at that time. she was also admitted for chf exacerbation 20 lbs over her baseline in and considered for valvuloplasty, however this was not done due to concerns regarding significant aortic regurgitation. she underwent a complete evaluation for tavi during the stay including carotid ultrasound, presantine perfusion scan, dipyridamole stress, and ct of the chest/ abdomen/ and pelvis. recently, the patient has been experiencing decline in her functional status due to worsening sob and lightheadedness and is limited to walking to the bathroom. (adapted from aortic valve service history & physical) at baseline, patient has a history of anxiety. nyha class: iii aortic valve replacement was uneventful and the lvedp was measured at 33. the patient required 2 units of prbcs. upon arriving to the floor, patient became acutely dyspnic, gasping for breath with saturations in the mid 80s. simultaneously, the patient had increased blood pressures measured at 200s/100s by arterial line. initial abg was drawn and demonstrated 7.29/52/72 (ph/pco2/po2). an urgent chest x-ray demonstrated acute pulmonary edema with no evidence of pneumothorax and was treated with 40mg lasix iv. echo showed + ar/mr and mild paravalvular leak. patient was given albuterol and ipratropium nebulizer treatments followed by 125mg methylprednisolone and patient was put on a non-rebreather mask. patient was also given 0.5mg morphine sulfate, 0.5mg lorazepam. repeat abg demonstrated increasing academia and hypercarbia (7.20/73/108) and patient was transitioned to bipap 15/5. repeat abg after 30 minutes of bipap showed 7.40/ 40/97 and patient was weaned off the bipap. past medical history: 1. cardiac risk factors: - hypertension - hyperlipidemia 2. cardiac history: - critical aortic stenosis - severe two-vessel cad s/p nstemi () - congestive heart failure 3. other past medical history: - pulmonary hypertension - asthma - anemia - depression - h/o right leg fracture s/p orif - s/p knee replacement social history: lives at nursing home. limited ambulation. daughter supportive, lives about 20 min away. retired from clerical work. denies alcohol and tobacco. family history: mother died at age and father died at 78 from heart disease. physical exam: admisson exam: tmax: 35.9 ??????c (96.7 ??????f) hr: 53 (53 - 58) bpm bp: 109/43(65) {109/43(65) - 158/59(94)} mmhg rr: 24 (8 - 24) insp/min spo2: 100% heent: nc/at sclera anicteric, mmm, pupils dilated jvp: unable to assess with pacing wire in right neck, but appears flat on left lungs: patient is gasping for air with labored breathing. upper airway sounds present with poor air movement. cardiac: tachycardic, with no murmurs heard. abdomen: soft, non-tender, non distended. positive bowel sounds. extremities: no edema, pulses 2+ dp/pt. no edema. . discharge exam: general: comfortable in no acute distress heent: perrla, no pharyngeal erythemia, mucous membs moist, no lymphadenopathy, jvp non elevated. right next with mod bruising and 2 cm hematoma from large central line that is slowly resolving chest: ctabl no wheezes, no rales, no rhonchi, at bases. cv: s1 s2 nl, 2/6 systolic murmur at rusb. abd: soft, non-tender, non-distended, bs normoactive. no rebound/guarding. ext: wwp, no edema. dps, pts 2+. neuro: cns ii-xii intact. 5/5 strength in u/l extremities. dtrs 2+ bl (biceps, achilles, patellar). skin: no rash pertinent results: admission labs: 02:26pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-sm 05:45pm wbc-7.1 rbc-3.52* hgb-10.2* hct-30.3* mcv-86 mch-29.0 mchc-33.7 rdw-16.9* 05:45pm plt count-212 05:45pm pt-12.6 ptt-21.6* inr(pt)-1.1 05:45pm albumin-4.1 calcium-9.6 05:45pm ck-mb-3 probnp-* 05:45pm alt(sgpt)-18 ast(sgot)-26 ck(cpk)-70 alk phos-66 tot bili-0.6 . discharge labs: . pertinent studies: tte (): the left atrium is dilated. overall left ventricular systolic function is mildly depressed with basal inferior and basal to mid lateral hypokinesis (lvef= 50 %). right ventricular chamber size and free wall motion are normal. an aortic corevalve prosthesis is present. the transaortic gradient is normal for this prosthesis. moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is a very small pericardial effusion. there are no echocardiographic signs of tamponade. . tte (): the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with focal inferior and basal to mid inferolateral hypokinesis. the remaining segments contract normally (lvef = 50 %). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size is mildly dilated and free wall motion is normal. the diameters of aorta at the sinus, ascending and arch levels are normal. an aortic corevalve prosthesis is present. the transaortic gradient is higher than expected for this type of prosthesis. moderate (2+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , the severity of tricuspid and mitral regurgitation have increased. the trans-corevalve gradient is higher while the severity of aortic regurgitation is unchanged. pericardial effusion is smaller. the right ventricle appears mildly dilated. . tte (): overall left ventricular systolic function is mildly depressed (lvef= 45 %). there is considerable beat-to-beat variability of the left ventricular ejection fraction due to an irregular rhythm/premature beats. right ventricular chamber size is normal. with borderline normal free wall function. an aortic corevalve prosthesis is present. the transaortic gradient is higher than expected for this type of prosthesis. a paravalvular aortic valve leak is present. mild to moderate (+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric. moderate (2+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. . cardiac cath (): 1. elevated lvedp 2. mild to moderate aortic insufficiency 3. no gradient across the corevalve (no aortic stenosis) 4. mild to moderate pulmonary hypertension (from diastolic dysfunction) brief hospital course: primary reason for admission: -year-old caucasian female with cad, nstemi pulmonary htn, and known critical aortic stenosis (aova = 0.6cm2, ef 40%) s/p corevalve. active diagnoses: . # corevalve patient's perioperative course was complicated by flash pulmonary edema after 2 units prbcs in the cath lab. she was treated with diuresis and bipap, with succesful weaning onto nasal canula. 24 hours after placement, echo demonstrated high trans gradients and continued aortic regurgitation. the picture was complicated by decreased maps below 65 and urine output to 15-20 cc/h and creatinine increasing to 1.6. patient was clinically stable throughout with no further episodes of dyspnea. patient was started on dopamine drip at 2mcg/kg/min with increase in uop and maps above 65. on reassessment in cath lab with pcwp was 20-22 mmhg and the pa systolic pressure was < 50 mmhg. the ra pressure was . the lved was 30 mmhg (due to diastolic dysfunction and unchanged from pre) and there was a minimal trans-aortic gradient. patient began to clinically improve with activity around the ccu including walking. she was weaned of the dopamine gtt. subsequent tte showed continued ar, but the patient remained stable and was transferred to the floor and then rehab. # wenchibach with persistent bradycardia likely etiolgy is sick sinus syndrome. patient was evaluated by ep team with decision made to not place a pace maker. # cad patient was continued on aspirin 81 mg daily, plavix 75mg daily and crestor 20 mg daily. she was not on bb secondary to sinus bradycardia. # asthma pt was continued on fluticasone-salmeterol diskus (250/50) and montelukast 10 mg daily. # chf furosemide 20mg was started within 48 hours of corevalve placement with spironolactone 25. hctz 25 was discontinued. she was started on lisinopril 10mg/day during this admission. # geriatric care: pt was continued on home trazadone for sleep throughout her course. she intermittently required benzos for anxiety, which she tolerated well. #anxiety/ insomnia we continued home escitalopram and trazadone. trazodone was briefly discontinued due to prolongation of qt on one ekg, but was restarted with no incident. medications on admission: medications - prescription alprazolam - 0.25 mg tablet - one tablet(s) by mouth twice daily escitalopram - (prescribed by other provider) - 10 mg tablet - 1 tablet(s) by mouth once a day fluticasone - (prescribed by other provider) - dosage uncertain fluticasone-salmeterol - (prescribed by other provider) - dosage uncertain furosemide - 20 mg tablet - one tablet(s) by mouth daily isosorbide mononitrate - (prescribed by other provider) - 30 mg tablet extended release 24 hr - 1 (one) tablet(s) by mouth once a day montelukast - (prescribed by other provider) - 10 mg tablet - 1 tablet(s) by mouth once a day rosuvastatin - (prescribed by other provider) - 20 mg tablet - 1 (one) tablet(s) by mouth once a day spironolacton-hydrochlorothiaz - (prescribed by other provider) - 25 mg-25 mg tablet - 1 tablet(s) by mouth once a day trazodone - 50 mg tablet - one tablet(s) by mouth at bedtime medications - otc ascorbic acid - (prescribed by other provider) - 500 mg tablet - 1 tablet(s) by mouth once a day aspirin - (prescribed by other provider; otc) - 81 mg tablet, chewable - 1 tablet(s) by mouth once a day vitamin e - (prescribed by other provider) - 600 unit capsule - 2 capsule(s) by mouth once a day discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 2. lorazepam 0.5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for anxiety. 3. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 4. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily). 5. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 6. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 7. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 8. rosuvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 9. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime). 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: at discharge diagnosis: critical aortic stenosis coronary artery disease systolic congestive heart failure hypertension anemia bradycardia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you had a percutaneous replacement of your aortic valve. the procedure went well and the valve is functioning appropriately. you had some slow heart rhythms after the procedure that has now resolved. we expect that the shortness of breath with gradually improve over the next month. weigh yourself every morning, call dr. if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. . we made the following changes to your medicines: 1. stop taking imdur, aldactazide, vitamin c and vitamin e. 2. start lisinopril to help your heart pump better 3. change aprazolam to lorazepam to treat your anxiety followup instructions: department: cardiac services when: friday at 12:00 pm with: , md building: sc clinical ctr campus: east best parking: garage department: cardiac services when: friday at 11:00 am with: echocardiogram building: sc clinical ctr campus: east best parking: garage procedure: combined right and left heart cardiac catheterization combined right and left heart cardiac catheterization angiocardiography of left heart structures open and other replacement of aortic valve percutaneous balloon valvuloplasty intracardiac echocardiography diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension acute on chronic diastolic heart failure asthma, unspecified type, unspecified aortic valve disorders hypopotassemia other and unspecified hyperlipidemia anxiety state, unspecified other specified cardiac dysrhythmias old myocardial infarction knee joint replacement examination of participant in clinical trial other abnormal blood chemistry insomnia, unspecified long qt syndrome chronic pulmonary heart disease, unspecified 

Answer: The patient is high likely exposed to