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: atorvastatin / clarithromycin / biaxin / gemfibrozil / influenza virus vaccine / morphine / percocet attending: chief complaint: aortic stenosis major surgical or invasive procedure: redo sternotomy, aortic valve replacement (21mm porcine) history of present illness: this 79 year old female with an extensive past medical history including coronary artery disease requiring multiple interventions including coronary artery grafting in . she has known aortic stenosis which has been followed by serial echocardiograms. she has recently noted chest pain with dyspnea on exertion. she was recently admitted in for redo-operation which was cancelled due to upper gi bleed. she subsequently underwent endoscopic cauterization of angiotasia in the lesser curvature of the stomach. of note, she was recently hospitalized at the for anemia and shortness of breath, where she required several units of prbc's. at this time, she has no further evidence of gi bleed is admitted for redo-operation. past medical history: s/p coronary artery bypass grafting peripheral disease s/p gastric hemorrhage and cauterization insulin dependent diabetes mellitus diastolic heart failure hypertension hyperlipidemiaq abdominal aortic aneurysm s/p right total hip replacement h/o hemolytic anemia s/p left carotid artery endarterectomy paroxysmal atrial fibrillation chronic renal insufficiency social history: denies etoh use nonsmoker family history: noncontributory physical exam: admission: pulse: 69 resp: 18 o2 sat: 100% bp 156/68 general: pleasant, elderly female in no acute distress skin: dry intact - well healed sternotomy heent: perrla eomi neck: supple full rom well healed l cea incison chest: lungs clear bilaterally well healed sternotomy incision heart: rrr irregular murmur :loud blowing systolic murmur abdomen: soft non-distended non-tender bowel sounds + well healed midline abdm incision extremities: warm , well-perfused edema-none varicosities: none . well healed bilat svg harvest site incisions bilaterally. she has remaining gsv in her left lower extremity that appears to be 4-5mm in diameter. neuro: grossly intact a&ox3, mae, follows commands pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 1+ left: 1+ radial right: 2+ left: 2+ carotid bruit right: loud radiated murmur left: loud radiated murmur pertinent results: 12:45am blood wbc-8.8 rbc-3.39* hgb-10.0* hct-29.4* mcv-87 mch-29.6 mchc-34.1 rdw-17.9* plt ct-135* 01:10pm blood wbc-15.7*# rbc-2.50*# hgb-7.2*# hct-22.2*# mcv-89 mch-29.0 mchc-32.6 rdw-18.7* plt ct-107* 02:50pm blood pt-14.4* ptt-35.3* inr(pt)-1.2* 01:10pm blood pt-15.6* ptt-35.4* inr(pt)-1.3* 12:45am blood glucose-57* urean-66* creat-1.6* na-136 k-4.2 cl-99 hco3-26 angap-15 03:02am blood glucose-162* urean-36* creat-1.4* na-139 k-5.9* cl-110* hco3-22 angap-13 echocardiography report , portable tte (complete) done at 10:20:00 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 79 f hgt (in): 63 bp (mm hg): 109/39 wgt (lb): 132 hr (bpm): 88 bsa (m2): 1.62 m2 indication: pericardial effusion. tamponade. s/p avr icd-9 codes: 402.90, 423.3, 423.9, v42.2, 424.0, 424.2 test information date/time: at 10:20 interpret md: , md test type: portable tte (complete) son: , rdcs doppler: full doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: suboptimal tape #: 2009w080-0:00 machine: vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.3 cm <= 4.0 cm left atrium - four chamber length: *5.9 cm <= 5.2 cm left atrium - peak pulm vein s: 0.6 m/s left atrium - peak pulm vein d: 0.5 m/s right atrium - four chamber length: *6.5 cm <= 5.0 cm left ventricle - septal wall thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.2 cm <= 5.6 cm left ventricle - ejection fraction: 60% >= 55% left ventricle - lateral peak e': *0.08 m/s > 0.08 m/s left ventricle - septal peak e': *0.04 m/s > 0.08 m/s left ventricle - ratio e/e': *23 < 15 aorta - sinus level: 2.9 cm <= 3.6 cm aorta - ascending: *3.6 cm <= 3.4 cm aortic valve - peak velocity: *2.9 m/sec <= 2.0 m/sec aortic valve - peak gradient: *36 mm hg < 20 mm hg aortic valve - lvot diam: 1.9 cm mitral valve - e wave: 1.4 m/sec mitral valve - a wave: 0.8 m/sec mitral valve - e/a ratio: 1.75 mitral valve - e wave deceleration time: 174 ms 140-250 ms tr gradient (+ ra = pasp): 20 to 22 mm hg <= 25 mm hg pulmonic valve - peak velocity: 0.9 m/sec <= 1.5 m/sec findings left atrium: moderate la enlargement. right atrium/interatrial septum: moderately dilated ra. left ventricle: mild symmetric lvh. normal lv cavity size. overall normal lvef (>55%). tdi e/e' >15, suggesting pcwp>18mmhg. no resting lvot gradient. right ventricle: normal rv wall thickness. dilated rv cavity. rv function depressed. paradoxic septal motion consistent with conduction abnormality/ventricular pacing. paradoxic septal motion consistent with prior cardiac surgery. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. mildly dilated ascending aorta. focal calcifications in ascending aorta. aortic valve: bioprosthetic aortic valve prosthesis (avr). increased avr gradient. trace ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. moderate mitral annular calcification. mild thickening of mitral valve chordae. calcified tips of papillary muscles. no ms. mild (1+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. normal tricuspid valve supporting structures. no ts. moderate tr. pulmonic valve/pulmonary artery: pulmonic valve not well seen. no ps. normal main pa. no doppler evidence for pda pericardium: no pericardial effusion. general comments: suboptimal image quality - poor echo windows. conclusions the left atrium is moderately dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 60%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). the right ventricular cavity is dilated with depressed free wall contractility. the ascending aorta is mildly dilated. a bioprosthetic aortic valve prosthesis is present. the transaortic gradient is higher than expected for this type of prosthesis. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is no tricuspid stenosis. moderate tricuspid regurgitation is seen. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , the aortic valve has been replaced; mitral regurgitation is reduced. electronically signed by , md, interpreting physician 12:26 ?????? caregroup is. all rights reserved. brief hospital course: as a same day admission on the patient underwent redo sternotomy with a 21 mm porcine aortic valve replacement. cross clamp time was 47 minutes, total bypass time 68 minutes. see operative note for details. she weaned from bypass on propofol and neosynephrine infusions in stable condition. she was extubated the evening of surgery and remained stable. she was started on nitroglycerin for hypertension and weaned from the drip on post operative day #1. post operatively, the patient developed acute tubular nephrosis with a peak creatinine of 1.9 (baseline 1.3.) the patient's lasix dose was decreased and her creatinine was slowly decreasing at the time of discharge to 1.6. she is to have her bun and creatinine checked in 1 week after discharge. her potassium was also peaked at 7.0 post operatively. the patient was given lasix, kayexalate, d50 and insulin to treat the hyperkalemia. at the time of discharge, potassium was stable at 4.2. on postoperative day 2, pt went into rapid atrial fibrillation (with a history of afib.) she was started on an amiodarone gtt, transitioned to be amiodarone and her beta blocker was increased. her blood pressure was 80-90's systolically and increased after 1 unit of red blood cells for a hematocrit of 25, allowing further increase in beta blocker dose. at the time of discharge, she was in a rate controlled afib. she is not to receive any coumadin (only asa 81) due to history of gi bleed. chest tubes and pacing wires were removed per cardiac surgery protocol. insulin was started at half her home dose on post operative day # 4 with good blood sugar control. she was transferred to the floor and continued to work with physical therapy. she was noted to have a right upper extremity phlebitis, likely from an amiodarone infiltrated iv. she was started on a 5 day course of keflex. on post operative day # 5 her renal function continued to improve, potassium was stable, she was ambulating in the halls with assistance and her incisions were healing well. it was felt that she was safe for transfer to rehab at this time. medications on admission: norvasc 10mg tablet daily calcitonin 200 units nasal spray daily cyanocobalamin 1000mcg sq bimonthly procrit 40,000 units weekly novolog insulin 70/30 25 units imdur 30mg daily lopressor 25mg tid nitroglycerin 0.4 mg tablet prn chest pain pantoprazole 40mg tablet zocor 40mg tablet daily aspirin 81mg tablet daily ferrous sulfate 325mg tablet daily multivitamin 1 tablet daily preservision daily discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 7 days. disp:*7 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation for 30 days. disp:*60 capsule(s)* refills:*0* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*100 tablet, delayed release (e.c.)(s)* refills:*2* 4. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever/pain. 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 7. amiodarone 200 mg tablet sig: two (2) tablet po every twelve (12) hours for 7 days. 8. amiodarone 200 mg tablet sig: two (2) tablet po once a day for 7 days. 9. amiodarone 200 mg tablet sig: one (1) tablet po once a day for 14 days: further dosing to be adjusted by cardiologist. 10. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 12. hydromorphone 2 mg tablet sig: one (1) tablet po every hours as needed for pain for 10 doses. 13. insulin nph & novolog 100 unit/ml (70-30) suspension sig: one (1) 10 units subcutaneous once a day: q am. increase to home dose of 20 units q am as po intake increases. 14. insulin nph & novolog 100 unit/ml (70-30) suspension sig: one (1) 15 units subcutaneous once a day: q pm. increase dose to 30 units q pm as po intake increases. 15. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for (r)forearm phlebitis for 5 days. 16. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). discharge disposition: extended care facility: - discharge diagnosis: aortic stenosis s/p coronary artery bypass grafting peripheral disease s/p gastric hemorrhage noninsulin dependent diabetes mellitus diastolic heart failure hypertension hyperlipidemiaq abdominal aortic aneurysm s/p right total hip replacement h/o hemolytic anemia s/p left carotid artery endarterectomy paroxysmal atrial fibrillation chronic renal insufficiency discharge condition: good discharge instructions: shower daily, no baths or swimming no lotions, creams or powders to incisions no driving for 4 weeks and off all narcotics no lifting more than 10 pounds for 10 weeks report any redness of, or drainage from incisions report any fever greater than 100.5 report any weight gain greater than 2 pounds a day or 5 pounds a week take all medications as directed followup instructions: dr. in 4 weeks () dr. in weeks () dr. in 2 weeks pt is to have k, bun/crea, cbc drawn in 1 week after discharge procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: acute kidney failure with lesion of tubular necrosis diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status aortic valve disorders peripheral vascular disease, unspecified chronic kidney disease, unspecified other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure abdominal aneurysm without mention of rupture other vascular complications of medical care, not elsewhere classified phlebitis and thrombophlebitis of upper extremities, unspecified 

Answer: The patient is high likely exposed to