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: vioxx attending: chief complaint: dyspnea major surgical or invasive procedure: swan placement with central venous line history of present illness: this is a 77 y.o. female with cad s/p cabg, chf secondary to as ( 0.7), s/p icd/pm, afib presenting s/p d/c to rehab on with dyspnea. she was evaluated for avr/mvr by dr. during her admission last week and it was determined that she would benefit from rehab prior to surgery. she was doing reasonably well at rehab until when she noted gradual dyspnea on exertion, even with walking a few feet. ros: + 10 pound weight gain and peripheral edema. mild nausea with one episode of vomiting this am. profound weakness. no cp/palp/c/d/weakness/numbness/ha/lightheadedness. she was transferred to the ccu for tailored therapy with swan. past medical history: 1. cad s/p cabg (lima-lad, svg-pda/rpl, svg-om) s/p recent pci of svg-pda/rplv 2. chf ef 35% due to valvular disease 3. valvulvar disease: aortic stenosis - valve area 0.9 cm2 - 4. carotid stenosis s/p bilateral ceas 5. disease 6. cri 7. cataract surgery 8. paf s/p vvi/icd placement 9. pvd 80% rcia lesion 10. emphysema social history: 1. lives at home with her husband2. 2 children. currently non-smoker but smoked 1 ppd since age 154. non-drinker family history: father and brothers with cardiac disease physical exam: temp: 96.8 bp:110/33, hr:72, rr:20, o2: 93 ra, 98 2l gen: nad. lying at 30 degrees. a/o x 3. speaking in full sentences. heent: jvd at 15. pearla. eomi. op: dentures top and bottom cv: rr. iii/vi sem at rusb heard throughout with mild radiation to carotids. non-displaced pmi. pulm: dullness at bases w/o wheezes/rales. abd: distended. +pulsatile liver. soft/nt. no bruits. no hsm. ext: 2+ pitting edema b/l. 1+dp/pt b/l neuro: motor at all joints. : gi to lt. cn ii-xii gi. pertinent results: 134 96 72 ----------- < 4.8 32 1.4 ca: 9.3 mg: 2.7 p: 3.5 wbc:10.2, hct: 32.3, plt:306 pt: 13.5 ptt: 39.2 inr: 1.2 cxr: pending ecg: pending dobutamine echo : the patient received intravenous dobutamine in 5 min (low dose 5mcg/kg/min) and 3 minute stages (>5mcg/kg/min) to a maximum of 40mcg/kg/min plus 0 mg atropine. the ecg was uninterpretable due to the presence of a paced rhythm. there was a blunted heart rate response to stress (heart rate 65 paced throughout). resting images were acquired at a heart rate of 65 bpm and a blood pressure of 110/70 mmhg. these demonstrated moderate regional left ventricular systolic dysfunction with anteroseptal and apical akinesis. doppler demonstrated mild aortic regurgitation and moderate severe mitral regurgitation with severe aortic stenosis ( 0.7 cm2). peak aortic valve velocity 3.9 m/sec, peak gradient 61 mmhg and mean gradient 38 mm hg. there is severe tricuspid regurgitation with at least mild pulmonary artery systolic hypertension. right ventricular free wall motion appears preserved (although intrinsic function may be depressed given severity of tricuspid regurgitation). at low dose dobutamine , there was mild augmentation of all left ventricular segments except the anterior septum and apex. the peak aortic valve velocity was 3.9 m/sec, peak gradient 62 mmhg with a mean gradient 36 mmhg. at low dose dobutamine , there was mild augmentation of all left ventricular segments. the peak aortic valve velocity was 3.9 m/sec, peak gradient 60 mmhg with a mean gradient 33 mmhg. at mid dose dobutamine , there was mild augmentation of all left ventricular segments except the anterior septum and apex. the peak aortic valve velocity was 4.2 m/sec, peak gradient 69 mmhg with a mean gradient 42 mmhg. at mid dose dobutamine , there was mild augmentation of all left ventricular segments except the anterior septum and apex. the peak aortic valve velocity was 4.2 m/sec, peak gradient 71 mmhg with a mean gradient 43 mmhg. at mid dose dobutamine , there was mild augmentation of all left ventricular segments except the anterior septum and apex. the peak aortic valve velocity was 4.5 m/sec, peak gradient 81 mmhg with a mean gradient 48 mmhg. at mid dose dobutamine , there was mild augmentation of all left ventricular segments except the anterior septum and apex. the peak aortic valve velocity was 4.5 m/sec, peak gradient 80 mmhg with a mean gradient 46 mmhg. at mid dose dobutamine , there was mild augmentation of all left ventricular segments except the anterior septum and apex. the peak aortic valve velocity was 4.6m/sec, peak gradient 85 mmhg with a mean gradient 51 mmhg. at high dose dobutamine , there was continued augmentation of all left ventricular segments except the anterior septum and apex. the peak aortic valve velocity was 4.6m/sec, peak gradient 84 mmhg with a mean gradient 53 mmhg. impression: moderately depressed left ventricular systolic function with significant augmentation of function with dobutamine stress. no evidence of ischemia seen to workload attained (submaximal hr; no hr response to pharmacologic stress). severe aortic stenosis with increase in gradient with dobutamine stress. severe tricuspid regurgitation with preserved right ventricular free wall motion. aortic valve area - 0.7 echo : "the left atrium is moderately dilated. a secundum type atrial septal defect is suggested, but could not be confirmed. left ventricular wall thicknesses and cavity size are normal. there is mild global left ventricular hypokinesis with focal septal dyskinesis (dysnchrony?). the apex is mildly aneurysmal and dyskinetic. no intraventricular thrombus is seen (but apical views are technically suboptimal). right ventricular chamber size is dilated with preserved free wall motion. . the aortic valve leaflets (?#) are moderately thickened. there is moderate aortic valve stenosis with no aortic regurgitation. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. severe tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (tape reviewed) of , the right ventricle is now mildy dilated (free wall motion remains preserved) and severe tricuspid regurgitation is now present. the severity of aortic valve stenosis and left ventricular systolic function are similar." cardiac catheterization : 1. 3vd 2. patent svg to pda and rpl 3. patent lima to lad 4. tricupsid regurgitation 5. moderate pulmonary hypertension urine cx : enterococcus urine cx : enterococcus (3000/ml), beta-strep (1000/ml) -------------------- renal u/s : 1. no evidence of hydronephrosis, renal stones or other intrinsic renal abnormalities. 2. huge right subhepatic contained fluid collection. the etiology of this is unclear from the study. possibilities could include retroperitoneal or mesenteric cysts. ct : 1. extremely large right-sided peritoneal fluid collection, probably outside of gerota's fascia, which displaces both the right kidney and the liver. on ultrasound, this had an essentially anechoic appearance, and on the current examination, it has attenuation values of fluid (15 ). it is entirely homogeneous in appearance, and could represent a retroperitoneal cyst. viewing the ultrasound from , this finding was present. 2. marked cardiomegaly and marked vascular calcifications. 3. bibasilar atelectasis with mild right lower lobe consolidation. brief hospital course: 77 y.o. female with cad s/p cabg, afib s/p icd/pacer, chf with ef 30% secondary to as (va of 0.7-1.0 on echo ), 2+ mr, 4+tr presenting with mild nausea and dypsnea. 1) chf with ef 30% secondary to as and mr (see data for dobutamine echo results) -ct surgery evaluated the patient and felt that the patient was not a candidate for surgical valve correction which dr. agreed with. - thus the utility of aortic valvuloplasty did not validate surgical correction due to the patient's relatively large valve area (0.9-1.0) -the patient was originally placed on a dopamine gtt, lasix gtt, and dobutamine gtt and a swan was placed for further hemodynamic monitoring. - she was also continued on a low dose digoxin (0.125mg qod). - however, when surgery no longer was an option, the patient and her family decided to withdraw aggressive medical measures and the patient was made comfort measures only. she passed away peacefully without further events. 2) cad s/p cabg: - the patient was on asa, coreg, and a statin. 3) ep issues: s/p vvi pacer and icd. h/o afib. - we held her coumadin in light of possible biventricular pacer placement and covered with lovenox. in addition, we hoped increased pacing hr to 80 bpm would improve her overall cardiac function but this proved to have no added benefit. 4) dm: - she was maintained on glargine and iss. medications on admission: 1. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. pravastatin sodium 20 mg tablet sig: two (2) tablet po daily (daily). 4. cyclobenzaprine hcl 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 7. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 8. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 9. insulin regular human 100 unit/ml cartridge sig: one (1) asdir injection four times a day: sliding scale. 10. maalox 200-200-20 mg/5 ml suspension sig: five (5) ml po qid (4 times a day) as needed for heartburn. 11. furosemide 40 mg iv daily start: in am 12. glargine sig: fifteen (15) units once a day. 13. coumadin 3 qhs discharge medications: none. discharge disposition: extended care discharge diagnosis: severe mitral and tricuspid regurgitation discharge condition: death. discharge instructions: death. followup instructions: none. md procedure: venous catheterization, not elsewhere classified pulmonary artery wedge monitoring monitoring of cardiac output by other technique injection or infusion of nesiritide infusion of vasopressor agent diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified aortocoronary bypass status rheumatic heart failure (congestive) acute respiratory failure mitral valve insufficiency and aortic valve stenosis iron deficiency anemia, unspecified other and unspecified coagulation defects diseases of tricuspid valve fitting and adjustment of automatic implantable cardiac defibrillator 

Answer: The patient is high likely exposed to