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: advair diskus attending: chief complaint: doe major surgical or invasive procedure: avr(23mm mosaic porcine valve) history of present illness: 78 yo f with known as and recent doe that limits her lifestyle. serial echos over past several years showing worsening as. referred for avr. past medical history: pmhx: as, htn, mycobacterium pna, hypothyroid, copd/asthma, arthritis, gerd, s/p cataract . social history: retired quit tobacco 20 years ago 1 etoh/day family history: nc physical exam: hr 87 rr 14 bp 158/78 wdwn f in nad lungs decreased at both bases rrr 4/6 sem abdomen soft/nt, mild hepatomegaly. trace edema mild superficial varicosities bilaterally carotids with transmitted murmur pertinent results: 02:16am blood wbc-9.5 rbc-2.75* hgb-8.4* hct-25.3* mcv-92 mch-30.4 mchc-33.0 rdw-14.9 plt ct-378 02:16am blood glucose-99 urean-20 creat-0.6 na-140 k-4.0 cl-99 hco3-37* angap-8 02:16am blood pt-24.6* ptt-30.5 inr(pt)-2.4* radiology final report chest (portable ap) 12:32 am chest (portable ap) reason: r/o pneumothorax medical condition: 78 year old woman with reason for this examination: r/o pneumothorax clinical history: 78-year-old female, referred to rule out pneumothorax. ap chest radiograph: no pneumothorax. tracheostomy, right pic catheter, median sternotomy wires are all unchanged. again identified is unchanged lucency in the right lung apex and upper lobe corresponding to the large cystic lesion with calcified peripheries. there is persistent bibasilar opacity likely representing atelectasis. impression: no pneumothorax. otherwise stable chest. the study and the report were reviewed by the staff radiologist. dr. dr. echocardiography report , (complete) done at 9:55:08 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 78 f hgt (in): 67 bp (mm hg): / wgt (lb): 130 hr (bpm): bsa (m2): 1.69 m2 indication: intraoperative tee for avr icd-9 codes: 424.1, 424.0 test information date/time: at 09:55 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: suboptimal tape #: 2007aw1-: machine: 1 echocardiographic measurements results measurements normal range left ventricle - inferolateral thickness: *1.6 cm 0.6 - 1.1 cm left ventricle - ejection fraction: 65% >= 55% aorta - sinus level: 3.2 cm <= 3.6 cm aorta - ascending: 3.2 cm <= 3.4 cm aorta - descending thoracic: 2.5 cm <= 2.5 cm aortic valve - peak velocity: *4.7 m/sec <= 2.0 m/sec aortic valve - peak gradient: *88 mm hg < 20 mm hg aortic valve - mean gradient: 67 mm hg aortic valve - valve area: *0.6 cm2 >= 3.0 cm2 findings right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. normal interatrial septum. no asd by 2d or color doppler. left ventricle: moderate symmetric lvh. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. complex (>4mm) atheroma in the aortic arch. normal descending aorta diameter. complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. severe as (aova <0.8cm2). mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. moderate (2+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. suboptimal image quality. the patient appears to be in sinus rhythm. results were conclusions pre-bypass: 1. no atrial septal defect is seen by 2d or color doppler. 2. there is moderate symmetric left ventricular hypertrophy. overall left ventricular systolic function is normal (lvef>55%). 3. right ventricular chamber size and free wall motion are normal. 4. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). mild (1+) aortic regurgitation is seen. 6. the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen. 7. the tricuspid valve leaflets are mildly thickened. post-bypass: a prosthetic aortic valve is in place, with no ai, no leak. normal biventricular systolic fxn. mr remains 3+. aorta intact. other parameters as pre bypass. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 21:03 radiology final report ct chest w/o contrast 4:15 pm ct chest w/o contrast reason: r/o plugging, effusions medical condition: 78 year old woman with copd reason for this examination: r/o plugging, effusions contraindications for iv contrast: none. reason for examination: followup of a patient with copd after aortic valve replacement. comparison: chest ct from . technique: unenhanced mdct of the chest from thoracic inlet to upper abdomen was obtained with subsequent 1.25 and 5 mm collimation axial images reviewed in conjunction with coronal reformats. findings: new anterior mediastinum collection 5 cm in width and about 9 cm in length is located immediately retrosternally and might represent post- surgical hematoma giving it relatevely high density of up to 32 . the replaced aortic valve is demonstrated, as well as post- cabg sutures. the heart size is mildly enlarged but stable. there is no sizable pericardial effusion. the patient is intubated with the et tube tip about 3 cm above the carina. the trachea contains a large amount of secretions, especially in its distal portion, continue toward the right main bronchus, bronchus intermedius, and right lower lobe bronchi. the appearence of the tracheal lumen suggest tracheomalacia. the known right upper lobe cavity is unchanged as well as previously mentioned dense nodular calcified opacities in the right lower lobe and right middle lobes. severe emphysema involving the left upper lobe and superior segment of left lower lobe is again noted, unchanged. there is no evidence of congestive heart failure. bilateral pleural effusions are new, layering and non-hemorrhagic, left more than right, moderate in size. the imaged portion of the upper abdomen is unremarkable. the ng tube tip terminates in the stomach. small right paracardiac lymph node, 6 mm, 2:47 is new and might be reactive to recent surgery. there are no bone lesions suspicious for malignancy. no sternal dehiscence is demonstrated. impression: 1. new retrosternal collection might represent postsurgical hematoma. 2. status post recent sternotomy, aortic valve replacement, and bypass surgery. 3. new bilateral moderate pleural effusions. 4. large amount of secretions in the trachea and lower lobe bronchi, possible tracheomalacia. 5. unchanged left upper lobe cavity and multiple calcified nodules as described on previous study. findings were discussed with dr at te time of dictation by dr . the study and the report were reviewed by the staff radiologist. dr. dr. dr. brief hospital course: she was taken to the operating room on where she underwent an avr. she was transferred to the icu in critical but stable condition on neo and propofol. she was extubated on pod #1 but required reintubation later that day for co2 retention. she continued to have difficulty weaning from the vent. tube feeds were started. pulmonary was consulted, and she was continued on bronchodilators. she again failed trial of extubation on . on she developed rapid afib, and was rate controlled with increasing diltiazem. she underwent tracheostomy and peg tube placement on . she had a chest ct which revealed severe bullous disease on the right. she had intermittent af which responded to calcium channel blockers better than beta blockers. she is anticoagulated with coumadin for af. on pod#14/5 she was transferred to rehab for vent weaning in stable condition. medications on admission: diltiazem 120', theophylline 200', zantac 150", synthroid 25mcg', combivent, fexofenadine 60' discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). tablet, delayed release (e.c.)(s) 2. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 3. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 4. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 5. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 6. ranitidine hcl 15 mg/ml syrup sig: one (1) po daily (daily). 7. theophylline 80 mg/15 ml elixir sig: one (1) po q8h (every 8 hours). 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 9. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q4h (every 4 hours). 10. diltiazem hcl 90 mg tablet sig: one (1) tablet po qid (4 times a day). 11. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 12. coumadin 3 mg tablet sig: one (1) tablet po once a day: titrate for inr goal of .5. 13. lasix 40 mg tablet sig: one (1) tablet po once a day. 14. potassium chloride 20 meq packet sig: one (1) po once a day. discharge disposition: extended care facility: - discharge diagnosis: as now s/p avr post-op respiratory failure pmh: htn, mycobacterium pna, hypothyroid, copd/asthma, arthritis, gerd, s/p cataract . discharge condition: stable discharge instructions: call with fever, redness or drainage from incisions or weight gain more than 2 pounds in one day or five in one week, shower, no baths, no lotions, creams or powders to incisions. no lifting more than 10 pounds or driving until follow up with surgeon. p instructions: dr. 2 weeks dr. 4 weeks dr. / 2 weeks procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery intraoperative cardiac pacemaker diagnostic ultrasound of heart insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arterial catheterization insertion of other (naso-)gastric tube temporary tracheostomy open and other replacement of aortic valve with tissue graft pulmonary artery wedge monitoring diagnoses: acidosis anemia, unspecified esophageal reflux unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation personal history of tobacco use atrial flutter pulmonary collapse long-term (current) use of anticoagulants mitral valve insufficiency and aortic valve stenosis chronic obstructive asthma, unspecified long-term (current) use of aspirin other diseases of trachea and bronchus dependence on respirator, status arthropathy, unspecified, site unspecified 

Answer: The patient is high likely exposed to