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: penicillins attending: chief complaint: shortness of breath; chest pain with radiation to left arm major surgical or invasive procedure: redo sternotomy, aortic valve replacement (21mm biocore epic) history of present illness: this patient is an 80 year old female with severe aortic stenosis and history significant of cad s/p cabg, atrial fibrillation on coumadin, pulmonary hypertension, hyperlipidemia, sleep apnea, and worsening renal insufficiency stage iii. the patient was seen by dr for follow up of her worsening dyspnea, now having to sit after walking as little as 3 steps. this is a marked decrease to what she could do 3-6 months ago. she fatigues more easily and has cut back on her activities wanting to sleep all the time. she also notes lue pain that starts in the left arm and radiates upward to the heart happens when she is short of breath. she also does have some chest pain that is exertional. she sits down and it gets better rather quickly. the patient is unable to perform pulmonary function tests because of her difficulty with performing the test. an echocardiogram on revealed severe aortic stenosis with peak transalvular velocity of 4.44 m/sec, peak/mean pressure gradiesnt of 79/45 mmhg, and calculated by continuity equation of 0.5-0.6 cm2. lvef was 50-55%. cardiac catheterization revealed mild-moderate coronary artery disease which will be managed medically. she presents pre-operatively for heparin prior to redo sternotomy. past medical history: aortic stenosis, s/p aortic valve replacement pmh: cad: s/p cabg at atrial fibrillation, on coumadin pulmonary htn hypertension hyperlipidemia sleep apnea, unable to tolerate cpap stage iii renal insufficiency hypothyroid cancer-skin of face difficulty swallowing anxiety depression mild dementia rhinitis tinnitus spinal stenosis s/p gallstone gerd past surgical history: s/p c-section x4 right knee replacement social history: lives with son and daughter-in-law. retired clerical worker at unemployment office in . discharge contact: , daughter. c: care services: housekeeper once per week. companion tobacco: never etoh: none recreational drug use: denies family history: mother had cad in her 70's physical exam: pulse: 62 resp: 20 o2 sat: 99%ra b/p right: left: 115/55 height: 5'3" weight: 170lb general: nad, pleasant, forgetful, poor historian skin: dry intact well healed sternotomy heent: perrla eomi tympanic membranes in tact bilaterally without evidence of erythema or fluid neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade __3/6__ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema trace (wearing compression stockings), well healed incisions of endoscopic vein harvest of lle, with incision of open harvest in thigh. well-healed incision of right tka varicosities: none neuro: grossly intact pulses: femoral right: 2+ left:2+ dp right: 1+ left:1+ pt : left: radial right: left: carotid bruit right: left: bruits vs. radiation of cardiac murmur pertinent results: echo prebypass a patent foramen ovale is present. there is a bidirectional shunt across the interatrial septum at rest. left ventricular wall thicknesses are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is mildly depressed (lvef= 45 %). the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). moderate (2+) aortic regurgitation is seen. there is a minimally increased gradient consistent with trivial mitral stenosis. mild (1+) mitral regurgitation is seen. the main pulmonary artery is dilated. dr. was notified in person of the results on at 930 am. postbypass patient is av paced and receiving an infusion of phenylephrine. biventricular systolic function is unchanged. bioprosthetic valve seen in the aortic position. it appears to be well seated. there is mild aortic insufficiency noted at the junction of the native non and right coronary cusps. 1- 2+ mitral regurgitation present. aorta is intact post decannulation. rest of the examination is unchanged. very poor transgastric views. brief hospital course: the patient was brought to the operating room on where she underwent redo sternotomy, and aortic valve replacement by dr. . please see operative note for details. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition. she was left intubated and sedated overnight. she required packed red blood cells for a postoperative anemia. on postoperative day one, she awoke neurologically intact and was extubated without incident. she initially experienced intermittent hypertension which responded well to nicardipine drip. warfarin was resumed for atrial fibrillation but held after one dose due to supratherapeutic inr. over several days, beta blockade and diltiazem were titrated accordingly with much improved blood pressure and rate control. however required titration down due to bradycardia. she responded well to lasix, and dose adjusted for diuresis. inr gradually improved, and low dose warfarin was resumed. she continued to progress and physical therapy worked with her on strength and mobility. on post-op day number 7, her inr was 2.5, the coumadin dose was help on . on post-op day 9, the patient's inr is stable at 2.6. she will be advised to take coumadin 0.5mg on , and inr will be followed every other day until a steady therapeutic inr is achieved. it is now felt that the patient is safe to be discharged to rehabilitation center on post-op day #9. medications on admission: allopurinol 100mg daily, aricept 2.5mg am, 5mg pm, aspirin 81mg daily, calcium 500mg tid, centrum mvi daily, cranberry caps , crestor 5mg daily, digoxin 0.125 qod (ld ), diltiazem cd 180 daily, enablex 7.5mg daily, fluoxeetine 40mg daily, fluticasone nasal spray daily, folic acid 1mg daily, furosemide 40mg daily, levothyroxine 100mcg daily, losartan 25mg daily, metoprolol 25mg , nicobid 250mg daily, ntg prn, omeprazole 20mg daily,k vitamin d 400 u daily, warfarin 3mg daily (ld ), claritin discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 5. rosuvastatin 5 mg tablet sig: one (1) tablet po daily (daily). 6. warfarin 1 mg tablet sig: 0.5 mg po daily (daily): please draw inr on . 7. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day). 8. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever. 9. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 10. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 11. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: inhalation q6h (every 6 hours) as needed for dypsnea. 12. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for dyspnea. 13. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 14. polyethylene glycol 3350 17 gram powder in packet sig: one (1) powder in packet po daily (daily). 15. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 16. donepezil 5 mg tablet sig: 0.5 tablet po qam (once a day (in the morning)). 17. donepezil 5 mg tablet sig: one (1) tablet po hs (at bedtime). 18. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 19. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 20. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 21. diltiazem hcl 30 mg tablet sig: one (1) tablet po tid (3 times a day). 22. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 7 days: then after 7 days, decrease lasix to 40mg by mouth daily. 23. potassium chloride 20 meq packet sig: one (1) po twice a day for 7 days: after 7 days, decrease kcl to 20meq by mouth daily. 24. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: aortic stenosis, s/p aortic valve replacement pmh: cad: s/p cabg at atrial fibrillation, on coumadin pulmonary htn hypertension hyperlipidemia sleep apnea, unable to tolerate cpap stage iii renal insufficiency hypothyroid cancer-skin of face difficulty swallowing anxiety depression mild dementia rhinitis tinnitus spinal stenosis s/p gallstone gerd past surgical history: s/p c-section x4 right knee replacement discharge condition: alert and oriented x ***** nonfocal ambulating, deconditioned sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments: surgeon: dr. at 1:30pm cardiologist dr. at 11:00am please call to schedule the following: primary care dr. , e. 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 coumadin for atrial fibrillation goal inr 2.0 - 2.5 first draw day after discharge then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. to phone fax procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: obstructive sleep apnea (adult)(pediatric) abnormal coagulation profile anemia, unspecified unspecified pleural effusion congestive heart failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortocoronary bypass status aortic valve disorders other chronic pulmonary heart diseases other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) other specified cardiac dysrhythmias long-term (current) use of anticoagulants knee joint replacement examination of participant in clinical trial chronic diastolic heart failure acquired cardiac septal defect 

Answer: The patient is high likely exposed to