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: patient recorded as having no known allergies to drugs attending: chief complaint: dyspnea major surgical or invasive procedure: aortic valve replacement(21 mm ce pericardial)& replacement of ascending aorta (24 mm gelweave) history of present illness: this is a 79 year old female with known aortic stenosis and a heavily calcified aorta. after extensive workup, which revealed she is no longer a candidate for percutaneous intervention, she wishes to proceed with high risk surgical intervention. past medical history: paroxysmal atrial fibrillation hypertension arthritis osteoporosis s/p right pontine cva in with associated right sided weakness asthma hypercholesterolemia aortic stenosis s/p total knee replacement s/p carpal tunnel releases s/p rotator cuff repais social history: race:caucasian last dental exam:edentulous lives with:living downstairs from grandson occupation: :remote hx minimal tobacco use etoh:denies family history: non-contributory physical exam: on admission physical exam pulse: 63 resp: 16 o2 sat: 100% b/p right: 162/53 height: 4ft, 8in weight: 88lbs general: elderly female in no acute distress. kyphotic with scoliosis. thin and frail. skin: dry intact heent: perrla eomi neck: supple full rom - no jvd chest: lungs clear bilaterally heart: rrr irregular murmur - 4/6 systolic ejection murmur radiating to carotids abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema none varicosities: none neuro: grossly intact pulses: femoral right: 2 left: 2 dp right: 1 left: 1 pt : 1 left: 1 radial right: 2 left: 2 carotid bruit transmitted murmurs pertinent results: conclusions pre-bypass: the left atrium is moderately dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. there are simple atheroma in the descending thoracic aorta. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is mild valvular mitral stenosis (area 1.5-2.0cm2). mild to moderate (+) mitral regurgitation is seen. there is a trivial/physiologic pericardial effusion. post-bypass: the patient is not receiving inotropic support post-cpb. there is a well-seated bioprosthesis in the aortic position with good leaflet excursion. there is no paravalvular or transvalvular regurgitation. the mean transvalvular pressure gradient is 6 mm hg with a cardiac output of 2.2 l/min. biventricular systolic function is preserved and all other findings are consistent with prebypass findings. there is an ascending aorta tube graft. all findings were communicated with the surgeon intraoperatively. preliminary report developed by a cardiology fellow. not reviewed/approved by the attending echo physician. certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician 05:40am blood wbc-19.9* 05:20am blood wbc-18.9* rbc-3.71* hgb-11.5* hct-33.9* mcv-91 mch-30.9 mchc-33.8 rdw-14.3 plt ct-309 04:40am blood neuts-88* bands-0 lymphs-9* monos-3 eos-0 baso-0 atyps-0 metas-0 myelos-0 05:40am blood pt-30.5* inr(pt)-3.0* 05:20am blood urean-20 creat-1.0 na-137 k-3.6 cl-95* 05:20am blood alt-17 ast-27 ld(ldh)-375* alkphos-110* amylase-143* totbili-0.6 05:20am blood lipase-145* 05:20am blood albumin-4.5 mg-2.0 04:45am blood wbc-16.4* rbc-3.48* hgb-10.3* hct-32.0* mcv-92 mch-29.6 mchc-32.2 rdw-14.4 plt ct-307 04:45am blood pt-25.4* inr(pt)-2.4* brief hospital course: ms. was taken to the operating room and underwent aortic valve replacement( ce #21 mm pericardial valve) and replacement of the ascending aorta ( #24 mm gelweave)with dr. . please refer to his operative report for further details. she tolerated the procedure well and was transferred to the cvicu in stable condition on phenylephrine and propofol drips. she awoke neurologically intact and was extubated without incident on pod#1. electrophysiology ( dr. was consulted for a junctional rhythm postop as well as her recurrent atrial fibrillation. she was cardioverted on and was converted to sinus rhythm. she was started on amiodarone. a right chest tube was placed on for a recurrent pleural effusion, and then removed on . a picc was placed for venous access. she was gently diuresed toward her preop weight. she transferred to the floor on pod # 9 for further monitoring. physical therapy was consulted for strength and mobility evaluation. her rhythm developed pauses while on amiodarone and she continued to alternate in and out of rate controlled atrial fibrillation. amiodarone was discontinued and she was placed back on her home dose of sotalol. anticoagulation was resumed with coumadin. she developed a right forearm phlebitis and was started on kefzol briefly. this continued to improve over the next few days and antibiotics were stopped. her white count remained elevated without evidence of infection and then fell. she was cleared for discharge by dr. . all incisions were clean and healing well. she was discharged to rehab on . all follow up appointments, precautions, medications and restrictions were given. the inr goal is 2-2.5 and an inrwill be needed on with target inr 2.0-2.5. medications on admission: nexium 40 daily, hctz 25 daily, combivent prn, simvastatin 10 daily, sotalol 40 twice daily, aspirin 81 daily, calcium, colace, iron, mv discharge medications: 1. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. simvastatin 10 mg tablet sig: one (1) tablet po hs (at bedtime). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 6. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 7. polyethylene glycol 3350 17 gram/dose powder sig: one (1) powder po daily (daily). 8. sotalol 80 mg tablet sig: 0.5 tablet po bid (2 times a day). 9. hydralazine 25 mg tablet sig: one (1) tablet po q6h (every 6 hours). 10. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever, pain. 11. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 13. outpatient lab work first blood draw inr ; target inr 2.0-2.5 for a fib 14. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 15. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 1 weeks. 16. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 1 weeks. 17. warfarin 1 mg tablet sig: as directed tablet po once daily at 4 pm: 2mg ., then daily based upon inr results. discharge disposition: extended care facility: crest discharge diagnosis: s/p aortic valve replacement, ascending aortic graft interposition aortic stenosis, chronic diastolic congestive heart failure s/p stroke (right pontine cva in with associated right sided weakness). paroxysmal atrial fibrillation hypertension hypercholesterolemia arthritis osteoporosis asthma s/p right carpal tunnel surgery s/p right total knee replacement s/p left rotator cuff surgery x 2 s/p appendectomy discharge condition: alert and oriented x3 ,nonfocal ambulating with unsteady gait incisional pain managed with tramadol incisions: sternal - healing well, no erythema or drainage edema -trace legs right forearm phlebitis essentially resolved discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments provider: , md () on at 2:00 please call to schedule appointments with: primary care: dr. ,vayl () in 6 weeks cardiologist: dr. in 4 weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** inr draw , goal inr 2.0-2.5 for atrial fibrillation procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery other electric countershock of heart thoracentesis open and other replacement of aortic valve with tissue graft resection of vessel with replacement, thoracic vessels endarterectomy, aorta procedure on single vessel diagnoses: thrombocytopenia, unspecified anemia, unspecified pure hypercholesterolemia unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension atherosclerosis of aorta atrial fibrillation asthma, unspecified type, unspecified osteoporosis, unspecified other late effects of cerebrovascular disease long-term (current) use of anticoagulants other postprocedural status phlebitis and thrombophlebitis of superficial veins of upper extremities knee joint replacement other malaise and fatigue chronic diastolic heart failure mitral valve stenosis and aortic valve stenosis arthropathy, unspecified, site unspecified 

Answer: The patient is high likely exposed to