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: history of present illness: this is a 74 year old woman who has not sought medical treatment in many years and had a recent fall fracturing her right humerus and soon thereafter she was noted to have some irregular heart beat. she took some medication of a neighbor who had a similar problem and ultimately went to be treated in the emergency department in where the patient lived. she was found at that time to be in atrial flutter with a rapid ventricular response in the 130s. this spontaneously converted to sinus rhythm but she has had bouts of paroxysmal atrial fibrillation since that time. at that time, echocardiogram was obtained which demonstrated significant mitral valve prolapse with severe mitral regurgitation and a large ventriculoseptal defect with a left to right shunt. left ventricular function was normal. she was also noted to have moderate to severe pulmonary artery hypertension. the patient was discharged from the hospital on beta blocker, lipitor and coumadin at that time and she has since come to the area to seek further treatment of this. past medical history: significant for at least two previous bouts of endocarditis, one in and one in which was treated with antibiotics with no sequelae. she has also had three uneventful pregnancies and has not taken any medications regularly and has not had any medical treatment over the past 20 years or so. the patient was admitted to the hospital . allergies: the patient also states an allergy to penicillin. medications prior to admission: lipitor 20 mg p.o. q.d., xl 50 mg p.o. q.d., coumadin 5 mg monday, wednesday and friday and 2.5 mg alternating four days per week. she was also taking alprazolam for anxiety. hospital course: the patient was admitted to the hospital on and taken directly to the operating room where she underwent mitral valve repair with a #28 mm annuloplasty band as well as tricuspid valve repair with a #32 mm annuloplasty ring and a primary closure of ventriculoseptal defect. postoperatively the patient was transported from the operating room to the cardiac surgery recovery unit in stable condition on milrinone, neo-synephrine and propofol intravenous drips. she was initially atrioventricularly paced with an adequate blood pressure. the pacemaker was ultimately turned off the following morning and she was in normal sinus rhythm with first degree atrioventricular block. on postoperative day #1, the patient remained with a swan-ganz catheter and the milrinone was weaned off, the neo-synephrine had been discontinued, the patient was weaned from mechanical ventilation and successfully extubated to nasal cannula oxygen. diuretics were begun on postoperative day #1. on postoperative day #2 it was noted that the patient had significant thrombocytopenia, after being started on heparin. the heparin was discontinued. heparin antibodies were sent and have subsequently come back negative. the patient remained on intravenous neo-synephrine throughout the course of postoperative day #2 which was ultimately discontinued late that day. on postoperative day #3, the patient was continued with aggressive diuresis, was hemodynamically stable and remained in normal sinus rhythm at that time. on postoperative day #4 the patient's chest tubes had been removed. the patient remained with adequate heart rhythm and rate and blood pressure and was transferred out from the cardiac surgery recovery unit to the telemetry floor. the patient was begun ambulating with physical therapy and tolerating that well. her foley catheter was discontinued and she was voiding without problems. on postoperative day #5, the patient was noted to have some atrial fibrillation with a ventricular response rate between 90 and 125. she was treated with magnesium and intravenous lopressor and she was placed on amiodarone as well. the patient converted to normal sinus rhythm later that day and had had no subsequent atrial fibrillation while on the lopressor and the amiodarone. the patient continued to progress with physical therapy on . the patient was still unable to be weaned completely from oxygen due to desaturation. chest x-ray was obtained. she also had symptomatic shortness of breath. the chest x-ray from the previous day revealed a significant left pleural effusion. on , she underwent a thoracentesis for approximately 400 cc of serosanguinous fluid. the patient tolerated the procedure well and did state symptomatic relief of her symptoms. the subsequent chest x-ray showed decreased pleural effusion although some residual fluid remains with left lower lobe atelectasis and no pneumothorax noted. today, , the patient remained off oxygen with adequate oxygen saturation. on room air her saturday was 93 to 95%. she remains hemodynamically stable and is ready to be discharged home. condition on discharge: good. temperature is 98.6, blood pressure 110/70, heartrate 87 in normal sinus rhythm with a first degree atrioventricular block, respiratory rate 20. neurologically, the patient is alert and oriented. her lungs are clear to auscultation bilaterally, however, diminished lung space. her heart rhythm is regular with no rub or murmur noted. abdomen is soft, nontender, nondistended with positive bowel sounds. she has no peripheral edema. the patient is discharged today in good condition. discharge instructions: she is to follow up with dr. , the patient's primary cardiologist in one to two weeks. she is to follow up with dr. in four weeks for a postoperative check. discharge medications: lasix 20 mg one p.o. b.i.d. times ten days potassium chloride 20 meq p.o. b.i.d. times ten days lipitor 20 mg p.o. q. day ibuprofen 400 mg p.o. q. 8 hours prn pain amiodarone 200 mg one p.o. q.d. to be continued for one month or as deemed necessary by dr. xl 50 mg p.o. q.d. enteric coated aspirin 325 mg p.o. q.d. discharge diagnosis: 1. mitral regurgitation 2. tricuspid regurgitation 3. ventriculoseptal defect 4. status post mitral valve repair 5. status post tricuspid valve repair 6. status post ventriculoseptal defect closure , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart thoracentesis cardioplegia open heart valvuloplasty of mitral valve without replacement open heart valvuloplasty of tricuspid valve without replacement other and unspecified repair of ventricular septal defect operations on chordae tendineae diagnoses: mitral valve disorders unspecified pleural effusion atrial fibrillation pulmonary collapse tricuspid valve disorders, specified as nonrheumatic acquired cardiac septal defect rupture of chordae tendineae 

Answer: The patient is high likely exposed to