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: nifedipine / lisinopril / felodipine / fosinopril / ace inhibitors / ibuprofen attending: chief complaint: dyspnea major surgical or invasive procedure: aortic valve replacement (21mm pericardial),coronary artery bypass graft (svg-rca) simple extractions numbers 10 and 20 left and right heart catheterization, coronary angiogram history of present illness: 84 yo f with pmh severe as by echo () with peak gradient 66mg, mean of 38mmhg, aortic valve area 0.5cm2 without aortic insufficiency, copd (mild), gerd, hld, arthritis, and occult anemia transferred from for evaluation for valve replacement. she was in her usual good state of health until 2 days prior to admission at on , when she noticed doe and mild sob. she denied any chest pain, palpitations or cough. at baseline, works 4 days/week and is physically active. on admission, she had sob and ams requiring intubation in er. cxr showed pulmonary edema. she received 40mg iv lasix and had significant diuresis. while in icu, she was agitated on vent. she was extubated this am and found to have mild confusion but alert and oriented to place, person, month, year and day (not date). of note, she was also started on abx and steroids due to d/d of copd acute exacerbation; is planned for quick prednisone taper and short abx course. cardiac surgery was consulted for aortic valve replacement. past medical history: - severe aortic stenosis - hypertension - hypercholesterolemia - arthritis - copd (mild) - gerd - anemia - b/l knee replacement social history: lives in alone. works for a fuel company doing billing, 4 days a week. -tobacco history: smokes 2ppd for at least 60 yrs -etoh: social, ~1 month -illicit drugs: none family history: mother died of old age, father died of lung cancer physical exam: admission physical examination: vs: 98.1 100/63 109 18 97% on 2l general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 9 cm. cardiac: tachy, normal s1, s2. systolic murmur. lungs: no chest wall deformities, scoliosis or kyphosis. ctab, no crackles, wheezes or rhonchi. poor inspiratory effort. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominal bruits. extremities: 1+ ,a. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: echo : the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. there is moderate to severe global left ventricular hypokinesis (lvef = 30 %). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). doppler parameters are most consistent with grade ii (moderate) left ventricular diastolic dysfunction. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. 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 mildly thickened. there is moderate thickening of the mitral valve chordae. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a very small pericardial effusion. impression: suboptimal image quality. critical aortic stenosis. moderate to severe global left ventricular systolic dysfunction. moderate diastolic dysfunction with elevated estimated pcwp. very small anterior pericardial effusion. . carotid us : right ica <40% stenosis. left ica <40% stenosis. . cxr osh: mild pulmonary edema, improved from day prior. small right pleural effusion. . echo osh: severe as with peak gradient of 66 mmhg, mean of 28 mmhg. valve area os 0.5 cm2. thickened mitral leaflets, calcified annulus, mild mr. . normal rv. borderline normal lv. lvef 50-55%. mild pulm hypertension, estimated pa pressure 45mmhg. 07:05am blood wbc-9.0 rbc-3.67* hgb-9.1* hct-28.1* mcv-76* mch-24.7* mchc-32.4 rdw-16.7* plt ct-199 05:12pm blood wbc-16.6* rbc-4.48 hgb-11.3* hct-34.6* mcv-77* mch-25.2* mchc-32.7 rdw-16.0* plt ct-294 02:31am blood pt-14.5* ptt-32.4 inr(pt)-1.2* 05:12pm blood pt-12.4 ptt-23.8 inr(pt)-1.0 07:05am blood glucose-98 urean-14 creat-0.6 na-139 k-4.6 cl-99 hco3-36* angap-9 05:12pm blood glucose-141* urean-28* creat-0.8 na-138 k-4.5 cl-99 hco3-27 angap-17 08:19am blood alt-45* ast-26 alkphos-113* totbili-0.4 brief hospital course: mrs. was admitted to the on via transfer from for aortic valve replacement.on arrival she was stable, but still with some dyspnea. over the course of the day her respiratory status worsening, with hypoxia, increasing respiratory rate, increasing pulse and hypertension. a chest xray revealed worsening pulmonary edema. she responded well to lasix 40mg iv and morphine, with resolution of symptoms after diuresis. she remained stable and comfortable on home regimen of lasix 20mg po daily. she was initially brought to the or on , but had a coughing fit with concern for pneunomia. she was brought back to the floor and a chest xray revealed improving pulmonary edema without infiltrates. she was monitored over the weekend without event and returned to the or on where she underwen coronary bypass grafting x1 with reverse saphenous vein graft to the right coronary artery/ aortic valve replacement with a 21-mm magna ease pericardial tissue valve. cross-clamp time:87 minutes.pump time:106 minutes. please see operative note for details. postoperatively she was transferred to the intensive care unit for invasive monitoring. within 24 hours, she awoke neurologically intact and was extubated without incident. her cvicu course was uneventful and she transferred to the sdu on postoperative day two. chest tubes and pacing wires were removed without complication. beta blockade was resumed and advanced as tolerated. an ace-i was not able to be resumed at this time due to her blood pressure. this will need to be readdressed as an outpatient due to her lvef=30%. she remained in a normal sinus rhythm. over several days, she continued to make clinical improvement with diuresis. she was eventually cleared for discharge to health care rehab on postoperative day # 5.all follow up appointments were advised. medications on admission: home medications: lasix 20mg daily omeprazole 20mg daily simvastatin 20mg qhs mvi colace tylenol levalbuterol inhaler 0.31mg neb . medications on transfer: prednisone 60mg (quick taper) nicotine 21mg po daily ceftriaxone 1gm iv daily pantoprazole 40mg iv daily duonebs q6hours furosemide 10mg iv albuterol 2.5mg nebs q2hr prn sob asa 325 mg po daily ntg prn heparin 5000 iu q8hr sq discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 4. multivitamin tablet sig: one (1) tablet po daily (daily). 5. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 6. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 2-4 puffs inhalation q4h (every 4 hours) as needed for wheezing. 7. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 8. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily). 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 10. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 11. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 12. metoprolol succinate 25 mg tablet extended release 24 hr sig: 0.5 tablet extended release 24 hr po daily (daily). 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 14. furosemide 40 mg tablet sig: one (1) tablet po once a day for 1 weeks: 40mg daily x 1 week, then resume 20mg daily. 15. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po bid (2 times a day) for 1 weeks: x 1 week, then resume daily dose. discharge disposition: extended care facility: tba discharge diagnosis: severe aortic stenosis ( 0.5cm2) coronary artery disease s/p aortic valve replacement, coronary artery bypass hypertension hypercholesterolemia arthritis chronic obstructive pulmonary disease (mild) gastroesophageal reflux disease osteoarthritis discharge condition: alert and oriented x3, nonfocal ambulating with steady gait incisional pain managed with oral analgesia incisions: sternal - healing well, no erythema or drainage leg left - healing well, no erythema or drainage. edema: 1+ discharge instructions: 1) 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. 2) please no lotions, cream, powder, or ointments to incisions. 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart provided. 4) no driving for approximately one month and while taking narcotics. driving will be discussed at follow up appointment with surgeon when you will likely be cleared to drive. 5) no lifting more than 10 pounds for 10 weeks 6) 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 surgeon: dr. () on at 1:15 pm cardiologist: dr. on at 2:00pm please call to schedule appointments with: primary care: dr. (in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft extraction of other tooth diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension obstructive chronic bronchitis with (acute) exacerbation aortic valve disorders acute diastolic heart failure pulmonary congestion and hypostasis knee joint replacement dental caries, unspecified 

Answer: The patient is high likely exposed to