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 / aspirin / bactrim ds / shellfish derived attending: chief complaint: afib, flash pulmonary edema following dccv major surgical or invasive procedure: direct current cardioversion - history of present illness: 65 yo f with history of rheumatic mitral valve disease with 4+ mr and + tr, recently diagnosed afib on warfarin (2-3 weeks ago), now s/p dccv complicated concerns for flash pulmonary edema. she has been feeling fatigued and short of breath for the last 2-3 weeks, was found to be in atrial fibrillation. she had been experiencing some orthopnea, dyspnea on exertion, and overall fatigue. she underwent tee/cardioversion today, following which she was hypotensive with sbp in the 70's. she received iv fluids, following which she became acutely short of breath. thought to be in flash pulmonary edema and received a total of 60 mg of iv lasix, to which she put out 500 cc of urine with symptoms improving. patient was started on a nitro drip and transferred to the ccu for further medical management. . currently patient is still feeling a little short of breath but much improved. having a slight headache, but otherwise no other complaints. . on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: - diabetes, - dyslipidemia, - hypertension 2. cardiac history: atrial fibrillation on warfarin and bb (diagnosed 2 weeks ago) 4+ mr + tr 3. other past medical history: anxiety rheumatic fever social history: she lives with husband independently at home. no etoh, tobacco, or illicit drug use. family history: mother - died in her sleep at age 78, unknown causes father - ?cancer physical exam: vs: 96.8, 91/56, 66, 24, 96% 4l general: wdwn female in nad, aaox3 heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. no lad. no jvd cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. crackles in r base, crackles in l lung of the way up. no wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: tee (complete) done at 5:28:18 pm the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no atrial septal defect is seen by 2d or color doppler. there is mild global left ventricular hypokinesis (lvef = 50 %). right ventricle with depressed free wall contractility. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened with characteristic rheumatic deformity. severe (4+) mitral regurgitation is seen. there is a trivial/physiologic pericardial effusion. impression: no spontaneous echo contrast or intraatrial thrombus identified. mild global -ventricular systolic dysfunction. severe mitral regurgitation. simple atheroma in descending aorta. cbc 05:21am blood wbc-12.9* rbc-3.83* hgb-11.7* hct-35.0* mcv-91 mch-30.5 mchc-33.3 rdw-13.1 plt ct-289 05:00pm blood wbc-12.1* rbc-3.85* hgb-11.7* hct-35.8* mcv-93 mch-30.4 mchc-32.7 rdw-12.9 plt ct-325 coags 05:21am blood pt-20.3* ptt-32.6 inr(pt)-1.9* 05:00pm blood pt-19.2* ptt-25.9 inr(pt)-1.8* 08:10am blood pt-19.8* inr(pt)-1.8* chemistry 05:21am blood glucose-121* urean-22* creat-0.8 na-139 k-3.8 cl-101 hco3-28 angap-14 05:00pm blood glucose-99 urean-18 creat-0.7 na-141 k-4.1 cl-103 hco3-29 angap-13 05:21am blood calcium-8.4 phos-3.8 mg-2.0 05:00pm blood albumin-4.1 calcium-8.8 phos-3.7 mg-2.0 tft 05:00pm blood tsh-1.0 05:00pm blood free t4-1.3 brief hospital course: 65 yo f with history of rheumatic mv disease with 4+ mr and + tr, recently diagnosed afib on warfarin (2-3 weeks ago), now s/p cardioversion, complicated by flash pulmonary edema. . # pump/mr/tr/pulmonary edema: patient has history of rheumatic heart disease. tee on this admission shows mild global -ventricular systolic dysfunction with severe mitral regurgitation, mild to moderate tricuspid regurgitation, and mild aortic regurgitation. her last ef on tte was 60%. her post cardioversion course was complicated by flash pulmonary edema for which she was admitted to the ccu where she was diuresed with improvement of her symptoms. she responded well to iv lasix 40 mg doses. she was discharged on metoprolol. initiation of an ace inhibitor can be considered as an outpatient, as her ef is likely overestimated on her tte given her severe mr. valve replacement/repair was discussed with the patient on this admission. she is a candidate for valve replacement/repair given that she is symptomatic with new onset afib. she will discuss this further with her outpatient cardiologist. . # rhythm/a fib - patient was diagnosed with atrial fibrillation 2-3 weeks prior to this admission, her symptoms being fatigue and dyspnea on exertion. she is now s/p tee and cardioversion, reverted back to normal sinus rhythm. patient will continue with warfarin and lovenox bridge (discharge inr of 1.9) until she can have her inr rechecked at on . per ep recommendations, she was also started amiodarone 200 mg tid for 3 weeks, then will decrease to 200 mg daily. patient will need outpatient pfts because of initiation of amiodarone. . # coronaries - patient has no history of coronary disease . # anxiety - patient was continued on home regimen of clonazepam medications on admission: clonazepam 0.5-1 mg po tid prn metoprolol 50 mg po bid coumadin 2.5 mg po daily prochlorperazine 10 mg q6h prn nausea discharge medications: 1. amiodarone 200 mg tablet sig: one (1) tablet po tid (3 times a day): take 1 tablet 3 times a day from - , then switch to taking 1 tablet daily from then on. disp:*70 tablet(s)* refills:*1* 2. clonazepam 0.5 mg tablet sig: two (2) tablet po bid (2 times a day). 3. clonazepam 0.5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 4. warfarin 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*3* 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. compazine 10 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. discharge disposition: home discharge diagnosis: pulmonary edema discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to for a cardioversion. following the procedure, you developed shortness of breath because you suddenly developed of fluid in your lungs. you were admitted to the cardiac intensive care unit where we gave you medications in order to help remove fluid from your body. your symptoms improved overnight. your heart is currently in a regular rhythm. you will need to follow up with your cardiologist as an outpatient. the following changes were made to your medications: - new: amiodarone - please take 200 mg three times a day for 3 weeks, then switch to taking 200 mg once a day from then on - please decrease your metoprolol to 25 mg twice a day you anticoagulation should be managed as follows: - please take warfarin 5mg on - starting on , start taking warfarin 2.5mg daily and then as directed by the - you will need to have your inr checked on thursday - please continue taking lovenox until you have your inr checked on thursday the rest of your medications have not changed. please continue to take them as originally prescribed you will need to continue to have your inr checked periodically at the weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: please follow up with your cardiologist, dr. , in weeks after discharge from the hospital. procedure: diagnostic ultrasound of heart other electric countershock of heart diagnoses: atrial fibrillation other chronic pulmonary heart diseases anxiety state, unspecified diseases of tricuspid valve rheumatic mitral insufficiency acute edema of lung, unspecified 

Answer: The patient is high likely exposed to