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: palpitations major surgical or invasive procedure: mitral valve repair with a posterior leaflet (p3) triangular resection and anterior leaflet cleft closure and ring annuloplasty using a 34-mm - physio ii ring. left-sided maze procedure with atricure bipolar synergy rf system with resection of left atrial appendage. history of present illness: the patient was in her usual state of health until , when she experienced a rapid heart beating at ~8.15am. she has had sporadic rapid heart rates and mitral regurgitation since , but her typical episodes usually only last 10-15 minutes. she often stops the rapid beating by lying still on the floor. this time, her heart rate stayed elevated at ~200 bpm for 45 minutes despite lying on the floor, and the pt called 911. pt keeps a regular log and her hr at home is otherwise almost always 70-75. during the entire episode, pt did not experience chest pain, shortness of breath, or light-headedness. per the pt, she has had episodes of rapid heart rate ~ 1x yearly in the late , increasing to a few times yearly in the , and notably more in when her husband died, after which she would experience a rapid hr ~1x monthly. since , she experiences rapid hr episodes ~1x weekly. she is generally asymptomic, but sometimes feels very faint and weak. ems did ecg and found her to be in a-fib w/ rapid ventricular response w/ rate ~200s. she was given iv diltiazem (unknown amount) and transferred to in , ma. during her hospitalization, she was treated with diltiazem extended release 120mg po daily and metoprolol 12.5mg po tid. her bp was 90s and her resting hr was 90s-100s, but would jump up to 170s-180s for several minutes. osh also began anticoagulation w/ enoxaparin and warfarin on . she was transferred to for higher level of care on . past medical history: -bleeding peptic ulcer s/p egd and h pylori rx -mitral valve prolapse with mitral regurgitation -paroxysmal atrial fibrillation w/ rapid ventricular response -cataract surgery, osh -osteoarthritis social history: -lives alone in . retired book-keeper. -widowed, no children. -no tobacco history, 2 glasses wine daily, no drugs. family history: -mother had rheumatic heart disease, no other cardiac family history -father died of lung cancer at 71 -several maternal relatives with stomach cancer - uncle died in 40s, 2 aunts died in 70s. physical exam: physical examination on presentation: vs: t=96.2 bp=130/77 hr=98 rr=20 o2 sat=96 ra general: well-appearing woman sitting on bed in no acute distress. heent: perl, eomi, normal oropharynx, no lad neck: supple with jvp of 5 cm. lungs: clear to auscultation bilaterally cardiac: irregular rhythm, regular rate, early prolonged systolic murmur, no rubs or gallops. abdomen: normal bowel sounds (cardiac murmur audible), abdomen is soft and non-tender, not distended, no masses. extremities: 2+ pulses radial and dp bilaterally. no edema in lower extremities. pertinent results: conclusions pre-bypass: the left atrium is dilated. no spontaneous echo contrast is seen in the body of the left atrium. no spontaneous echo contrast is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the ascending aorta. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are myxomatous. there is moderate/severe anterior and posterior leaflet mitral valve prolapse. there is partial p3 mitral leaflet flail. torn mitral chordae are present. an eccentric, anteriorly directed jet of severe (4+) mitral regurgitation is seen. tricuspid valve prolapse is present. moderate tricuspid regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results at time of surgery prior to incision. post-bypass: the patient is status post mitral valve repair. there is a mitral annuloplasty ring in position. no mitral regurgitation is seen. no mitral stenosis is seen. left ventricular function is depressed compared to pre-bypass exam (lvef 40-45%). there is mild hypokinesis of the inferior and inferoseptal walls at the mid-papillary level. right ventricular function is unchanged. there is trace aortic regurgitation. moderate (2+) tricuspid regurgitation is unchanged from pre-bypass exam. the ascending aorta, aortic arch, and descending aorta are intact. history: status post mvr, evaluate effusions. chest, two views. the patient is status post sternotomy, with cardiomegaly. the mvr is unchanged. there is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. allowing for technical differences, this is similar to . there is right cardiophrenic density, which appears worse compared with the earlier film. there is minimal blunting of the right costophrenic angle which is probably new. the lateral film suggests small bilateral effusions. the upper zones are clear without evidence of chf or focal consolidation. impression: compared with , left base consolidation is unchanged. right cardiophrenic density and right lateral cpa effusion are new. 06:40am blood wbc-7.3 rbc-3.12* hgb-9.8* hct-29.0* mcv-93 mch-31.4 mchc-33.8 rdw-13.5 plt ct-345 08:00pm blood wbc-6.7 rbc-5.09 hgb-16.1* hct-47.6 mcv-94 mch-31.6 mchc-33.8 rdw-13.9 plt ct-195 06:40am blood plt ct-345 06:40am blood pt-13.7* inr(pt)-1.2* 08:00pm blood plt ct-195 08:00pm blood pt-13.6* ptt-36.0* inr(pt)-1.2* 11:55am blood fibrino-143* 06:40am blood glucose-95 urean-15 creat-0.8 na-140 k-4.4 cl-109* hco3-26 angap-9 06:30am blood alt-39 ast-43* ld(ldh)-270* alkphos-51 totbili-0.6 06:40am blood mg-2.1 08:00pm blood calcium-9.5 phos-4.4 mg-2.2 06:30am blood %hba1c-5.4 eag-108 08:00pm blood tsh-2.9 brief hospital course: she was admitted for rapid atrial fibrillation but was asymptomactic. she underwent further evaluation which included echocardiogram and cardiac catheterization. echocardiogram showed severe mitral regurgitation with bileaflet mitral valve prolapse and partial p3 flail. coronary angiography revealed normal coronary arteries. preoperative course was otherwise uneventful and she was cleared for surgery. on , mrs. was taken to the operating room for mitral valve repair and maze procedure with dr. . for surgical details, please see operative note. following surgery, she was admitted to the cvicu for invasive monitoring. she was initially noted to have a normal sinus rhythm. within 24 hours, she awoke neurologically intact and was extubated without incident. she developed atrial fibrillation and was treated with amiodarone and lopressor and converted back to sinus rhythm, then junctional rhythm. due to junctional rhythm then heart block the amiodarone and lopressor were stopped and electrophysiology was consulted. the ecg demonstrated high grade heart block and accelerated junctional rhythm at the time. over several days, heart rate improved and low dose beta blockade was resumed. she eventually converted back to a normal sinus rhythm with first degree av block with pr interval 0.32-0.38. warfarin was eventually resumed for history of atrial fibrillation and dosed for a goal inr between 2.0 - 2.5. she continued to make clinical improvements and was cleared for discharge to rehab at with plan for twice a week ekg to be followed by dr , electrophysiology. medications on admission: pt took no medications aside from occasional acetaminophen as an outpatient. from outside hospital, she was transferred on: -diltiazem er 120mg po qhs -metoprolol 12.5mg po tid -enoxaparin 60 mg sc bid -warfarin 5mg po daily discharge medications: 1. ekg ekg twice a week monday and thrusday - please fax to dr fax # 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. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day): 12.5 mg twice a day do not increase dose with out discussing with dr - ep . 6. warfarin 3 mg tablet sig: one (1) tablet po once a day: 3mg on - then inr check for further dosing - goal inr 2-2.5 for atrial fibrillation . 7. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 8. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours) as needed for pain. 9. potassium chloride 20 meq tablet, er particles/crystals sig: one (1) tablet, er particles/crystals po once a day for 7 days. 10. lasix 40 mg tablet sig: one (1) tablet po once a day for 7 days. 11. outpatient lab work bun, cr, potassium, magnesium - please check and to evaluate electrolytes and replete as needed due to lasix 12. outpatient lab work labs: pt/inr coumadin for atrial fibrillation goal inr 2-2.5 first draw then please do inr checks monday, wednesday, and friday for 2 weeks discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: mitral valve prolapse/regurgitation s/p mitral valve repair paroxysmal atrial fibrillation s/p maze procedure postoperative high grade heart block with junctional rhythm first degree av block diabetes mellitus dyslipidemia hypertension bleeding peptic ulcer s/p egd and h pylori rx osteoarthritis discharge condition: alert and oriented x3 nonfocal ambulating, gait steady with assist of one sternal pain managed with tylenol prn sternal incision - healing well, no erythema or drainage edema none 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. on at 1:15pm in the medical office building cardiologist dr. by her pcp's office for at 4:50pm please call to schedule the following: 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** labs: pt/inr coumadin for atrial fibrillation goal inr 2-2.5 first draw then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as directed by dr. through clinic: phone , fax ekg twice a week monday and thrusday - please fax to dr fax # labs: bun, cr, magnesium and potassium and procedure: extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters excision or destruction of other lesion or tissue of heart, open approach open heart valvuloplasty of mitral valve without replacement diagnoses: mitral valve disorders unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation other and unspecified hyperlipidemia primary pulmonary hypertension diseases of tricuspid valve first degree atrioventricular block 

Answer: The patient is high likely exposed to