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 on exertion major surgical or invasive procedure: s/p minimally invasive mitral valve replacement (29mm porcine) history of present illness: 62 y/o female with known ms for many years who recently has had an increase in dyspnea on exertion, shortness of breath, and fatigue. in she was admitted to the hospital for an episode of congestive heart failure. most recent cath showed moderate to severe mitral regurgitation along with mitral stenosis with a mva of 0.82cm2. now presents for surgical intervention. past medical history: s/p mitral valvuloplasty , hyperlipidemia, rheumatic heart disease, s/p tibal ligation social history: quit smoking 3 yrs ago after 1ppd x 40yrs. denies etoh use. family history: father died from ms at age 55. uncle died at 37 from valvular disease. physical exam: vs: 58 155/71 61" 154# gen: wdwn female in nad skin: warm, dry -c/c/e heent: nact, perrl, sclera anicteric, op benign neck: supple, from, -jvd, -carotid bruit chest: ctab -w/r/r heart: rrr 3/6 systolic and diastolic murmur abd: soft, nt/nd +bs ext: warm, well-perfused, -edema, severe varicosities rle, superficial lle neuro: a&o x 3, mae, non-focal pertinent results: echo: pre-bypass: 1. the left atrium is moderately dilated. mild spontaneous echo contrast is seen in the body of the left atrium. no mass/thrombus is seen in the left atrium or left atrial appendage. 2. no atrial septal defect is seen by 2d or color doppler. 3. overall left ventricular systolic function is normal (lvef>55%). 4. right ventricular chamber size and free wall motion are normal. 5. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 6. the aortic valve leaflets (3) are mildly thickened. trace aortic regurgitation is seen. 7. the mitral valve leaflets are moderately thickened. the mitral valve shows characteristic rheumatic deformity. there is moderate valvular mitral stenosis (area 1.0-1.5cm2). moderate (2+) mitral regurgitation is seen. 8. the tricuspid valve leaflets are mildly thickened. 9. there is no pericardial effusion and there may be a suggestion of pericardial cyst close to the lef atrium and descending thoracic aorta. post-bypass: for the post-bypass study, the patient was receiving vasoactive infusions including nitroglycerine and was in an intrinsic sinus rhythm. 1. a well-seated bileaflet valve is seen in the mitral position with normal leaflet motion and gradients (mean gradient = 4 mmhg). mva by pht estimated to be 3.3 cm2 trivial (normal for prosthesis) mitral regurgitation is seen. 2. regional and global left ventricular systolic function are normal. 3. right ventricular systolic function is normal. 4. aortic contours are intact post decanulation. brief hospital course: mrs. was a same day admit after undergoing all pre-operative work-up as an outpatient. on day of admission she was brought directly to the operating room where she underwent a minimal invasive mitral valve replacement. please see operative report for surgical details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. later on op day she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was started on beta-blockers and diuretics and gently diuresed towards her pre-op weight. her chest tubes were removed and was later transferred to the telemetry floor for further care. on in to the am of , she went in to atrial fibrillation with a controlled ventricular rate. she was started on coumadin for anticoagulation, has remained hemodynamically stable, and is now ready for discharge home. coumadin management will be followed by dr. office, as confirmed with . medications on admission: zocor 40mg qd, atenolol 25mg qd, aspirin 81mg qd, lasix 20mg qd prn discharge medications: 1. ibuprofen 600 mg tablet sig: one (1) tablet po every eight (8) hours for 4 weeks. disp:*84 tablet(s)* refills:*0* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*1* 5. furosemide 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 6. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 7 days. disp:*7 tab sust.rel. particle/crystal(s)* refills:*0* 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day) for 7 days: then 1 tab daily until discontinued by dr. . disp:*60 tablet(s)* refills:*0* 9. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 10. warfarin 1 mg tablet sig: two (2) tablet po daily16 (once daily at 16) for 1 days: then inr to be drawn and called to dr. office for continued dosing. disp:*120 tablet(s)* refills:*0* 11. dilaudid 2 mg tablet sig: 1-2 tablets po every 4-6 hours. disp:*40 tablet(s)* refills:*0* discharge disposition: home with service facility: vna of greater / discharge diagnosis: mitral stenosis/regurgitation s/p mitral valve replacement pmh: s/p mitral valvuloplasty , hyperlipidemia, rheumatic heart disease, s/p tibal ligation discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately two weeks or while taking narcotics please call with any questions or concerns p instructions: dr in 4 weeks () please call for appointment dr in 1 week - please call for appointment dr in weeks - please call for appointment wound check appointment 2 as instructed by nurse () procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart cardioplegia open and other replacement of mitral valve with tissue graft diagnoses: atrial fibrillation rheumatic heart failure (congestive) other and unspecified hyperlipidemia mitral stenosis with insufficiency 

Answer: The patient is high likely exposed to