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: increasing doe with recent chf exacerbations major surgical or invasive procedure: aortic valve replacement 21mm ce pericardial tissue valve history of present illness: 86yo female with known h/o as admitted for chf in . diagnosed with critical as by echo 0.7, mild to mod mr d pap past medical history: chf oa osteoporosis psoriasis anemia facial numbness social history: lives at home with family, retired. denies tobacco, rare etoh. family history: denies fh of cad physical exam: 86yo f in chair nad neuro aa&ox3, nonfocal chest ctab resp unlab median sternotomy stable, c/d/i no d/c, rrr aortic valve click. chest tubes and epicardial wires removed. abd s/nt/nd/bs+ ext warm with trace edema pertinent results: 05:15am blood wbc-13.3* rbc-3.66* hgb-10.4* hct-31.2* mcv-85 mch-28.3 mchc-33.2 rdw-15.5 plt ct-191 05:30am blood glucose-122* urean-39* creat-1.0 na-143 k-3.7 cl-104 hco3-27 angap-16 cardiology report echo study date of patient/test information: indication: aortic valve disease. congenital heart disease. hypertension. valvular heart disease. status: inpatient date/time: at 08:32 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2006aw590-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. measurements: left atrium - four chamber length: 4.7 cm (nl <= 5.2 cm) left ventricle - septal wall thickness: 1.1 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 1.0 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.9 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 3.2 cm left ventricle - fractional shortening: 0.35 (nl >= 0.29) left ventricle - ejection fraction: >= 55% (nl >=55%) aorta - valve level: 2.0 cm (nl <= 3.6 cm) aorta - ascending: 3.2 cm (nl <= 3.4 cm) aortic valve - peak velocity: *4.6 m/sec (nl <= 2.0 m/sec) aortic valve - peak gradient: 86 mm hg aortic valve - mean gradient: 54 mm hg aortic valve - valve area: *0.5 cm2 (nl >= 3.0 cm2) interpretation: findings: left atrium: mild la enlargement. no mass/thrombus in the laa. good (>20 cm/s) laa ejection velocity. all four pulmonary veins not identified. right atrium/interatrial septum: normal ra size. no spontaneous echo contrast or thrombus in the body of the ra or raa. a catheter or pacing wire is seen in the ra. left-to-right shunt across the interatrial septum at rest. secundum asd. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness. normal lv cavity size. overall normal lvef (>55%). lv wall motion: basal anterior - normal; mid anterior - normal; basal anteroseptal - normal; mid anteroseptal - normal; basal inferoseptal - normal; mid inferoseptal - normal; basal inferior - normal; mid inferior - normal; basal inferolateral - normal; mid inferolateral - normal; basal anterolateral - normal; mid anterolateral - normal; anterior apex - normal; septal apex - normal; inferior apex - normal; lateral apex - normal; apex - normal; right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic root diameter. simple atheroma in aortic root. normal ascending aorta diameter. simple atheroma in ascending aorta. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. severe as. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. moderate mitral annular calcification. moderate thickening of mitral valve chordae. mild (1+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. moderate tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. the patient was under general anesthesia throughout the procedure. conclusions: the left atrium is mildly dilated. no mass/thrombus is seen in the left atrium or left atrial appendage. no spontaneous echo contrast or thrombus is seen in the body of the right atrium or the right atrial appendage. a left-to-right shunt across the interatrial septum is seen at rest. a secundum type atrial septal defect is present. left ventricular wall thicknesses are normal. the left ventricular cavity size 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 aortic root. there are simple atheroma in the ascending aorta. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is moderate thickening of the mitral valve chordae. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is no pericardial effusion. cardiology report ecg study date of 3:57:48 pm sinus rhythm. left anterior fascicular block. t wave inversions in leads i and avl could be due to ischemia. compared to the previous tracing of left anterior fascicular block and t wave inversions are new and qrs voltage is decreased. read by: , k. intervals axes rate pr qrs qt/qtc p qrs t 62 142 92 396/400.71 -15 -30 109 brief hospital course: mrs. was admitted to the on for further management of her dyspnea on exertion. she was taken to the catheterization lab in where she was found to have no significant cad, severe mitral regurgitation with moderate pulmonary hypertension, lvef 55%. given the severity of her disease, the cardiac surgical service was consulted for surgical repair of her valve. she was worked-up in the usual preoperative manner including an echocardiogram which revealed severe aortic stenosis, 1+ mitral regurgitation with a resting left to right shunt via a small secundum asd. on , mrs. was taken to the operating room. she underwent a aortic valve replacement using a 21mm pericardial model 2700 bioprosthesis. postoperatively she was taken to the cardiac surgical intensive care unit for monitoring. on postoperative day one, she awoke neurologically intact and was extubated. beta blockade and aspirin were resumed. she was gently diuresed towards his preoperative weight. on pod 2 her pressors were weaned, chest tubes were removed, and she was transferred to the cardiac stepdown unit. beta blockade and aspirin were resumed. she was gently diuresed towards his preoperative weight. on pod 3 her epicardial wires were removed without incident. the physical therapy service was consulted to assist with her postoperative strength and mobility. she had episodes of hypertension requiring hydralazine. her ace-i, calcium channel blocker, and beta blocker were titrated to good effect. her oxygen saturations improved to 97% on 2liters o2. the physical therapy service was consulted to assist with her postoperative strength and mobility. on pod 6 ms. was 3kg above her preop weight with marginal exercise tolerance, no sob, or chest pain. her blood pressure was stable. her sternotomy incision was clean, dry, and intact without evidence of infection. she was discharged to an extended care facility on pod 6 with services in good condition, cardiac diet, sternal precautions, and instructed to follow up with her pcp and cardiologist in 2 weeks. she will follow up with dr. in four weeks. medications on admission: celebrex 200' norvasc 10' lisinoril 40' lasix 20' coreg 3.125'' neurontin hctz 25' actonel 35 qweek hydroxyzine 50 prn vit b12 im qmonth coal tar/salicylic acid tramcinolone oint mvi/folic acid/calcium amoxicillin prophylaxis discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days. disp:*14 tablet(s)* refills:*0* 2. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours). disp:*28 capsule, sustained release(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. 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* 5. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. disp:*60 tablet(s)* refills:*0* 6. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. disp:*40 tablet(s)* refills:*0* 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 8. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 9. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 3 days: then two tablets once daily for one week; then one tablet daily thereafter. disp:*90 tablet(s)* refills:*0* 11. lorazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed. disp:*90 tablet(s)* refills:*0* 12. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: extended care facility: of discharge diagnosis: aortic stenosis chf htn oa psoriasis anemia facial numbness s/p dental procedure discharge condition: good discharge instructions: shower, wash incisions with mild soap and water and pat dry. no lotions, creams or powders to incisions. call with fever >101, redness or drainage from incision, or weight gain more than 2 pounds in one day or five pounds in one week. no lifting more than 10 pounds for 10 weeks. no driving until follow up with surgeon. followup instructions: follow up with dr. in four weeks, follow up with dr. in two weeks, follow up with dr. in two weeks, procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft other and unspecified repair of atrial septal defect diagnoses: unspecified essential hypertension atrial fibrillation other chronic pulmonary heart diseases rheumatic heart failure (congestive) ostium secundum type atrial septal defect osteoporosis, unspecified mitral valve insufficiency and aortic valve stenosis other psoriasis 

Answer: The patient is high likely exposed to