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: attempted minimally-invasive mitral valve replacement, median sternotomy and standard mitral valve replacement with a 33-millimeter st. epic bioprosthesis, and closure of the pfo. history of present illness: 43 year old female with cardiomyopathy and followed with serial echocardiograms, which indicated worsening mitral regurgitation and increasing dyspnea on exertion. past medical history: mitral regurgitation psoriasis psoriatic arthritis endometriosis obesity tobacco social history: lives with spouse etoh rare tobacco 20 year pack history - currently smoking not currently working family history: mother deceased at 62 from cardiomyopathy physical exam: nad skin psoriatic breakout bilat lower extremities improved heent unremarkable neck supple full rom chest cta bilat heart rrr mumur abdomen soft, nd, nt +bs ext warm, well perfused neuro grossly intact pertinent results: 05:25am blood wbc-4.6 rbc-2.62* hgb-8.3* hct-24.2* mcv-92 mch-31.6 mchc-34.3 rdw-17.1* plt ct-112* 01:36pm blood pt-15.9* ptt-60.0* inr(pt)-1.4* 05:25am blood glucose-115* urean-22* creat-0.8 na-136 k-3.7 cl-104 hco3-25 angap-11 , f 43 radiology report chest (portable ap) study date of 5:58 pm , csru sched chest (portable ap) clip # reason: s/p ct removal ? ptx medical condition: 43 year old woman with s/p mvr reason for this examination: s/p ct removal ? ptx final report chest radiograph indication: status post chest tube removal. followup. comparison: , 11:27 a.m. findings: as compared to the previous examination, all monitoring and support devices have been removed. there only remains an introduction sheath in the left internal jugular vein. the size of the cardiac silhouette is unchanged. also unchanged is the extent of a small left-sided pleural effusion and the overall normal transparency of the lung parenchyma. there is no evidence of overhydration and no evidence of pneumonia. the study and the report were reviewed by the staff radiologist. dr. dr. approved: wed 9:52 am echocardiography report , (complete) done at 10:57:49 am preliminary referring physician information , c. , status: inpatient dob: age (years): 43 f hgt (in): 62 bp (mm hg): / wgt (lb): 206 hr (bpm): bsa (m2): 1.94 m2 indication: intraop mvr icd-9 codes: 440.0, 394.1 test information date/time: at 10:57 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2008aw2-: machine: aw 2 echocardiographic measurements results measurements normal range left atrium - four chamber length: *5.7 cm <= 5.2 cm left ventricle - inferolateral thickness: *1.5 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.6 cm <= 5.6 cm left ventricle - systolic dimension: 3.3 cm left ventricle - fractional shortening: *0.28 >= 0.29 left ventricle - ejection fraction: 50% to 55% >= 55% left ventricle - peak resting lvot gradient: 2 mm hg <= 10 mm hg aorta - annulus: 1.8 cm <= 3.0 cm aorta - sinus level: 3.0 cm <= 3.6 cm aorta - sinotubular ridge: 2.8 cm <= 3.0 cm aorta - ascending: 2.8 cm <= 3.4 cm aorta - arch: 2.3 cm <= 3.0 cm aorta - descending thoracic: 1.7 cm <= 2.5 cm aortic valve - peak velocity: 1.0 m/sec <= 2.0 m/sec aortic valve - peak gradient: 4 mm hg < 20 mm hg aortic valve - mean gradient: 3 mm hg aortic valve - valve area: *2.8 cm2 >= 3.0 cm2 findings left atrium: moderate la enlargement. elongated la. no thrombus in the laa. right atrium/interatrial septum: normal ra size. lipomatous hypertrophy of the interatrial septum. pfo is present. left ventricle: moderate symmetric lvh. normal lv cavity size. mild regional lv systolic dysfunction. low normal lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. simple atheroma in aortic arch. normal descending aorta diameter. simple atheroma in descending aorta. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: moderately thickened mitral valve leaflets. characteristic rheumatic deformity of the mitral valve leaflets with fused commissures and tethering of leaflet motion. cannot exclude ms. moderate to severe (3+) mr. tricuspid valve: normal tricuspid valve leaflets. physiologic tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. physiologic (normal) pr. pericardium: trivial/physiologic pericardial effusion. pericardial calcifications. 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. conclusions pre bypass: the left atrium is moderately dilated. the left atrium is elongated. no thrombus is seen in the left atrial appendage. a patent foramen ovale is present. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with mild inferior . overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are moderately thickened. the mitral valve shows characteristic rheumatic deformity. the study is inadequate to exclude significant mitral valve stenosis. moderate to severe (3+) mitral regurgitation is seen. there is a trivial/physiologic pericardial effusion. there are pericardial calcifications. post bypass: patient is in sinus rhythm on phenylepherine gtt. preserved biventricular function, lvef 50-55%. there is a well seated bioprosthetic valve insitu. initial trace mr resolved over time. no perivalvular leaks. mean gradient across mitral prosthesis 5.5-6.5 mm hg at a cardiac output of 5 lpm. aortic contours intact. remaining exam is unchanged. all findings discussed with surgeon at the time of the exam. i certify that i was present for this procedure in compliance with hcfa regulations. interpretation assigned to , md, interpreting physician brief hospital course: admitted to same day surgery and went to the operating room. underwent attempted mini thoracotomy for mitral valve replacement, but had to convert to a sternotomy with a epic tissue valve and closure of the pfo. she was admitted to the cvicu post op and had an uncomplicated post-op course. she was extubated, chest tubes were pulled and she was transferred to the floor on pod 2. her epicardial pacing wires were d/c'd on pod 3 and she was discharged to home in stable condition on pod #4. medications on admission: enbrel 25mg po twice a week folate 1mg po daily lasix 20 mg po daily as needed methotrexate 2.5 mg, 8 tabs per week mirtazapine 15 mg po qhs moexepril 15 mg po daily etodolac 400mg po twice daily paxil 20 mg po daily clonazepam 1mg po twice daily chantix cyclopsorin albuterol inhaler discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(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:*0* 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*50 tablet(s)* refills:*0* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 7. lasix 20 mg tablet sig: one (1) tablet po twice a day for 7 days. disp:*14 tablet(s)* refills:*0* 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po every twelve (12) hours for 7 days. disp:*14 tab sust.rel. particle/crystal(s)* refills:*0* 9. mirtazapine 15 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*0* 10. chantix 1 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: vna of discharge diagnosis: mitral regurgitation s/p mvr patent foreman ovale s/p pfo closure psoriasis endometriosis obesity 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 one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: dr on at 1:15pm at medical building, please call to schedule appointments with dr for 6 weeks dr for 4 weeks can restart immunosupressive medication 1 month after surgery per dr. procedure: extracorporeal circulation auxiliary to open heart surgery other and unspecified repair of atrial septal defect open and other replacement of mitral valve with tissue graft diagnoses: other primary cardiomyopathies obstructive sleep apnea (adult)(pediatric) mitral valve disorders chronic airway obstruction, not elsewhere classified ostium secundum type atrial septal defect psoriatic arthropathy 

Answer: The patient is high likely exposed to