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: aspirin attending: chief complaint: transfer from /referring dr. major surgical or invasive procedure: s/p cardiac catherization s/p dental extractions s/p avr(19mm mosaic porcine tissue valve)/cabgx1(lima->lad) s/p cardioversion history of present illness: this is a 74 yo woman with hypertension and moderate-to-severe aortic stenosis with valve area of 0.8cm2 (gradient 78.3) presented to on with sob and left sided chest pain that radiated down her left arm associated with nausea and vomiting. ekg demonstrated t wave inversion in inferior leads (new). she was treated with sublingual nitro, maalox and tylenol. she ruled out for mi by cardiac enzymes. transferred to for cardiac catherization past medical history: coronary artery disease aortic stenosis hypothyroidism ^chol. djd gerd s/p chole s/p r shoulder surgery osteoporosis htn ddd ppm social history: son lives with her and she functions independently. walks without a walker. never smoked, no alchohol. family history: mother died of mi at 68. father died healthy at 97. physical exam: vitals: t: 97.9 p: 76 bp: 134/60 r: 18 sao2: 96% on ra general: awake, alert, nad. heent: nc/at, perrl, eomi without nystagmus, no scleral icterus noted, mmm, no lesions noted in op neck: supple, no jvd appreciated pulmonary: lungs cta bilaterally (anteriorly) cardiac: rrr, nl. s1s2, iii/vi systolic murmur heard best over lusb abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp pulses b/l. skin: dry skin in le. neurologic: -mental status: alert, oriented x 3. able to relate history without difficulty. discharge 98.5, sr w/ vpacing 60, 115/59, 20, ra sat 94% neuro a/ox3 nonfocal pulm cta bilat cardiac rrr no m/r/g abd soft, nt, nd +bs ext warm, +1 edema inc sternal no drainage/erythema, sternum stable pertinent results: 06:45am blood wbc-7.6 rbc-3.61* hgb-9.9* hct-30.3* mcv-84 mch-27.5 mchc-32.7 rdw-14.7 plt ct-282 01:00pm blood wbc-4.6 rbc-3.76* hgb-10.4* hct-30.1* mcv-80* mch-27.6 mchc-34.5 rdw-14.0 plt ct-188 01:00pm blood neuts-61.8 lymphs-31.3 monos-4.5 eos-2.1 baso-0.3 06:45am blood plt ct-282 06:45am blood pt-18.6* ptt-98.4* inr(pt)-1.8* 01:00pm blood plt ct-188 01:00pm blood pt-12.9 ptt-31.4 inr(pt)-1.1 06:45am blood glucose-96 urean-20 creat-1.2* na-139 k-4.0 cl-99 hco3-31 angap-13 01:00pm blood glucose-122* urean-20 creat-0.8 na-137 k-3.6 cl-103 hco3-28 angap-10 01:00pm blood alt-10 ast-20 ck(cpk)-50 alkphos-59 amylase-41 totbili-1.4 dirbili-0.4* indbili-1.0 06:35am blood calcium-8.6 phos-4.6* mg-2.3 01:00pm blood caltibc-277 vitb12-276 folate-greater th ferritn-138 trf-213 01:00pm blood %hba1c-6.4* -done -done 05:55am blood tsh-2.9 cxr indication: 85-year-old woman status post aortic valve replacement. evaluate effusions. comparison: . frontal and lateral chest: a left-sided pacemaker with leads are in unchanged positions. the patient is status post median sternotomy. skin staples remain in place. the cardiac and mediastinal contours are similar in appearance. the lungs remain clear with minor atelectasis in the left base. there is a small left-sided pleural effusion that appears roughly similar compared to the prior study. pulmonary vascularity remains within normal limits. hardware in the right humerus is unchanged. the thoracic spine demonstrates extensive degenerative change with a marked kyphosis. impression: small left-sided pleural effusion and minimal left basilar atelectasis. tee measurements: left ventricle - ejection fraction: 55% (nl >=55%) aorta - ascending: *3.5 cm (nl <= 3.4 cm) aortic valve - peak velocity: *2.7 m/sec (nl <= 2.0 m/sec) aortic valve - peak gradient: 45 mm hg aortic valve - mean gradient: 30 mm hg aortic valve - lvot diam: 1.6 cm aortic valve - valve area: *0.5 cm2 (nl >= 3.0 cm2) mitral valve - peak velocity: 0.9 m/sec mitral valve - mean gradient: 2 mm hg mitral valve - mva (p t): 1.8 cm2 interpretation: findings: right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. left-to-right shunt across the interatrial septum at rest. small secundum asd. left ventricle: normal regional lv systolic function. overall normal lvef (>55%). no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. mildly dilated ascending aorta. simple atheroma in ascending aorta. normal aortic arch diameter. there are complex (>4mm) atheroma in the aortic arch. normal descending aorta diameter. there are complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. severe as (aova <0.8cm2). mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. moderate mitral annular calcification. mild ms (mva 1.5-2.0cm2). moderate (2+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. physiologic (normal) pr. 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. the patient appears to be in sinus rhythm. results were personally conclusions: prebypass 1. a left-to-right shunt across the interatrial septum is seen at rest. a small secundum atrial septal defect is present. 2. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). 3.right ventricular chamber size and free wall motion are normal. 4.the ascending aorta is mildly dilated. there are simple atheroma in the ascending aorta. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. 5.there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). mild (1+) aortic regurgitation is seen. 6. the mitral valve leaflets are moderately thickened. there is mild mitral stenosis (area 1.5-2.0cm2). moderate (2+) mitral regurgitation is seen. 7. the tricuspid valve leaflets are mildly thickened. post bypass 1. patient is receiving an infusion of phenylephrine. 2. bioprosthetic valve seen in the aortic position. leaflets move well (demonstrated on deep gastric views) and valve appears well seated. peak gradient across the aortic valve is 30 mm hg. trace aortic insufficiency. 3. moderate mitral regurgitation persists. 4. aorta intact post decannulation. 5. biventricular systolic function is unchanged path diagnosis: aortic valve leaflets: valve leaflets with extensive calcifications. brief hospital course: the patient underwent cardiac catheterization which revealed: calcified lm, 70% prox. lad, 70% prox lcx. heavily calcified rca, tr. mr, and an ef of 60%. she had aortic stenosis with an av gradient of 44 and of 0.71 cm2. dr. was consulted and then a dental consult recommended extraction of 7 teeth. she underwent extraction of 7 teeth on , and on she had avr(19mm mosaic tissue valve)/cabgx1(lima->lad). the cross clamp time was 86 mins., total bypass time 115 mins. please see operative report for further details. she tolerated the procedure well and was transferred to the csru in stable condition on neo and propofol. she was extubated on the post op night and was transferred to the floor on pod#2. she slowly progressed and was diagnosed with a uti which is being treated with cipro. she went into rapid af on pod#5 and did not convert with beta blockers or amiodarone. she was started on anticoagulation and ep consulted and had cardioveriosn resulting in sr with intermittent pacing. she continued to progress and was ready for discharge to rehab . she continues on coumadin with target inr 2.0-2.5 for atrial fibrillation. medications on admission: lipitor 10 mg po daily synthroid 0.05 mg daily zantac 150 mg po daily protonix 40 mg po daily lisinopril 10 mg po daily hctz 25 mg po daily? discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 2. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 6. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 7. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily): on plavix instead of asa per pt request. 8. furosemide 40 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 7 days. 9. amiodarone 200 mg tablet sig: one (1) tablet po tid (3 times a day): 200 mg tid x 1 week per ep, then 200 mg daily until dc'd at one month by dr. ; do not stop until seen by cardiologist. 10. warfarin 2.5 mg tablet sig: one (1) tablet po once (once): please check inr for dosing goal inr 2-2.5 for atrial fibrillation . discharge disposition: extended care facility: tcu - discharge diagnosis: coronary artery disease aortic stenosis hypothyroidism ^chol. djd gerd s/p chole s/p r shoulder surgery osteoporosis htn ddd ppm discharge condition: good. discharge instructions: follow medications on discharge instructions. do not drive for 4 weeks. do not lift more than 10 lbs for 10 weeks. shower daily, let water flow over wounds, pat dry with a towel. do not use lotions, creams, or powders on wounds. call our office for temp>101.5, sternal drainage. followup instructions: make an appointment with dr. for 1-2 weeks. make an appointment with dr. for 2-3 weeks. make an appointment with dr. for 4 weeks. pt/inr as needed first check with goal inr 2-2.5 procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures atrial cardioversion open and other replacement of aortic valve with tissue graft other surgical extraction of tooth diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders cardiac pacemaker in situ dental caries, unspecified 

Answer: The patient is high likely exposed to