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 / inderal / morphine attending: chief complaint: post-op bleeding after tooth extraction major surgical or invasive procedure: none history of present illness: 79 yo woman with history of a-fib, chf s/p bioprosthetic mitral and s/p tricuspid valve annuloplasty, who initially was admitted to after she presented to ed with persistent bleeding following l tooth extractions and posterior superior palate i and d. patient initially had inr elevated to 2.1 secondary to warfarin use for atrial fibrillation. in ed ent was consulted and pt was packed to help control bleeding. her inr was reversed with vitamin k, 2 units ffp and her inr now is 1.1. she was hypotensive with sbp in 80's on admission and was admitted to the icu. hct was 21 on admission (baseline 30) and the patient required 3 units of prbcs on . her hct has been stable at 28-29 x more than 24 hours and she was called out from the icu today. . pt currently denies any feelings of light-headedness, no chest pain or difficulty breathing. denies pain in her mouth, no recent fevers or chills. further ros negative. past medical history: - mvr in , , last with bioprosthetic valve - severe pulmonary htn - tr - right-sided heart failure - chronic af - cva x 2 - htn - mild renal insuff, hyperkalemia - anemia - last c-scope >10 years ago - had a few polyps removed - aorto-femoral bypass - last echo : ef >65%, mild lvh, severe pulmonary htn and (4+) tr, 1+ mr/ar. social history: lives alone, children nearby. 6 children and 12 grandchildren. born in but moved to the us at a young age. denies tob, etoh, ivdu. walks with a cane. family history: n/c physical exam: gen: awake, alert, thin, nad heent: atraumatic, anicteric, gauze in mouth, no active bleeding neck: no lad, no jvp cv: holosystolic murmur heard throughout, irregularly irregular lungs: mild crackles at bases, good air movement, no accessory muscle use abd: soft, nt, non-distended, nabs ext: warm, dry. trace edema b/l, chronic venous stasis pigmentation changes. some eccymoses on ue neuro: a/o x3, answers questions appropriately, follows commands pertinent results: 10:50am pt-24.6* ptt-35.8* inr(pt)-2.5* 10:50am wbc-4.8 rbc-3.54* hgb-10.0* hct-29.8* mcv-84 mch-28.4 mchc-33.7 rdw-16.6* 10:40pm pt-26.6* ptt-35.7* inr(pt)-2.7* 10:40pm wbc-4.9 rbc-3.24* hgb-9.0* hct-27.1* mcv-83 mch-27.7 mchc-33.2 rdw-16.6* 10:40pm glucose-120* urea n-90* creat-2.5* sodium-134 potassium-4.5 chloride-96 total co2-27 anion gap-16 06:07am fibrinoge-304 06:07am neuts-75.7* lymphs-14.3* monos-7.3 eos-1.9 basos-0.8 06:07am wbc-3.1* rbc-2.54* hgb-7.1* hct-21.3* mcv-84 mch-28.2 mchc-33.5 rdw-16.6* 06:07am calcium-9.1 phosphate-4.1 magnesium-2.7* 06:07am glucose-93 urea n-91* creat-2.3* sodium-137 potassium-4.5 chloride-100 total co2-31 anion gap-11 09:40am hct-22.8* 07:34pm hct-28.4* . chest (portable ap) 2:39 am findings: there is stable cardiomegaly. elevation of right hemidiaphragm persists. there is chronic pleural thickening on the right, with right basilar atelectasis and small pleural effusion present. there are no consolidations. pulmonary vascularity is normal. impression: no radiographic evidence of congestive heart failure. right chronic pleural thickening. small right-sided pleural effusion, probably unchanged. right basilar atelectasis. . ekg- hr 86 probable atrial fibrillation with multifocal pvcs or aberrant ventricular conduction right axis deviation right bundle branch block low qrs voltages in limb leads . chest (pa & lat) 1:56 pm bilateral pleural effusions and bibasilar atelectasis. pneumonia is not excluded. cardiomegaly, unchanged. mild kyphotic angulation at a mid thoracic level. finding may be better assessed with dedicated thoracic spine radiographs, if clinically indicated. no fracture is seen. brief hospital course: 79 yo female with h/o a atrial fibrillation, s/p bioprosthetic mitral valve replacement, admitted with post-op bleeding following dental extraction and palate i and d two days prior to the admission in the setting of being anticoagulated (inr in therapeutic range). . # bleeding: post-op due to anticoagulation with warfarin use for atrial fibrillation. bleeding started on , increased in ed packed and pressure applied. inr 2.7, and hematocrit 27, sbp in the 80's to 90's. hematocrit lowest at 21 on admission. bleeding from posterior palate incision and drainage site. bleeding resolved with no events in the icu. hd stable. last transfusion on . received 2 units of ffp, one unit of prbc, fluid boluses and vitamin k. to medicine floor at hematocrit stable , but that night encountered bleeding from i&d site, afrin spray applied and pressure with resolution, no prbc's given, hematocrit 27.7. no further bleeding during course of admission. coumadin restarted as per instruction with dr. , and dr. . 3 mg initial dose, given risk for stroke in patient with a-fibb. as per wishes of patient and family, patient remained in house until incision site appeared healed, inr increased and no evidence of bleed. discharged with follow-up by cardiology and her oral surgeon. clindamycin 450 po q6 for abscess stopped after iv then po course for 10 days. coumadin increased to 5 mg on discharge. . # atrial fibrillation: rate control with beta-blocker. continue statin/ beta-blocker. held coumadin until when restarted given decreasing concern of rebleed. in discussion with dr. , pt's cardiologist in regards to anticoagulation. . # chf: ef >65% in 1/. continued beta-blocker. restarted per outpatient dose 4 days into admission. had been held in micu given hypotension. fluids also given. held aldactone during admission given elevated potassium and hypotension. with increasing work of breathing 3 days prior to discharge, evidence of increasing overload on cxr, given. pt stable on 40 po and resuming 25 aldacton at discharge with follow-up in the heart failure clinic. . # hypotension: likely secondary to hypovolemia. fluids given on admission. stopped as evidence of overload. baseline low normal. . # cri: creatinine slowly trending up. baseline ranging from 1.9-3.0. stable as baseline at discharge. continued renal diet . # fen: soft diet given abscess site tenuous for rebleed. . # contact: daughter medications on admission: 40 mg twice a day toprol-xl 25 mg daily spironolactone 50 mg daily lipitor 10 mg daily omeprazole 20 mg twice a day ferrous sulfate coumadin 2.5 mg carafate 1 gram qid discharge medications: 1. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 4. sucralfate 1 g tablet sig: one (1) tablet po qid (4 times a day). 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 6. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. spironolactone 25 mg tablet sig: one (1) tablet po bid (2 times a day). 9. coumadin 5 mg tablet sig: one (1) tablet po at bedtime: until discussion with outpatient provider. check inr in two days. disp:*10 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: bleeding from palate abcess i&d and tooth extraction site secondary: chf cri thrombocytopenia discharge condition: stable discharge instructions: you were admitted with a bleed from an incision and drainage site. youe were transfused and have not had bleeding from your mouth since . -please take all medications as you previously had in addition to the increased dose of coumadin to 5 mg pending repeat inr check and follow up with your doctor. -please check coumadin level labs, as previously had with next check in two days. -please maintain follow up appointments. -please return to the hospital if you are experiencing shortness of breath, weight gain, bleeding, chest pain, fainting, swelling or any other symptoms concerning to you. followup instructions: please follow up with dr. , unable to be reached, please call for an appointment. please have inr checked in two days, with information faxed to dr. office. via lab. contact dr. office with recs. , m.d. phone: please follow up with dr. in the heart failure clinic . they have been contact and are awaiting confirmation. please call if you have not received confirmation within one day. . please contact your oral surgeon. dr. for follow-up on abcess site, and bleed. procedure: transfusion of other serum diagnoses: thrombocytopenia, unspecified abnormal coagulation profile acute posthemorrhagic anemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation other chronic pulmonary heart diseases mitral valve insufficiency and aortic valve insufficiency chronic kidney disease, unspecified rheumatic heart failure (congestive) hemorrhage complicating a procedure long-term (current) use of anticoagulants anticoagulants causing adverse effects in therapeutic use heart valve replaced by transplant hypovolemia diseases of tricuspid valve cellulitis and abscess of oral soft tissues 

Answer: The patient is high likely exposed to