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: past medical history: 1. rheumatic fever at age 18. 2. hypertension. 3. palpitations. medications: 1. protonix. 2. hydrochlorothiazide. 3. digoxin. 4. toprol. 5. verapamil. 6. history of coumadin, currently on lovenox. allergies: keflex. past surgical history: 1. fracture of tibia and fibula on the right. 2. vaginal hysterectomy for prolapse. physical examination: on admission in general the patient was an elderly woman in no acute distress. vital signs were stable, afebrile. heent: atraumatic, normocephalic, extraocular movements intact, pupils were equal, round, and reactive to light, anicteric. neck: supple, midline, without masses or lymphadenopathy. chest: clear to auscultation bilaterally. cardiovascular: regular rate and rhythm with a 2-3/6 systolic ejection murmur. abdomen: soft, nontender, nondistended, without masses or organomegaly. extremities: warm, noncyanotic, nonedematous x 4. neurological: grossly intact. laboratory data: complete blood count was 7.1/11.8/34.2/238. inr 1.2. urinalysis was negative. chemistries were 140/4.0/100/30/16/0.9/144. alt 57, ast 31, alkaline phosphatase 56, total bilirubin 0.7, albumin 3.6. type and screen was performed. hospital course: the patient was admitted for replacement of her atrial and mitral valves. she has a history of atrial fibrillation and a maze procedure was planned at the same time. on the patient was taken to the operating room for aortic valve replacement, mitral valve replacement, left atrial maze performed with 23 and 27 mm - valves respectively. the patient tolerated the procedure well and without complication. the patient was taken to the csru postoperatively for closer monitoring. on postoperative day zero the patient was extubated without incident. the patient did have a burst of supraventricular tachycardia and went into atrial fibrillation. the patient was attempted to be cardioverted electrically but failed. the patient was transferred to the floor later on postoperative day number two. on postoperative day three the patient's pacing wires were removed and the patient began anticoagulation for underlying atrial fibrillation. the remainder of her hospital stay was largely unremarkable with the exception of a short nine-beat run of ventricular tachycardia which occurred on the evening of postoperative day four. the ep service was consulted who recommended only beginning amiodarone 400 mg q.d. and anticoagulation. they also recommended sending the patient home on of hearts holter monitor, probable electric cardioversion in one month's time. from that point on, the patient had an unremarkable hospital stay where she remained in atrial fibrillation but was asymptomatic. she was awaiting therapeutic anticoagulation. ultimately, the patient was discharged on postoperative day number nine, status post her aortic valve replacement, mitral valve replacement and maze procedure, tolerating a regular diet with adequate pain control and p.o. pain medications and with a therapeutic inr of 2.0. the patient remained in atrial fibrillation. discharge condition: good. disposition: to home. diet: cardiac. medications: 1. coumadin 3 mg q.d. 2. percocet 5/325 1-2 tablets q. four hours p.r.n. 3. colace 100 mg b.i.d. 4. peri-colace 30/100 mg b.i.d. p.r.n. 5. aspirin 325 mg q.d. 6. amiodarone 400 mg q.d. 7. lasix 20 mg b.i.d. x 7 days. 8. potassium chloride 20 meq q.d. x 7 days. 9. lopressor 50 mg b.i.d. fop: the patient is to continue following up with her primary care physician, . for weekly inr checks. he is her primary care physician and should adjust her coumadin appropriately for a goal inr of between 2 and 3. the patient will be sent home with of hearts holter monitor with transmissions to dr. for follow up. the patient will have a probable cardioversion attempt in one month. the patient should follow up within 1-2 weeks with her cardiologist and address the need for diuretics as well as adjusting her cardiac medications at that time. the patient should follow up with dr. in approximately four weeks. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery other electric countershock of heart open and other replacement of aortic valve with tissue graft open and other replacement of mitral valve with tissue graft other operations on heart and pericardium diagnoses: unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation paroxysmal ventricular tachycardia mitral valve insufficiency and aortic valve stenosis 

Answer: The patient is high likely exposed to