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 / diuretics / shellfish attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement 21-mm biocor epic tissue valve history of present illness: 78 year female with a history of aortic stenosis followed by serial echocardiogram. over the past several months, she has noted worsening symptoms of dyspnea with exertion and lower extremity swelling. he last echocardiogram in revealed an lvef of 55%, mild left ventricular hypertrophy and moderate to severe aortic stenosis. given the progression of her symptoms and severity of her disease, she was referred for surgical evaluation. past medical history: severe aortic stenosis nonobstructive diffuse coronary artery disease on cardiac catheterization in insulin-dependant diabetes hypertension hyperlipidemia chronic diastolic congestive heart failure chronic low back pain depression reactive airway disease face lift, cheek implants right cataract surgery cesarean sections social history: race: caucasian last dental exam: full dentures lives: alone occupation: retired tobacco use: remote, quit more than 30 years ago etoh: occasional wine, one glass per week illicit drug use: denies family history: denies premature coronary artery disease physical exam: pulse: 79 resp: 18 o2 sat: 97% b/p right: 146/56 left: 149/63 height: 61 inches weight: 190 lbs general: elderly female in no acute distress. obese skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade 4/6 sem abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: trace varicosities: none neuro: grossly intact pulses: femoral right: 1 left: 1 dp right: 1 left: 1 pt : 1 left: 1 radial right: 1 left: 1 carotid bruit: transmitted murmurs bilaterally pertinent results: echo: pre-cpb: the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. 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 descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is severe mitral annular calcification. mild to moderate (+) mitral regurgitation is seen. post-cpb: there is a bioprothetic valve in the aortic position. the valve appears well-seated with normally mobile leaflets. there are no paravalvular leaks and no ai. the lv systolic function remains normal, estimated ef>55%. there is no evidence of dissection. chest x-ray: pa and lateral chest compared to previous vascular congestion and borderline interstitial edema have cleared. cardiomediastinal silhouette has a normal postoperative appearance. lateral view shows small bilateral pleural effusions and mild to moderately severe bibasilar atelectasis. no pneumothorax. wbc-9.9 rbc-2.94* hgb-9.1* hct-26.7* mcv-91 mch-31.1 mchc-34.3 rdw-16.1* plt ct-111* wbc-5.5 rbc-2.90* hgb-9.1* hct-26.2* mcv-90 mch-31.4 mchc-34.7 rdw-16.2* plt ct-143* urean-30* creat-1.1 na-135 k-4.6 cl-98 glucose-97 urean-13 creat-1.0 na-139 k-4.8 cl-107 hco3-27 mg-2.6 brief hospital course: mrs. was a same day admit and on was brought directly to the operating room where she underwent an aortic valve replacement. please see operative note for surgical details. following surgery he was transferred to the cvicu for invasive monitoring in stable condition. within 24 hours she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was started on beta-blockers and diuretics and diuresed towards her pre-op weight. on post-op day two she was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. on post-op day three she had an episode of atrial fibrillation which converted to sinus rhythm with beta-blockers and amiodarone. she was started on coumadin for her afib. she was agressively diuresed toward her pre-op weight. she experienced post-op confusion and all narcotics were discontinued and her mental status claered. the patient was evaluated by the physical therapy service for assistance with strength and mobility amd rehab was recommended. by the time of discharge on pod #7 the patient was ambulating with assist, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to rehab in good condition with appropriate follow up instructions. medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - 1-2 puffs(s) by mouth every four (4) to six (6) hours as needed for cough/wheezing alendronate - (not taking as prescribed) - 70 mg tablet - 1 tab(s) by mouth weekly in the am with 6-8oz of plain water, do not eat, drink or lie down for 30 mins atorvastatin - 20 mg tablet - 1 tablet(s) by mouth once a day glyburide - (not taking as prescribed) - 5 mg tablet - 2 tablet(s) by mouth twice a day insulin glargine - 100 unit/ml (3 ml) insulin pen - 110 units sc once a day sertraline - 50 mg tablet - 1 tablet(s) by mouth once a day tiotropium bromide - 18 mcg capsule, w/inhalation device - 1 puff po daily torsemide - 20 mg tablet - 3 tablet(s) by mouth daily triamcinolone acetonide - (chart conversion) - 0.025 % cream - apply to affected area on back twice a day valsartan - (not taking as prescribed) - 80 mg tablet - 1 tablet(s) by mouth once a day medications - otc blood sugar diagnostic - (chart conversion) - strip - use as directed 1 time per day discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q6h (every 6 hours) as needed for bronchospasm. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. 3. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 5. glyburide 5 mg tablet sig: one (1) tablet po bid (2 times a day). 6. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 7. ranitidine hcl 150 mg capsule sig: one (1) tablet po once a day for 2 weeks. 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 9. polyethylene glycol 3350 17 gram/dose powder sig: seventeen (17) grams po daily (daily). 10. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever or pain. 11. torsemide 20 mg tablet sig: one (1) tablet po tid (3 times a day): home dose. 12. ipratropium bromide 0.02 % solution sig: one (1) neb ih inhalation q6h (every 6 hours) as needed for wheezing. 13. quetiapine 25 mg tablet sig: one (1) tablet po hs (at bedtime). 14. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day): hold for sbp <90 or hr < 55. 15. insilin sliding scale and fixed dose ( see attached) 16. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 5 days: 400 mg through . 17. amiodarone 400 mg tablet sig: one (1) tablet po once a day for 1 weeks: 400 mg daily through . 18. amiodarone 200 mg tablet sig: one (1) tablet po once a day: 200 mg daily starting ongoing. 19. potassium chloride 10 meq tablet extended release sig: two (2) tablet extended release po once a day: hold for k+ > 4.5; please recheck potassium level in days. 20. warfarin 1 mg tablet sig: daily dosing per rehab provider; dose today only is 4 mg; all further dosing per rehab; target inr 2.0-2.5 for a fib tablets po once daily at 4 pm: dose today only is 4 mg. discharge disposition: extended care facility: health care center - discharge diagnosis: severe aortic stenosis s/p aortic valve replacement past medical history: nonobstructive diffuse coronary artery disease on cardiac catheterization in insulin-dependant diabetes hypertension hyperlipidemia chronic diastolic congestive heart failure chronic low back pain depression reactive airway disease face lift, cheek implants right cataract surgery cesarean sections discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with oral analgesics incisions: sternal - healing well, no erythema or drainage edema ble 2+ discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication a fib goal inr 2.0- 2.5 first draw ***please arrange for coumadin followup prior to discharge from rehab followup instructions: you are scheduled for the following appointments surgeon: dr. on at 1:30pm cardiologist: dr. on at 11:00am primary care: dr. on at 2:30pm **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication a fib goal inr 2.0- 2.5 first draw ***please arrange for coumadin followup prior to discharge from rehab procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation acute on chronic diastolic heart failure asthma, unspecified type, unspecified aortic valve disorders personal history of tobacco use depressive disorder, not elsewhere classified other and unspecified hyperlipidemia surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of insulin long-term (current) use of anticoagulants altered mental status obesity, unspecified lumbago other sedatives and hypnotics causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to