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: history of present illness: briefly, this is a 79 year old woman with a previous history of scarlet fever status post - mitral valve for mitral stenosis in . at the time of her surgery, she was found to have normal coronaries with normal aortic valve. she also had a history of atrial fibrillation which had been managed on coumadin. in the past year, she had been complaining of fatigue and increasing shortness of breath while walking and exertion. she denied any chest pain, palpitations, dizziness or syncope. echocardiogram revealed biatrial enlargement, severe aortic stenosis with an aortic valve area of 0.6 centimeters, concentric left ventricular hypertrophy with normal left ventricular function, moderate tricuspid regurgitation and moderate pulmonic regurgitation. the patient was taken to the cardiac catheterization laboratory for evaluation of her aortic valve as well as evaluation of her coronary arteries. past medical history: 1. scarlet fever. 2. atrial fibrillation. 3. prior transient ischemic attacks with mild carotid disease noted on recent testing. 4. hypertension. 5. high cholesterol. 6. obstructive pulmonary disease noted on chest x-ray. past surgical history: 1. hernia repair. 2. mitral valve replacement. 3. elbow surgery. allergies: she had no known drug allergies. medications on admission: 1. aspirin 81 mg p.o. q. day. 2. lipitor 10 mg p.o. q. day. 3. toprol 100 mg p.o. twice a day. 4. coumadin 2.5 mg monday through saturday and none on sunday. 5 fosamax one tablet a week. laboratory: on admission white blood cell count was 9.1, hematocrit was 38.0 and her platelets were 299. her sodium was 140, potassium of 4.8, chloride 104, bicarbonate of 29, bun of 24, creatinine 1.1 with an inr of 1.3. physical examination: on physical examination, the patient was afebrile and her vital signs were stable. her lungs were clear to auscultation bilaterally. her neck was supple with no jugular venous distention. her heart was irregularly irregular with a loud systolic ejection murmur. hospital course: the patient was taken to the cardiac catheterization laboratory and cardiac surgery consultation at that time. the patient was taken to the operating room on , where an aortic valve replacement was done using a 19 centimeter pericardial valve. the patient was transferred to the csru postoperatively where she did well. she was slowly weaned from her ventilator and extubated, all of her drips of epinephrine and nitroglycerin were stopped. the patient was started on beta blockers and lasix at that time. the patient was transferred to the floor postoperatively where she continued to improve. on postoperative day number two her chest tubes were removed and her wires were removed. the patient was started back on her coumadin for her atrial fibrillation and a chest x-ray was done which was normal, however, showed a slightly enlarged heart on x-ray. physical therapy was consulted at this time for testing of ambulation and it was felt that the patient could possible be able to be discharged home. the patient continued to improve and coumadin was continued at her regular dose and was followed, and her inr was slowly increased. the patient did well with physical therapy and it was felt that that time that the patient could be discharged home when medically cleared. a cardiac echo performed showed normal lv function and good aortic and mitral prosthetic valve function. discharge medications: 1. aspirin 81 mg p.o. q. day. 2. albuterol one nebulizer q. six hours p.r.n. 3. lipitor 10 mg p.o. q. day. 4. coumadin 2.5 mg p.o. q. h.s. times six days a week. 5. percocet one to two tablets p.o. q. four hours p.r.n. 6. zantac 150 p.o. twice a day. 7. colace 100 mg p.o. twice a day. 8. 20 meq p.o. twice a day. 9. lasix 20 mg p.o. twice a day. 10. lopressor 25 mg p.o. twice a day. condition on discharge: the patient is discharged home in stable condition. discharge instructions: 1. she is instructed to follow-up with dr. in four weeks. 2. she is instructed to follow-up with her primary care physician in one to two weeks. 3. to follow-up with cardiology in two to four weeks. discharge diagnoses: 1. scarlet fever. 2. atrial fibrillation. 3. mitral valve regurgitation status post mitral valve repair. 4. aortic stenosis status post aortic valve repair. 5. prior transient ischemic attacks. 6. hypertension. 7. high cholesterol. 8. chronic obstructive pulmonary disease on chest x-ray. the patient is discharged home in stable condition. please see addendum for any changes in medications and correct discharge date. , m.d. dictated by: medquist36 d: 22:10 t: 05:02 job#: 1 1 1 dr procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures open and other replacement of aortic valve with tissue graft diagnoses: pure hypercholesterolemia unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation heart valve replaced by transplant rheumatic aortic stenosis 

Answer: The patient is high likely exposed to