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: patient recorded as having no known allergies to drugs attending: chief complaint: lightheadedness/fatigue major surgical or invasive procedure: - avr (19mm on-x mechanical valve) history of present illness: this is a 77-year-old female who had been followed for approximately one year for known aortic stenosis and recently had undergone increasing shortness of breath and exertional dyspnea. recent echocardiogram showed and of 0.6 as well as 1 to 2+ mr and an ef of 55%. the patient has a history of atrial fibrillation and also had a previous recent ct of the chest which revealed calcifications throughout her ascending aorta. based on all of these findings, the patient was to undergo an aortic valve replacement as well as possibility of the ascending aorta replacement. past medical history: pmh: -severe aortic stenosis (ao valve area 1.0) -afib -htn -gerd -thyroid nodules -cholesterol embolus to eye -peripheral neuropathy -degenerative joint disease -chronic bilateral pleural effusions psh: -tonsillectomy -d+c nkda social history: the patient does not smoke or drink currently. she is retired. she has a past 45 packyear history of smoking family history: significant for cancer: tissue of origin is unkown. physical exam: general: well developed, well nourished, and in no acute distress. heent: sclerae anicteric. lymphatics: lymph node survey was negative. lungs: clear to auscultation on right, diminished bs on left base. heart: irregularly irregular with a harsh 3/6 systolic ejection murmur. there were no gallops. abdomen: soft and nondistended and without palpable masses. there was no appreciable ascites. extremities: without edema. nonpalpable dp pulse bilaterally. neuro: nonfocal pertinent results: echo pre bypass: there is severe symmetric left ventricular hypertrophy. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. there are simple atheroma in the ascending aorta. there are complex (>4mm) atheroma in the aortic arch and the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. post bypass: a prosthetic aortic valve is in place with no leak and no i. trace mr. systolic fxn. aorta intact. other parametes as pre-bypass. cxr worsened bilateral pleural effusions, right greater than left. no pneumothorax appreciated. picc line placement uncomplicated ultrasound and fluoroscopically guided double lumen picc line placement via the right basilic venous approach. final internal length is 37 cm, with the tip positioned in the distal svc. the line is ready for use. brief hospital course: mrs. was admitted to the on . she was taken directly to the operating room where she underwent an aortic valve replacement with a 19mm on-x valve. please see operative note for details. postoperatively she was taken to the intensive care unit for monitoring. by postoperative day one, she had awoke neurologically intact and was extubated. aspirin and beta blockade were resumed. she went back into atrial fibrillation and amiodarone was started. coumadin was started for anticoagulation. she was then transferred to the step down unit for further recovery. she was gently diuresed towards her preoperative weight. the physical therapy service was consulted for assistance with her postoperative strength and mobility. heparin was started as a bridge to coumadin as her inr was subtherapeutic. as she had difficult venous access, a picc line was placed for blood draws. mrs. continued to make steady progress and was discharged home on . dr. will manage her coumadin dosing as an outpatient. she will follow-up with dr. and her cardiologist as an outpatient. medications on admission: toprol 100a/50p, coumadin 4', lasix, verapamil, lisinopril, protonix, levoxyl discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*30 capsule(s)* refills:*0* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 4. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 5. amiodarone 200 mg tablet sig: two (2) tablet po once a day for take 400mg once daily until . starting , take 200mg daily until otherwise instructed. months: take 400mg once daily until . starting , take 200mg daily until otherwise instructed. disp:*35 tablet(s)* refills:*0* 6. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*90 tablet, delayed release (e.c.)(s)* refills:*0* 7. toprol xl 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*0* 8. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po at bedtime. disp:*30 tablet sustained release 24 hr(s)* refills:*0* 9. furosemide 20 mg tablet sig: two (2) tablet po bid (2 times a day): 40 mg x 7 days, then 20 mg daily. disp:*120 tablet(s)* refills:*0* 10. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po bid (2 times a day): 20 meq x 7 days then 20 meq daily. disp:*120 capsule, sustained release(s)* refills:*0* 11. coumadin 5 mg tablet sig: one (1) tablet po once a day: take as instructed by dr. for a target inr of 2.5-3.0 for atrial fibrillation and a mechanical aortic valve. first blood draw . disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: as htn gerd thyroid nodules cholesterol emboli to left eye neuropathy atrial fibrillation cad pvd djd discharge condition: stable discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month. 7) take coumadin as directed by dr. . goal inr 2.5-3.0. please have blood checked at office lab on in the morning. . likely daily dose will be 4 or 5mg daily. 8) take lasix 40mg once daily and potassium 20meq once daily for 7 days then stop. 9) call with any questions or concerns. followup instructions: follow-up with dr. in 1 month. ( follow-up with cardiologist dr. in weeks. ( please follow-up with pcp . for pt/inr blood draw for coumadin dosing and in 2 weeks for a routine postoperative appointment. 2 wound clinic in 2 weeks. ( please call all providers for appointments. procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve diagnoses: esophageal reflux unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders 

Answer: The patient is high likely exposed to