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 attending: chief complaint: shortness of breath major surgical or invasive procedure: mitral valve replacement w/ 25/33 on-x valve, maze procedure, ligation history of present illness: 56 y/o female with h/o dm, htn and mvp who presented to osh with acute shortness of breath. she underwent an echo which revealed a flail mitral valve secondary to torn chordae and an ef of 60%. she was transferred to for surgical management. also during this she developed new onset atrial fibrillation. past medical history: at transfer: mitral regurgitation w/ flail leaflet atrial fibrillation, congestive heart failure pmh: mitral valve prolapse, diabetes mellitus, hypertension, depression social history: denies smoking. mod. etoh use. family history: non-contributory physical exam: vs: 90af 141/89 18 96%ra gen: nad neck: supple, from, -jvd, -carotid bruits cv: 90 irreg with holosystolic murmur pulm: ctab abd: soft, nt/nd +bs ext: w/d -c/c/e, -varicosities, 2+ pulses throughout neuro: mae, non-focal, a&o x 3 pertinent results: cath: 1. selective coronary angiography of this right dominant system revealed no significant flow-limiting disease. the lmca, lad, lcx, and rca were all widely patent with only mild luminal irregularities. 2. resting hemodynamics revealed mildly elevated right and left heart filling pressures with a mean ra of 8mmhg and mean pcwp of 18mmhg. the pasp was 34mmhg. the cardiac index was low-normal at 2.2l/min/m2. 3. left ventriculography revealed a calculated lvef of 71% with no regional mall motion abnormalities. there was severe (4+) mitral regurgitation. echo: pre-bypass: left ventricular systolic function is hyperdynamic(ef>75%). regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the anterior mitral valve leaflet has at least two flail segments. chordae can be seen in the left atrium intermittently. there is at least moderate (2+) mitral regurgitation. there is likely more mitral regurgitation present but the jet is eccentric and posteriorly directed. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. a small secundum atrial septal defect is present with a left-to-right shunt across the interatrial septum is seen at rest. the left atrial appendage emptying velocity is depressed (<0.2m/s). no spontaneous echo contrast is seen in the left atrial appendage. no thrombus is seen in the left atrial appendage. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. there is a trivial/physiologic pericardial effusion. post-bypass: preserved -ventricular systolic function. left ventricular ejection fraction is about 55%-60%. a -leaflet mechanical prosthetic valve is seated in the mitral position. there is trace to mild mitral regurgitation which is normal for this prosthesis. no perivalvular leak is seen but image quality prevents complete exclusion. mean gradient across the mitral valve is 2.6 mm hg. no evidence of aortic dissection post de-canulation. the rest of the exam is unchanged from pre-bypass. cxr: since most recent radiograph, there appears to be improved aeration to the lower lobes bilaterally with decreased atelectasis within the retrocardiac region. a small layering left-sided pleural effusion persists with no appreciable right-sided effusion identified. a small branching linear opacity projecting over the right mid hemithorax likely represents a small area of subsegmental atelectasis and there is otherwise unchanged appearance to cardiomegaly in this patient noted to be status post median sternotomy and mitral valve repair. there is no evidence of pneumothorax or pulmonary edema. 05:46pm blood wbc-6.2 rbc-5.37 hgb-16.2 hct-47.3 mcv-88 mch-30.3 mchc-34.3 rdw-13.8 plt ct-180 07:00am blood wbc-8.2 rbc-3.21* hgb-9.8* hct-29.6* mcv-92 mch-30.6 mchc-33.3 rdw-14.7 plt ct-386# 05:46pm blood pt-12.1 ptt-84.6* inr(pt)-1.0 07:00am blood pt-20.6* ptt-116.3* inr(pt)-2.0* 05:46pm blood glucose-140* urean-19 creat-0.9 na-139 k-3.9 cl-104 hco3-24 angap-15 07:00am blood glucose-130* urean-10 creat-0.9 na-136 k-4.1 cl-99 hco3-27 angap-14 07:00am blood calcium-8.5 phos-4.4# mg-2.4 brief hospital course: admitted from osh in chf for cath which was done on . this revealed 4+ mr, and normal coronaries, ef 70%. underwent mvr ( mechanical)/maze/ligation of left atrial appendage on with dr. . transferred to the csru in stable condition on propofol, insulin, and phenylephrine drips. extubated that evening and transferred to the floor on pod #1 to begin increasing his activity level. chest tubes and pacing wires were also removed and coumadin started that evening. heparin also started until inr was therapeutic. consult obtained for management of diarrhea since starting metformin. inr 2.9 on pod #7 and heparin dced. cleared for discharge to home with vna services on . pt. is to make all follow-up appts. as per discharge instructions. target inr is 3.0-3.5 for onyx mechanical valve. first blood draw with results to dr. for coumadin dosing/management. medications on admission: mat: hep gtt, lasix, cozaar, lopressor, norvasc, aspirin, colace, prozac, riss discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 5. fluoxetine 10 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*0* 6. olmesartan 20 mg tablet sig: two (2) tablet po daily (). disp:*60 tablet(s)* refills:*0* 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 8. glimepiride 2 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 9. metformin 500 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po bid (2 times a day). disp:*60 tablet sustained release 24 hr(s)* refills:*0* 10. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day): please take 400mg twice a day until then decrease to 400mg once a day for 1 week then decrease to 200mg once a day . disp:*120 tablet(s)* refills:*0* 11. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. disp:*20 tablet(s)* refills:*0* 12. potassium chloride 10 meq capsule, sustained release sig: one (1) capsule, sustained release po q12h (every 12 hours) for 10 days. disp:*20 capsule, sustained release(s)* refills:*0* 13. warfarin 6 mg tablet sig: goal inr 3-3.5 tablets po once a day. disp:*60 tablet(s)* refills:*2* 14. warfarin 1 mg tablet sig: goal inr 3-3.5 tablets po once a day. disp:*60 tablet(s)* refills:*2* 15. outpatient work pt/inr prn goal 3.0-3.5 for onyx mitral valve first draw with results to dr office # fax ( 16. coumadin please take 6mg coumadin and - have checked and follow up with dr for further dosing discharge disposition: home with service facility: home health care discharge diagnosis: mitral regurgitation s/p mitral valve replacement atrial fibrillation s/p maze procedure congestive heart failure pmh: mitral valve prolapse, diabetes mellitus, hypertension, depression discharge condition: good discharge instructions: follow medications on discharge instructions. do not drive for 4 weeks. do not lift more than 10 lbs. for 2 months. shower daily, let water flow over wounds, pat dry with a towel. do not use lotions, powders, or creams on wounds. call our office for temp>101.5, sternal drainage. followup instructions: provider: , . follow-up appointment should be in weeks provider: appointment should be in weeks provider: , follow-up appointment should be in 1 month wound check 2 please schedule with rn pt/inr goal 3.0-3.5 for onyx mitral valve first draw with results to dr office # fax ( procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters excision or destruction of other lesion or tissue of heart, open approach open and other replacement of mitral valve diagnoses: mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation depressive disorder, not elsewhere classified insulins and antidiabetic agents causing adverse effects in therapeutic use diarrhea 

Answer: The patient is high likely exposed to