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: the patient is a 45 year old female, being anticoagulated with coumadin, status post mitral valve replacement, #27 carbomedics in . she presented to the emergency department with one day history of abdominal pain and bright red blood per rectum. the patient usually takes 7 mg of coumadin during the week days and 9 mg of coumadin on the weekends, as per husband who administers her medications. reportedly, she had an inr of 3.2 ten days prior to admission. one day prior to admission, the patient started having crampy abdominal pain, mostly in the left lower quadrant. pain was non radiating but progressively worsened in intensity. since the beginning of the abdominal pain, the patient reports having passed three bloody bowel movements with visible clots in the toilet. the patient denies fevers, chills, sweats or any other systemic symptoms. past medical history: rheumatic heart disease with mitral stenosis and mitral regurgitation, status post mitral valve replacement in , with 27 mm carbomedics mitral valve (mechanical). asthma. hypercholesterolemia. anxiety. panic disorder. history of poly substance abuse, including alcohol and cocaine. disease. past surgical history: mitral valve replacement in as mentioned above. tubal ligation. allergies: the patient reports allergic reaction to penicillin and aspirin. medications at home: lipitor 20 mg p.o. q. day. coumadin regular home regimen of 7 mg on week days and 9 mg p.o. q. day on weekends, although the history is not clear whether the patient had been taking mostly 9 mg p.o. q. day prior to admission. zyprexa 5 mg p.o. q h.s. clonidine 0.1 mg p.o. q h.s. trazodone 150 mg q h.s. proventil mdi inhaled twice a day. calcium, vitamin d and vitamin c. social history: significant for prior abuse of cocaine and alcohol. the patient reports continuing one pack per day history of smoking. physical examination: temperature of 98.4; heart rate of 94; blood pressure of 105/86; respiratory rate of 16; 96% on room air. the patient was alert and oriented times three and not in apparent distress. head, eyes, ears, nose and throat: within normal limits. cardiovascular examination: regular rate and rhythm with s1 and s2, 3/6 systolic murmur, consistent with history of mitral valve replacement. respiratory examination: clear to auscultation bilaterally. abdominal examination with bowel sounds soft, diffusely tender. abdomen with worse pain and tenderness in the left lower quadrant with rebound and guarding. there was no rigidity. extremities were warm and well perfused without edema. laboratory data: white blood cell count of 10.2; hematocrit of 41.9; platelets of 202. pt was 100; ptt was 82.3 with inr of 112.3. chemistries were 143, potassium of 3.6; chloride 105; c02 of 27; bun of 10 and creatinine of 0.6; glucose of 125. ast was 59; alt was 28; alkaline phosphatase was 83; total bilirubin was 0.4; amylase 71 and lipase of 37. urinalysis showed large amounts of blood in the urine. ct scan of the abdomen showed a 10 cm segment of the proximal sigmoid colon with low attenuation signal within the sigmoid wall. there were also several small diverticula noted within the sigmoid colon. there was minimal stranding in the adjacent fat and trace amount of free fluid within the pelvis. these readings were consistent with intramural hemorrhage of the sigmoid colon. hospital course: because of the significantly elevated inr of 112.3, the patient was urgently given two units of ffp, 10 mg of vitamin k p.o., and one dose of factor vii, (2,400 units) while in the emergency department. the patient was followed closely with serial hematocrit checks and serial inr checks. the gastrointestinal service and the surgery service were called for urgent consultation. it was decided that the patient should be admitted to the surgical intensive care unit for management of the anticoagulation. within a span of six hours of the treatment for the elevated inr while in the emergency department, the patient's inr came down to a level of 2.2 and, in the next two hours, the inr dropped down to 0.6. given the mechanical valve, the patient was urgently started on heparin drip without a loading bolus. the patient was started on 18 units per kg per hour which translates to 800 units per hour, with a goal ptt of 60 to 80. however, the patient's ptt rose up to 120 after six hours of treatment on heparin drip at 800 units per hour and the heparin was held for one hour and restarted at 700 units per hour. serial check of the pt, ptt and hematocrit with subsequent adjustment in the heparin drip stabilized the patient at an acceptable ptt level, within the goal of 60 to 80 and the hematocrit remained stable. (it should be noted that while the patient had a hematocrit of 41.9 on admission, recheck of the hematocrit nine hours later showed hematocrit of 34.8 and, with proper resuscitation, the patient's hematocrit dropped to 30.5 on hospital day number two and this was monitored in the intensive care unit and the hematocrit remained stable and increased slightly while being observed in the intensive care unit. thus, the hematocrit was deemed to be stable and there were no suspicions that the patient was continuing to bleed.) at the end of hospital day number two, with documented evidence of stable hematocrit as explained above, and proper anticoagulation on heparin drip, the patient was transferred to the floor. while on the floor, the patient was maintained n.p.o. because she had not passed flatus during the two days of her hospital stay to that point. there was a question whether or not the sigmoid intramural hematoma may be causing an obstruction. it was thought to possibly be causing an obstruction. the patient underwent a hypaque enema on hospital day number five to rule out obstruction and the hypaque enema did not show any obstructing lesion. given the stable nature of the patient, the patient was started on p.o. which she tolerated without any difficulty and without any episode of bright red blood per rectum. the patient's coumadin had been held for three days by hospital day number five and, in discussion with the patient's primary care physician, the at which the patient is followed up, the patient was restarted on coumadin of 7 mg. the patient's inr which had drifted down to 0.6 with the quick reversal at the emergency department on the day of admission, slowly increased with the depletion of the factor vii infusion which had been given on hospital day number one. on the day of discharge, on hospital day number six, the inr was 2.5. the patient was discharged home with coumadin schedule of 7 mg p.o. q h.s. during week days and the weekends. the patient was instructed to follow-up on the day after discharge at the for check of the inr. on the day of discharge, the patient was tolerating a regular diet, without any difficulty, without any episodes of bright red blood per rectum. discharge condition: discharged to home. discharge diagnoses: sigmoid hematoma, secondary to over anticoagulation, status post mitral valve replacement. discharge medications: the patient is to continue all her preadmission medications as ordered by her primary care physician, the exception of coumadin and the patient is to take 7 mg p.o. q h.s. daily. follow-up: the patient is to be seen at the on the day after discharge, on for check of her inr. the patient is to see dr. , gastroenterologist in four weeks for sigmoidoscopy and is to call for an appointment date and time. the patient is to see dr. of gastrointestinal surgery in six weeks for surgical consult and will call his office for appointment date and time. the patient needs to see her primary care physician, . , within the next one or two weeks. the patient can follow-up with dr. as needed. , m.d. dictated by: medquist36 procedure: arterial catheterization transfusion of other serum diagnoses: abnormal coagulation profile pure hypercholesterolemia asthma, unspecified type, unspecified heart valve replaced by other means osteoporosis, unspecified long-term (current) use of anticoagulants hemorrhage of gastrointestinal tract, unspecified rheumatic heart disease, unspecified panic disorder without agoraphobia 

Answer: The patient is high likely exposed to