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: ms. is a 79 year old woman with a history of hypertension, atrial fibrillation, copd who was admitted to the cardiothoracic surgery service after transfer from an outside hospital. she presented to the outside hospital with substernal chest pain with radiated to her left arm and left leg. this was associated with dyspnea. on admission, she denied nausea, vomiting, diaphoresis, abdominal pain, hemoptysis or any pain on inspiration. she was given nitroglycerin sublingual tablets at an outside er after which her symptoms resolved. an ekg done at this time reportedly showed atrial fibrillation without any ischemic changes. she was subsequently worked up at an outside hospital with an echocardiogram that showed an ejection fraction of 55 percent, moderately severe mitral regurgitation, aortic insufficiency and severe tricuspid regurgitation. given these findings, she was transferred to the cardiac service at for further workup. past medical history: atrial fibrillation. hypertension. tobacco use. motor vehicle accident eight years ago. medications on admission: coumadin 4 mg po qhs, lisinopril 40 mg po qd, atenolol 50 mg po bid, norvasc 5 mg po qam, lasix 20 mg po qd. allergies: no known drug allergies. social history: she was a former smoker quitting eight years ago, denies alcohol, denies drugs and lives at home with husband and moderately physically active at baseline. family history: there was no family history of premature coronary events or sudden death. review of systems: positive for heartburn and intermittent symptoms of reflux and otherwise negative. physical examination: on admission, the temperature was 98.8, pulse 80, blood pressure 130/64, respirations 20, o2 sat 95 percent on 4 liters nasal cannula. heent examination shows extraocular muscles were intact and pupils were equal, reactive to light and accommodation. neck exam - supple, nontender, no jvd. chest exam was clear to auscultation bilaterally. cardiac examination - regular rate and rhythm with s1 and s2. abdominal exam - soft, nontender, nondistended. extremities - no clubbing or edema. neurologic exam - alert and oriented times three. pertinent laboratory and other tests: echocardiogram in shows moderately dilated left atrium with a small secundum atrial septal defect, left ventricular systolic function of 55 percent, moderately dilated ascending aorta with a mobile density in the ascending aorta consistent with an intimal flap/aortic dissection extending up to the aortic arch, moderate to severe aortic regurgitation, mild mitral regurgitation, moderate tricuspid regurgitation, mild pulmonary artery systolic hypertension and a large pleural effusion. summary of hospital course: ms. was transferred to after she presented to an outside hospital complaining of chest pain radiating to her left arm. on arrival to the on the cardiac surgery service, she received a consultation from the cardiology service. her initial evaluation included an echocardiogram which showed the results noted above. given her dissection and mitral aortic and tricuspid valve disease, her condition was felt to be grave and options for surgery were discussed with her and the family. when the risks for surgery were discussed with the patient, she initially did not want the procedure. however, she changed her mind while she was in the coronary care unit. she received a cardiac catheterization at this time which showed one vessel coronary artery disease, severe aortic regurgitation and severe mitral regurgitation. she had a type i aortic dissection. after her catheterization, she was sent back to the coronary care unit for further medical management. extensive discussions were held with the patient and the family given the severity of her situation. she was quoted a mortality rate of 20-30 percent for repair of her ascending aortic dissection and her valves. after much thought, the patient agreed to the surgery and she was prepared for surgery on the . on the morning of , she was taken to the operating room and received repair of her ascending aorta with a 30 cm gelweave graft and aortic valve replacement with a 23 mm ce-magna pericardial valve and a mitral valve replacement with a 29 mm mosaic porcine valve. in the operating room, she had a cardiopulmonary bypass time of 262 minutes, cross clamp time of 215 minutes and circulatory arrest time of 29 minutes. she was admitted to the cardiac intensive care unit for her postoperative care. her postoperative care initially was consistent with a slow recovery. she was kept intubated until postoperative day 2 and slowly weaned off her ventilator. initially, she required support by milrinone for her hemodynamics. this pressor was weaned off slowly by postoperative day 3. after extubation, she was neurologically intact and was started on lasix for diuresis and heparin for anticoagulation. her platelet count was noted to decrease to the level of 87 and her heparin was stopped and she was started on coumadin. an hrt panel was sent which was negative. her chest tubes were removed on postoperative day 4 and her physical activity was increased from bed to chair as she continued to stay in the cardiac intensive care unit for adequate blood pressure control. she developed atrial fibrillation around day 3 for which she received beta blockers and weight control. on the night of postoperative day 6 and morning of postoperative day 7, ms. was in the cardiac intensive care unit in her usual condition, maintaining her usual hemodynamics. at this time, she was found to have an acute episode of bradycardia for a few seconds followed by lack of consciousness and blood pressure. an acls protocol was initiated and all efforts including epinephrine, atropine, cpr, attempt at pacing were tried. despite more than 30 minutes of active resuscitation, ms. failed to show any signs of perfusion. at this time, she was pronounced dead at 2:16 a.m. on . the family was made aware of her demise and a consent was obtained for a postmortem examination per family's request. condition on discharge: death on . discharge status: death. discharge diagnoses: cardiopulmonary arrest resulting in death. coronary artery disease. cardiac valvular disease. hypertension. copd. ascending aortic dissection. ascending aortic dissection repair, aortic valve replacement and mitral valve replacement. follow up: the patient's family has been notified of patient's demise with senior cardiac service team present at bedside. , m.d. 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 resection of vessel with replacement, thoracic vessels open and other replacement of mitral valve with tissue graft suture of artery cardiopulmonary resuscitation, not otherwise specified diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation mitral valve insufficiency and aortic valve insufficiency rheumatic heart failure (congestive) abdominal aneurysm without mention of rupture dissection of aorta, thoracic diseases of tricuspid valve 

Answer: The patient is high likely exposed to