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: tetracycline / penicillins / tape attending: chief complaint: mild shortness of breath, known as for cath prior to hip surgery major surgical or invasive procedure: cabg/avr history of present illness: 81yo woman w/known as admitted for elective cath prior to planned hip replacement. cath revealed 2vd and she was transferred to for avr/cabg prior to hip repir past medical history: afib sss s/p ppm tia's ^chol htn s/p bilat tkr s/p hyst s/p bladder susp osteoarthritis social history: retired no tobbaco, no etoh family history: non contributory physical exam: admission vs gen a+ox3, nad pulm ctab cv rrr 2/3 sem abd soft, nt/nd ext no edema palpable pulses discharge vs t99 hr82 bp131/77 rr18 o2sat 95%ra neuro a&ox3, nonfocal exam pulm cta bilat cv irreg/irreg no murmur. sternum stable, incision with steris clean and dry abdm soft, nt/nd/+bs ext warm, no edema, left leg incision with steris cdi. left groin w/steris cdi pertinent results: 05:08pm glucose-128* urea n-14 creat-0.5 sodium-139 potassium-4.5 chloride-101 total co2-29 anion gap-14 05:08pm wbc-6.6 rbc-4.12* hgb-11.8* hct-34.0* mcv-83 mch-28.5 mchc-34.6 rdw-14.8 05:08pm plt count-149* 05:08pm pt-13.9* ptt-45.9* inr(pt)-1.2* 06:25am blood wbc-8.1 rbc-3.72* hgb-11.4* hct-33.7* mcv-91 mch-30.6 mchc-33.8 rdw-16.0* plt ct-229 06:25am blood plt ct-229 06:25am blood pt-16.5* ptt-24.1 inr(pt)-1.5* 06:25am blood glucose-87 urean-15 creat-0.5 na-136 k-4.2 cl-98 hco3-31 angap-11 chest (portable ap) 1:36 pm reason: r/o ptx medical condition: 81 year old woman with cad/as s/p cabg/avr. and ct removal reason for this examination: r/o ptx chest, ap portable single view indication: elderly woman with coronary artery disease and aortic stenosis, status post bypass surgery and aortic valve replacement. now chest tube removal, evaluate for pneumothorax. findings: ap single view of the chest obtained with patient in sitting semi- upright position is analyzed in direct comparison with a preceding similar portable chest examination of . during the interval, the patient has been extubated, swan-ganz catheter and mediastinal and left-sided chest tubes have been removed. there is no evidence of pneumothorax. in comparison with the next previous portable chest examination of , the postoperative mediastinal widening and perivascular haze in the pulmonary circulation have now normalized, and the findings are very similar to those noted on the preoperative examination of . the latter includes also mild blunting of the lateral pleural sinuses. three tiny ring-shaped metallic structures apparently components of the aortic valve prosthesis remain in position. as before, rather extensive mitral ring calcifications are seen. permanent pacer in left anterior axillary position with dual electrode system unchanged. impression: normalization of postoperative changes, no evidence of pneumothorax, pulmonary congestion, or significant infiltrates. dr. cardiology report echo study date of patient/test information: indication: intraop cabg, avr, ?mvr height: (in) 63 weight (lb): 128 bsa (m2): 1.60 m2 bp (mm hg): 140/82 hr (bpm): 100 status: inpatient date/time: at 13:37 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw1-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. measurements: left atrium - long axis dimension: *4.3 cm (nl <= 4.0 cm) left atrium - four chamber length: *5.8 cm (nl <= 5.2 cm) right atrium - four chamber length: *6.2 cm (nl <= 5.0 cm) left ventricle - inferolateral thickness: *1.3 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.1 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 3.2 cm left ventricle - fractional shortening: *0.22 (nl >= 0.29) left ventricle - ejection fraction: 50% to 60% (nl >=55%) left ventricle - peak resting lvot gradient: 1 mm hg (nl <= 10 mm hg) aorta - valve level: 2.7 cm (nl <= 3.6 cm) aorta - ascending: 3.0 cm (nl <= 3.4 cm) aorta - arch: 2.2 cm (nl <= 3.0 cm) aorta - descending thoracic: *2.6 cm (nl <= 2.5 cm) aortic valve - peak velocity: *2.3 m/sec (nl <= 2.0 m/sec) aortic valve - peak gradient: 43 mm hg aortic valve - mean gradient: 36 mm hg aortic valve - valve area: *0.6 cm2 (nl >= 3.0 cm2) mitral valve - peak velocity: 1.0 m/sec mitral valve - mean gradient: 2 mm hg mitral valve - pressure half time: 92 ms mitral valve - mva (p t): 2.4 cm2 mitral valve - e wave: 1.0 m/sec interpretation: findings: left atrium: mild la enlargement. elongated la. right atrium/interatrial septum: moderately dilated ra. no asd or pfo by 2d, color doppler or saline contrast with maneuvers. left ventricle: low normal lvef. right ventricle: mildly dilated rv cavity. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. no atheroma in ascending aorta. normal aortic arch diameter. complex (>4mm) atheroma in the aortic arch. mildly dilated descending aorta. simple atheroma in descending aorta. aortic valve: three aortic valve leaflets. severe as (aova <0.8cm2). no ar. mitral valve: moderately thickened mitral valve leaflets. severe mitral annular calcification. no ms. moderate (2+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. no pr. pericardium: trivial/physiologic pericardial effusion. conclusions: pre bypass: the left atrium is mildly dilated. the left atrium is elongated. the right atrium is moderately dilated. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricular cavity is mildly dilated. there are complex (>4mm) atheroma in the aortic arch. the descending thoracic aorta is mildly dilated. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. there is severe aortic valve stenosis (area <0.8cm2). no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is heavy mitral annular calcification. the posterior leaflet is partially calcified. moderate (2+) mitral regurgitation is seen. post bypass: preserved biventriular function. lvef 55%. there is a bioprosthetic valve in the aortic position. no perivalvular leaks or ai. peak gradient 10 mm hg. aortic contours are intact. mitral regurgitation is unchanged. remaining exam is unchanged. all findings discussed with surgeons at the time of the exam. electronically signed by , md on 19:27 brief hospital course: patient admitted preoperatively to bridge from coumadin and be covered with heparin. on she was brought to the operating room where she had avr/cabg, please see the or report for details. in summary she had avr(#23 tissue)cabgx2(lima-lad,svg-plv), her bypass time was 85 min with crossclamp time of 68 min. she tolerated the surgery well and was transferred to the ct icu in stable condition. she did well in the immediate post-op period but did require nipride for bp control. on pod1 she started on bblockers and ace and weaned from nipride. on pod2 her chest tubes and temporary pacer wirews were removed, her internal pacer was interegated and she was transferred from the icu to the step down floor. she did well over the next several days and on pod6 it was decided she was stable and ready to be discharged to rehabilitation medications on admission: cartia xt 120' toprol xl 12.5' klonopin 0.5@hs lexapro 15 @hs fosamax 35 qwk coumadin fish oil 200' vit c 1500' biotin 1200buid coenzyme q 100''' magnesium 200" discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po once a day for 2 weeks. 2. potassium chloride 10 meq tablet sustained release sig: two (2) tablet sustained release po once a day for 2 weeks. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. warfarin 1 mg tablet sig: as directed tablet po daily (daily): target inr 1.5-2. 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. 7. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 8. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 9. escitalopram 10 mg tablet sig: 1.5 tablets po qhs (once a day (at bedtime)). 10. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). 11. warfarin 3 mg tablet sig: one (1) tablet po once: dose for . 12. fosamax 35 mg tablet sig: one (1) tablet po once a week. discharge disposition: extended care facility: rehab unit at - discharge diagnosis: as/cad s/p avr(#23 mosaic)cabgx2(lima-lad,svg-plv) pmh: afib, sss s/p ppm, tia's, ^chol, htn, s/p bilat tkr, s/p bladder susp, s/p hyst, osteoarthritis discharge condition: good discharge instructions: keep wounds clean nad dry. ok to shower, no bathing or swimming. take all medication as prescribed. call for any fever, redness or drainage from wounds. followup instructions: dr 3-4 weeks after discharge from rehab dr in 4 weeks. pt to call for appt procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of one coronary artery open and other replacement of aortic valve with tissue graft transfusion of packed cells artificial pacemaker rate check diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified essential hypertension atrial fibrillation mitral valve insufficiency and aortic valve stenosis 

Answer: The patient is high likely exposed to