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: dyspnea on exertion major surgical or invasive procedure: 1. mitral valve replacement with a 27-mm st. epic bioprosthesis, reference number , serial number . 2. resection of left atrial appendage. 3. repair transected/avulsed azygos vein. history of present illness: 82 year old female with known mitral regurgitation followed by serial echocardiograms. her most recent echocardiogram revealed now severe mitral regurgitation. she has noted peripheral edema which has worsened over the past year. she underwent a cardiac catheterization in preparation for surgery which showed no significant coronary artery disease. she is referred today for evaluation for mitral valve surgery. past medical history: atrial fibrillation (presented 5-7 years ago) mitral regurgitation hypertension past surgical history: bilateral tkr resection of left arm basal cell cancer hammer toe surgery social history: lives with: husband. , ma occupation: retired tobacco: never etoh: social/rare use family history: mother and father died of heart disease in their 70's/80's. sister with heart disease in her 70's. physical exam: pulse: 82 af resp: 18 o2 sat: 95% b/p right: 144/60 left: height: 64" weight: 156 general: 82 yo in nad skin: warm dry intact heent: ncat perrla eomi neck: supple full rom no jvd chest: lungs clear bilaterally heart: irregular rhythm, nls1-s2, iii/vi holosystolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused 1+ le edema varicosities: left below knee with varicosities. mild rle varicosities. neuro: grossly intact pulses: femoral right:2 left:2 dp right:2 left:2 pt :1 left:1 radial right:2 left:2 carotid bruit transmitted vs bruit pertinent results: pre-op: 08:57pm pt-17.6* ptt-24.5 inr(pt)-1.6* 08:57pm plt count-337 08:57pm wbc-12.5* rbc-4.33 hgb-12.8 hct-38.2 mcv-88 mch-29.5 mchc-33.4 rdw-15.1 08:57pm %hba1c-6.4* eag-137* 08:57pm calcium-9.7 phosphate-3.7 magnesium-2.1 08:57pm lipase-36 08:57pm alt(sgpt)-19 ast(sgot)-22 alk phos-90 amylase-56 tot bili-0.5 08:57pm glucose-104* urea n-13 creat-0.7 sodium-144 potassium-4.0 chloride-105 total co2-29 anion gap-14 09:00pm ctropnt-<0.01 09:30pm urine rbc-0-2 wbc- bacteria-occ yeast-none epi-0-2 09:30pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-sm discharge: 04:35am blood hgb-10.1* plt ct-309 04:40am blood wbc-15.3* rbc-3.48* hgb-10.3* hct-31.3* mcv-90 mch-29.4 mchc-32.8 rdw-15.2 plt ct-252 04:35am blood plt ct-309 04:35am blood pt-19.9* inr(pt)-1.8* 04:35am blood urean-18 creat-0.6 na-138 k-4.1 cl-102 04:40am blood glucose-78 urean-19 creat-0.5 na-137 k-4.1 cl-102 hco3-26 angap-13 -echo pre-bypass: the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the right atrium is dilated. no atrial septal defect is seen by 2d or color doppler. right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is partial anterior mitral leaflet flail. an eccentric, posteriorly directed jet of moderate to severe (3+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). moderate tricuspid regurgitation is seen. ta in 4 chamber view is 3.1 cm in end systole.the ivc is dilated to 25mm. there is no pericardial effusion. dr. was notified in person of the results on prior to surgery. all the echo findings were also done, interpreted and conveyed to surgeon by dr. as well. post-bypass: there is a bioprosthesis sitting in the mitral position. it is stable and functioning well. there is valvular or perivalvular leak seen. the transmitral gradient was 7mm of hg mean with cardiac output of 5.0 l/min.the thoracic aorta is intact. normal rv systolic function. lvef 55%. radiology report chest (portable ap) study date of 12:57 pm medical condition: 82 year old woman s/p mvr tissue final report: in comparison with study of , all of the monitoring and support devices have been removed. no evidence of pneumothorax. substantial enlargement of the cardiac silhouette with bibasilar effusions and atelectasis. brief hospital course: the patient was brought to the operating room on where the patient underwent mitral valve replacement (27mm tissue) and left atrial appendage ligation. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. within 24 hours she was weaned from sedation, awoke neurologically intact and extubated. she was hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. coumadin was resumed for atrial fibrillation. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued per cardiac surgery protocol without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on post-op day four the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to pleasant nursing and rehab in , ma. in good condition with appropriate follow up instructions. medications on admission: digoxin 250mcg daily **coumadin 5mg daily**-last dose 4 days ago evista 60mg daily calcium and vitamin d 400-600mg tab twice daily lisinopril 30mg daily vitamin b 12 1000mcg inj monthly fluocinonide topical 0.05% prn cardizem cd 120mg daily lasix 40mg daily discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po every eight (8) hours. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 7. lisinopril 10 mg tablet sig: two (2) tablet po daily (daily). 8. furosemide 40 mg tablet sig: one (1) tablet po once a day for 2 weeks. 9. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 2 weeks. 10. evista 60 mg tablet sig: one (1) tablet po daily (). 11. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 12. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever, pain. 13. warfarin 1 mg tablet sig: as directed tablet po daily (daily): target inr 2-2.5 for afib 5 mg on . discharge disposition: extended care facility: pleasant bay nursing & rehabilitation center - discharge diagnosis: mitral regurgitation atrial fibrillation s/p mitral valve replacement and left atrial appendage ligation pmh: hypertension past surgical history: bilateral tkr resection of left arm basal cell cancer hammer toe surgery discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with percocet sternal incision - healing well, no erythema or drainage edema: + pedal edema bilat le discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments: surgeon dr. tuesday @ 2:00 pm cardiologist dr. @ 1:15 pm please call to schedule the following: primary care dr. , m. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr coumadin for atrial fibrillation goal inr 2-2.5 first draw day after discharge then please do inr checks monday, wednesday, and friday for 2 weeks then decrease as required upon discharge from rehab, dr. should be contact to follow coumadin and inr procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft suture of vein suture of artery excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: anemia, unspecified mitral valve disorders congestive heart failure, unspecified atrial fibrillation accidental puncture or laceration during a procedure, not elsewhere classified personal history of other malignant neoplasm of skin long-term (current) use of anticoagulants knee joint replacement other abnormal glucose tricuspid valve disorders, specified as nonrheumatic cardiomegaly accidental cut, puncture, perforation or hemorrhage during surgical operation unspecified hypertensive heart disease with heart failure edema family history of other cardiovascular diseases personal history of allergy to penicillin allergy to radiographic dye 

Answer: The patient is high likely exposed to