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: barium iodide attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: mitral valve replacement (27mm st. epic porcine valve) history of present illness: 65 year old female with progressive dyspnea on exertion which was evaluated by serial echocardiogram for mitral regurgitation. past medical history: hypercholesterolemia diabetes mellitus type 2 anxiety hypertension asthma s/p hysterectomy s/p herniorraphies bilateral cataracts seizure disorder social history: denies smoking occasional alcohol currently on disability lives with spouse family history: sister died of rheumatic fever age 13. father deceased hypertension, diabetes, kidney disease mother stroke at age 69 physical exam: admission: general no acute distress well nourished skin mid abdominal incision and multiple scope sites healed heent eomi peerla neck supple full range of motion chest clear to auscultation no wheezes or rhonchi heart regular 3/6 systolic murmur, diasystolic murmur abdomen soft, nontender, non distended + bowel sounds extremeties warm well perfused no edema pulses palpable, bilateral varicosties neuro alert and oriented x3 non focal pertinent results: echocardiography report , (complete) done at 8:52:30 am final referring physician information , r. , division of cardiothorac , status: inpatient dob: age (years): 65 f hgt (in): 61 bp (mm hg): / wgt (lb): 141 hr (bpm): bsa (m2): 1.63 m2 indication: left ventricular function. right ventricular function. valvular heart disease. icd-9 codes: 424.1, 394.2 test information date/time: at 08:52 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2009aw5-: machine: echocardiographic measurements results measurements normal range left ventricle - inferolateral thickness: 0.8 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 4.6 cm <= 5.6 cm left ventricle - ejection fraction: 55% to 65% >= 55% aorta - ascending: 2.8 cm <= 3.4 cm aorta - descending thoracic: 2.1 cm <= 2.5 cm aortic valve - peak velocity: 2.0 m/sec <= 2.0 m/sec aortic valve - peak gradient: 16 mm hg < 20 mm hg aortic valve - lvot pk vel: 1.80 m/sec aortic valve - lvot diam: 1.8 cm aortic valve - valve area: *1.2 cm2 >= 3.0 cm2 mitral valve - peak velocity: 1.5 m/sec mitral valve - mean gradient: 6 mm hg mitral valve - pressure half time: 111 ms mitral valve - mva (p t): 2.0 cm2 findings left atrium: moderate la enlargement. good (>20 cm/s) laa ejection velocity. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: wall thickness and cavity dimensions were obtained from 2d images. normal lv wall thickness, cavity size and regional/global systolic function (lvef >55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. no atheroma in ascending aorta. normal descending aorta diameter. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets. mild as (aova 1.2-1.9cm2). trace ar. mitral valve: moderately thickened mitral valve leaflets. mild mitral annular calcification. mild valvular ms (mva 1.5-2.0cm2). moderate (2+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. the patient appears to be in sinus rhythm. results were personally reviewed with the md caring for the patient. conclusions pre-bypass: the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. there is mild aortic valve stenosis (area 1.2-1.9cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is mild valvular mitral stenosis (area 1.5-2.0cm2). moderate (2+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results in the operating room. post-cpb: on infusions of epi, neo. av pacing. well-seated bioprosthetic valve in the mitral position. trace mr, no paravalvular leak. preserved biventricular systolic function on inotropic support. ai is mild. peak gradient of 20 mmhg through the aortic valve with now 1.3 probably reflects higher cardiac output on inotropes. aortic contour is normal post decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 16:41 brief hospital course: she was admitted to the hospital preoperatively for intravenous diuresis. she was brought to the operating room and underwent mitral valve replacement. see operative note for further details. she received cefazolin for perioperative antibiotics. she was transferred to the intensive care unit for hemodynamic monitoring. in the first twenty four hours she was weaned from sedation, awoke neurologically intact, and was extubated without complications. she was started on beta blockers and gentle diuresis. she was transferred to the floor and had episode of atrial fibrillation post operative day 1 treated with beta blockers, and then started on amiodarone for reoccurrences of atrial fibrillation. she continued to go in and out of atrial fibrillation and was started on coumadin for anticoagulation. last episode of atrial fibrillation in the am. her inr became elevated, coumadin held, and monitored level closely. physical therapy worked with her on strength and mobility. by post-operative day nine she was ready for discharge to home with services. her inr on the day of discharge was 3.2 so coumadin was again held. her discharge paperwork advised the dose to continue to be held until her inr fell below 2. the next inr draw is scheduled for and dr. office was faxed recent coumadin doses and corresponding inrs. medications on admission: sertaline 25mg/d metfromin 500mg loratadine 10mg/d gemfibrizil 600mg pravastatin 40mg/d enalapril 20mg/d mirtazapine 30mg/d lopressoe er 50mg/d albuterol inh lasix 40mg/d 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. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 4. 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* 5. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): 200mg twice a day for 7 days then decrease to 200 mg daily until follow up with cardiologist . disp:*37 tablet(s)* refills:*0* 6. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 7. mirtazapine 30 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*0* 8. sertraline 50 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*0* 9. pravastatin 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 10. proair hfa 90 mcg/actuation hfa aerosol inhaler sig: puffs inhalation four times a day. disp:*qs qs* refills:*2* 11. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 12. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) inhalation (2 times a day). disp:*qs qs* refills:*2* 13. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours) as needed. 14. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 15. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 16. enalapril maleate 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 17. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). disp:*270 tablet(s)* refills:*2* 18. oxybutynin chloride 5 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 19. warfarin 1 mg tablet sig: inr goal 2-2.5 tablets po once a day: please hold until inr < 2.5, inr to be checked with results to dr for further dosing . disp:*30 tablet(s)* refills:*0* 20. outpatient work pt/inr for coumadin dosing - atrial fibrillation with goal inr 2.0-2.5 - results to dr office # fax - currently holding coumadin until level less than 2.5 and then to resume - first draw 21. loratadine 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: allcare vna discharge diagnosis: mitral regurgitation s/p mitral valve replacement diabetes mellitus post operative atrial fibrillation hypercholesterolemia hypertension asthma s/p hysterectomy s/p herniorraphies anxiety bilateral cataracts seizure disorder discharge condition: good discharge instructions: please shower daily including washing incisions, no baths or swimming monitor wounds for infection - redness, drainage, or increased pain report any fever greater than 101 report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week no creams, lotions, powders, or ointments to incisions no driving for approximately one month no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: please call to schedule all appointments dr. in 4 weeks () dr. in 1 weeks ( dr. in weeks wound check appointment 6 as instructed by nurse () labs: pt/inr for coumadin dosing - atrial fibrillation with goal inr 2.0-2.5 - results to dr office # fax - currently holding coumadin until level less than 2.5 and then to resume - first draw procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft diagnoses: unspecified essential hypertension atrial fibrillation asthma, unspecified type, unspecified rheumatic heart failure (congestive) other and unspecified hyperlipidemia long-term (current) use of anticoagulants epilepsy, unspecified, without mention of intractable epilepsy mitral stenosis 

Answer: The patient is high likely exposed to