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 an 80 year old female who was admitted for preoperative anticoagulation with the plan of going to the o.r. on hospital day two for avr and mvr. the patient last took coumadin on . the patient is on coumadin for chronic atrial fibrillation. the patient currently is asymptomatic. denies chest pain, shortness of breath, dyspnea on exertion, fever, chills. the patient has reported some nausea times one week usually in the morning. the patient had a pacemaker placed on . the patient was admitted for preoperative iv heparin. past medical history: severe aortic stenosis. moderate mitral stenosis. chronic atrial fibrillation. history of chf. asthma. arthritis. goiter. hypertension. history of subdural hematoma. hypercholesterolemia. past surgical history: varicose vein ligation. craniotomy for subdural hematoma. permanent pacemaker placement. tonsillectomy. medications on admission: coumadin 4 mg and 2 mg every other day p.o. q.h.s., digoxin 250 mcg p.o. q.day, lescol 40 mg p.o. q.day, lasix 20 mg p.o. q.day, fluticasone two puffs q.12 hours, ditropan 5 mg p.o. q.day, combivent two puffs t.i.d., potassium chloride 10 meq p.o. q.day. allergies: no known drug allergies. social history: significant for 30 pack year smoking history as well as a two drinks per day alcohol history. family history: significant for unspecified valvular disease as well as diabetes mellitus. physical examination: the patient was afebrile, vital signs stable, sating 98 percent in room air. in no apparent distress. alert and oriented times three. head was normocephalic, atraumatic, no scleral icterus noted. neck was soft and supple, no masses and no bruits noted. heart was regular rate and rhythm with a grade 2/6 systolic ejection murmur. chest was clear to auscultation bilaterally with no rhonchi or rales. abdomen was soft, nondistended, nontender with positive bowel sounds. rectal exam was deferred. extremities were without cyanosis, clubbing or edema. neuro exam was without any deficits. laboratory data: the patient had an echocardiogram on which showed moderate dilation of the left atrium, moderate dilation of the right atrium, moderate left ventricular hypertrophy, ef 60 percent, moderately dilated aortic root, mildly dilated ascending aorta, severe aortic stenosis, 1+ aortic regurg, mild mitral stenosis, 1 to 2+ mitral regurg. cardiac cath on demonstrated no flow limiting disease, severe aortic stenosis, hyperdynamic ventricular function and moderate pulmonary hypertension. chest x-ray on showed left ventricular hypertrophy, no evidence of congestive heart failure, aortic valve calcification, bibasilar linear atelectasis. carotid ultrasound on demonstrated bilateral stenosis of the internal carotid arteries of less than 40 percent. ho course: the patient is an 80 year old female with severe as admitted for preoperative anticoagulation with iv heparin with a plan to go to the o.r. for avr and mvr. the patient was admitted to cardiac surgery, dr. attending, and was started on a heparin drip with no bolus at 700 with goal ptt between 50 and 70. on hospital day two the patient was atrially paced up to a heart rate of 110. electrophysiology cardiology was consulted and as a result settings of the pacemaker were changed to 70 with suppression algorithm off and rate response off. th was taken to the o.r. on for avr and mvr with a 23 mm pericardial aortic valve and a 27 mm mosaic pig mitral valve. surgeon was dr. . for a more detailed account, please see operative report. postoperatively the patient was transferred to the csru. immediately postoperatively the patient went into atrial fibrillation dysrhythmia and was placed on amiodarone iv. the patient also had pressor requirements with fen neo-synephrine. chest tubes were discontinued on postoperative day two. also postoperatively the ep staff recommended changes to the pacemaker with ddd of 60. they also recommended continuing amiodarone and beta blocker. on postoperative day one ep noted that the patient was in an atrial tachycardiac rhythm with a 2:1 av block. recommendations were as stated above. the patient was extubated on postoperative day one without difficulty. on postoperative day two the patient was started on p.o. amiodarone. on postoperative day four the patient continued to be in and out of atrial tachycardiac rhythm. however, later in the day the patient went down to a heart rate of 71 ventricularly paced. on postoperative day five the patient was transferred to the floor in stable condition. the patient was complaining of some right sided arm and back pain which was alleviated by darvocet. the patient has a history of arthritic back pain. ep's final recommendations included amiodarone 400 mg p.o. b.i.d. and anticoagulation with coumadin until further followup. on postoperative day six the patient was doing very well. vitals stable, heart rate 64 paced, blood pressure 117/58 with no oxygen requirements. the patient was 3 kg above preoperative weight. the patient was started on coumadin on with a dose of 2. the patient is to resume preoperative regimen of 4 and 2 mg of coumadin alternating every day. the patient was recommended for rehabilitation by physical therapy and the patient was deemed well enough to be discharged there on postoperative day six. discharge disposition: to rehab. condition on discharge: good. discharge diagnoses: 1. severe aortic stenosis. 2. moderate mitral stenosis. 3. chronic atrial fibrillation. 4. asthma. 5. hypertension. 6. hypercholesterolemia. discharge medications: 1. lasix 20 mg p.o. q.day. 2. potassium chloride 20 meq p.o. q.day. 3. colace 100 mg p.o. b.i.d. 4. aspirin 325 mg p.o. q.day. 5. amiodarone 400 mg p.o. b.i.d. 6. combivent one to two puffs q.six hours p.r.n. 7. darvocet one tab p.o. q.six hours p.r.n. 8. coumadin 2 mg and 4 mg p.o. q.h.s. alternating every day. 9. lipitor 40 mg p.o. q.day. 10. fluticasone two puffs b.i.d. 11. oxybutynin 5 mg p.o. q.day. fo: the patient is to follow up in wound clinic in one weeks. pcp and cardiologist in two to three weeks. electrophysiologist please call for an appointment. inr checks as before. dr. in four weeks. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft pulmonary artery wedge monitoring open and other replacement of mitral valve with tissue graft diagnoses: pure hypercholesterolemia unspecified essential hypertension gout, unspecified atrial fibrillation asthma, unspecified type, unspecified pulmonary collapse other specified cardiac dysrhythmias mechanical complication due to cardiac pacemaker (electrode) mitral valve stenosis and aortic valve stenosis 

Answer: The patient is high likely exposed to