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: keflex / penicillins attending: chief complaint: dyspnea major surgical or invasive procedure: redo-sternotomy, mitral valve replacement history of present illness: 76f who underwent mvr in has developed progressive fatigue and dyspnea since . she also developed lower extremity edema. she was found to have severe ms as well as 3+mr and pulmonary htn with pa pressures in the 50s. she underwent cardiac catheterization and coronary angiography in preparation for cardiac surgery. she is transferred for cardiac surgery evaluation. past medical history: mitral stenosis hypertension pulmonary hypertension chronic diastolic heart failure s/p mitral valve replacement (bioprosthetic) with post-op atrial fibrillation s/p radiofrequency ablation sick sinus syndrome s/p pacemaker hypothyroidism multiple myeloma chronic renal insufficiency paralyzed right hemidiaphragm raynaud's disease gastroesophageal reflux disease right total knee replacement left lower extremity vein ligation social history: last dental exam: , dr. , , nh lives with: husband occupation: - : denies etoh: denies family history: mom 42 colon ca dad 56 hocm physical exam: pulse: 98 resp: 20 o2 sat: 98%2l b/p right: 122/82 left: height: 5'5" weight: 157lb general: skin: dry intact well healed median sternotomy incision right upper chest- port-a-cath heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally crackles at bases heart: rrr irregular murmur soft systolic and diastolic murmurs abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema 2+ varicosities: small varicosities b/l les none neuro: grossly intact x pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : left: not palpable edema radial right: 2+ left: 2+ carotid bruit right: left: no carotid bruits pertinent results: 07:45pm pt-13.7* ptt-58.1* inr(pt)-1.2* 07:45pm plt count-467* 07:45pm wbc-8.9 rbc-4.00* hgb-10.9* hct-35.6* mcv-89 mch-27.2 mchc-30.6* rdw-14.3 07:45pm %hba1c-7.0* 07:45pm albumin-3.7 calcium-8.8 phosphate-3.4 magnesium-1.9 07:45pm alt(sgpt)-47* ast(sgot)-44* ld(ldh)-306* alk phos-77 tot bili-0.7 07:45pm glucose-212* urea n-36* creat-1.4* sodium-138 potassium-3.8 chloride-101 total co2-25 anion gap-16 05:49am blood wbc-9.1 rbc-3.33* hgb-9.6* hct-30.2* mcv-90 mch-28.6 mchc-31.7 rdw-16.1* plt ct-258 05:49am blood plt ct-258 03:00am blood pt-13.6* ptt-47.0* inr(pt)-1.2* 05:49am blood glucose-94 urean-29* creat-1.0 na-138 k-4.4 cl-97 hco3-34* angap-11 carotid u/s: no significant carotid artery stenosis identified(less than 40% on the right, none on the left). : pre bypass the left atrium is markedly dilated. the left atrium is elongated. mild spontaneous contrast is seen in the body of the left atrium. no mass/thrombus is seen in the left atrium or left atrial appendage. mild spontaneous contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). the right atrium is dilated. no atrial septal defect is seen by 2d or color doppler. the coronary sinus is dilated (diameter >15mm). injection of agitated saline into the left upper extremity appeared in the right atrium through the superior vena cava, ruling out a persistent left svc. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). left ventricular dysnchrony is present. the right ventricular cavity is dilated with mild hypokinesis of the basilar portion but severe mid and apical free wall hypokinesis. there is abnormal septal motion/position consistent with right ventricular pressure/volume overload. there are simple atheroma in the aortic arch. there are focal calcifications 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. the aortic valve leaflets are moderately thickened. the non-coronary cusp is immobilized. there is mild to moderate aortic valve stenosis (valve area 1.3 cm2). trace aortic regurgitation is seen. the prosthetic mitral valve leaflets are thickened. motion of the prosthetic mitral valve leaflets is abnormal. the leaflets appear to be fused at their bases. the gradients are higher than expected for this type of prosthesis. there is severe valvular mitral stenosis (area <1.0cm2). moderate (2+) mitral regurgitation is seen. the valve ring appears somewhat more mobile than expected but there is no perivalvualr leak and no evidence of dehiscence. the tricuspid valve leaflets are mildly thickened. the tricuspid regurgitation is at least mild to moderate. at times it may be slightly worse and emanates from the center of the valve. there is a large left pleural effusion. dr. was notified in person of the results in the operating room at the time of the study. post bypass the patient is being av placed. the patient is receiving milrinone, epinephrine, and norepinephrine by infusion. the right ventricle displays improved systolic function with mild free wall hypokinesis. the left ventricle is hyperdynamic with an ejection fraction near 75 to 80%. there is a bioprosthesis in the mitral position. it appears well seated with normal leaflet function. there is trace valvular mitral regurgitation. no perivalvular regurgitation is seen. the maximum gradient through the mitral valve is 12 mmhg with a mean gradient of 5 mmhg at a cardiac output of about 5.7 liters/minute. the tricuspid regurgitation is significantly improved and is now mild. the aortic valve is unchanged. the thoracic aorta appears intact. chest (pa & lat) clip # final report pa and lateral chest radiographs: comparison is made to multiple prior radiographs, most recently and . lung volumes remain low without evidence of pneumothorax and with unchanged positioning to left-sided pacemaker and right port-a-cath. left pleural effusion has increased in the interval with expected probable adjacent compression atelectasis. mild right basilar atelectasis is improved with stable eventration of the hemidiaphragms. cardiac silhouette remains enlarged with no other change to mediastinal and hilar contours. the epicardial pacing leads as well as right central venous line have been removed in the interval. degenerative changes involving the right humeral head are again noted. impression: marked interval increase in size to moderate left pleural effusion and small right pleural effusion. the study and the report were reviewed by the staff radiologist. dr. dr. brief hospital course: 76f who underwent mitral valve replacement in who had developed progressive fatigue and dyspnea since . she also developed lower extremity edema. she was found to have severe ms as well as 3+mr and pulmonary hypertension with pa pressures in the 50s. she underwent cardiac catheterization at outside hospital, which showed no coronary artery disease. she was transferred to and on underwent a redo sternotomy and redo mitral valve replacement with a 29-mm st. medical biocor tissue valve. her bypass time was 108 minutes with a crossclamp time of 66 minutes. see operative note for full details. she tolerated the operation but required inotropic and pressor support post operatively, she was transferred from the operating room to the cardiac surgery icu in stable condition on epinephrine, milrinone and levophed. vasopressin was added and levophed was weaned to off on the operative day. on the morning of pod1 sedation was weaned and she was extubated. she was continued on milronone until post operative day 4 due to right ventricular dysfunction. she did have acute tubular nephrosis with a peak creatinine of 2.4. the renal team was consulted. the patient was started on natrecor and lasix drips with increased diuresis. the drips were discontinued on post operative day 4 and she continued to diurese with lasix daily. her renal function continued to improve with creatinine returning to baseline prior to discharge. chest tubes and pacing wires were removed per cardiac surgery protocol. physical therapy worked with her to improve strength and endurance. she was transferred to the floor on post operative day 6 (held in the unit one extra day due to bed availability). the patient continued to progress slowly with physical therapy and was found ready for transfer to rehab on pod 8. medications on admission: at home: levoxyl 25mcg', ambien 5 prn, norvasc 2.5' on admission: lorazepam 0.5 q6h prn, amiodarone 200', aspirin 81', bisacodyl 10', mylanta 30 q4h prn, ambien 5 prn, enoxaparin 40 hs, acetylcysteine 600mg 2 doses, lasix 40 x1 discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 4. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 6. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 7. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 9. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day). 10. furosemide 40 mg tablet sig: one (1) tablet po twice a day for 2 weeks. 11. potassium chloride 20 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po daily (daily). discharge disposition: extended care facility: pines discharge diagnosis: mitral valve stenosis s/p redo-sternotomy, mitral valve replacement past medical history: hypertension pulmonary hypertension chronic diastolic heart failure s/p mitral valve replacement (bioprosthetic) with post-op atrial fibrillation s/p radiofrequency ablation sick sinus syndrome s/p pacemaker hypothyroidism multiple myeloma chronic renal insufficiency paralyzed right hemidiaphragm raynaud's disease gastroesophageal reflux disease discharge condition: alert and oriented x3 nonfocal ambulating, with pain managed with percocet prn 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: surgeon dr. in 4 weeks at 1:00 pm please call to schedule appointments primary care dr. in weeks cardiologist dr. in weeks procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery esophageal reflux acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified acute on chronic diastolic heart failure other complications due to heart valve prosthesis other chronic pulmonary heart diseases other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) alkalosis surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation osteoporosis, unspecified other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation multiple myeloma, without mention of having achieved remission iron deficiency anemia, unspecified other and unspecified coagulation defects raynaud's syndrome fitting and adjustment of cardiac pacemaker disorders of diaphragm 

Answer: The patient is high likely exposed to