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: ms. is an 81-year-old woman with multiple episodes of congestive heart failure with known significant mitral regurgitation and chronic atrial fibrillation (on coumadin for her atrial fibrillation) admitted preoperatively to come off of her coumadin and be placed on iv heparin while awaiting her inr to come back to normal levels. the patient underwent a cardiac catheterization in which showed a cardiac index of 1.4, 30% to 60% rca lesion, 4+ mr, with positive mac. she had a tee done also in that showed mild aortic insufficiency, moderate mitral regurgitation, mild mitral stenosis, moderate tricuspid regurgitation, an ef of 35% to 40%, and a dilated left atrium without any thrombus. past medical history: significant for hypertension, mitral regurgitation, aortic insufficiency, copd, hypercholesterolemia, rheumatic heart disease, paroxysmal atrial fibrillation, left retinal artery embolus, cardiomyopathy, and pulmonary hypertension. past surgical history: significant for hysterectomy secondary to endometrial cancer. medications prior to admission: include zocor 10 mg daily, coumadin, multivitamin 1 tablet daily, lopressor 100 mg b.i.d., calcium 3 tablets daily, aspirin 325 mg daily, digoxin 0.125 mg daily, lasix 20 mg daily, lisinopril 20 mg daily, remeron 15 mg daily, amiodarone 400 mg daily, restoril 7.5 mg p.r.n., protonix 40 mg daily, and diamox (no dose or schedule given). allergies: the patient states no known drug allergies. family history: noncontributory. social history: she has a remote tobacco history; quit many years ago. she lives alone; however, immediately prior to admission to she was in a rehabilitation setting. the patient also denies alcohol use. physical examination on admission: height of 5 feet 3 inches, weight of 112 pounds, heart rate of 54 (atrial fibrillation), blood pressure of 104/56 on the right and 100/60 on the left, and respiratory rate of 20. neurologically, grossly intact. pulmonary reveals clear to auscultation bilaterally. cardiac reveals irregularly irregular. the abdomen is soft, nontender, and nondistended with positive bowel sounds and no masses appreciated. the extremities are warm and well perfused with no edema. summary of hospital course: the patient was admitted to the cardiothoracic service and begun on heparin while awaiting her inr to return to normal levels. her last dose of coumadin prior to admission was on . the patient was noted to have an admission inr of 6.1. therefore, the patient was administered vitamin k on both the day of admission and on hospital day 1. the patient has stated that she had a 3-week history of diarrhea prior to admission to the . therefore, the gastroenterology service was consulted. reportedly, the patient had been worked up by her primary care physician with all culture data being negative to date. she had recommended a lactose-free diet, additional stool cultures, and an outpatient colonoscopy. over the next several days the patient remained hemodynamically stable. her blood work was followed daily, and she was given p.r.n. vitamin k. ultimately, on , the patient was brought to the operating room where she underwent mitral valve replacement with a #27 mosaic valve. please see the or report for full details. in summary, she had mitral valve replacement. her bypass time was 87 minutes with a cross-clamp time of 66 minutes. she tolerated the operation well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer the patient was in atrial fibrillation at 76 beats per minute, with a cvp of 6, and pa pressures of 30/15. she had neo-synephrine at 0.5 mcg/kg/min and propofol at 20 mcg/kg/min. in the immediate postoperative period the patient had a somewhat course with a labile blood pressure requiring large volumes of fluid, and ultimately she was begun on milrinone for a low cardiac index. over the next 12 hours the patient did extremely well. her anesthesia was reversed. her sedation was discontinued. she was weaned from the ventilator and successfully extubated. on postoperative day 1, she was weaned from her milrinone infusion. however, she did require a nipride infusion to maintain a somewhat normalized blood pressure. on postoperative day 2, she was begun on an ace inhibitor as well as beta blockade and weaned from her nipride infusion. additionally, the patient's pa catheter was removed. additionally, the patient had a swallow evaluation; and she was transferred from the cardiothoracic intensive care unit to two for continuing postoperative care and cardiac rehabilitation. on postoperative day 3, the patient remained hemodynamically stable. however, she had dwindling urine output, and her foley catheter was re-placed. additionally, the patient had a swallow evaluation that did not demonstrate any signs of aspiration, and she was restarted on her coumadin. on postoperative day 4, the patient remained hemodynamically stable. her temporary pacing wires were discontinued. her beta blockade and lasix doses were adjusted, and her activity level was gradually increased with the assistance of the nursing staff and physical therapy. on postoperative day 6, the patient was noted to have an inr of 7; which was repeated and found to be accurate. she was transferred from the floor back to the cardiothoracic intensive care unit and treated with ffp and vitamin k; following which her inr returned to 2. however, she continued to be monitored in the cardiothoracic intensive care unit for an additional 2 days. on postoperative day 8, she was again transferred back to two. she had an uneventful course throughout the remainder of her hospitalization. on postoperative day 9, it was felt that the following day the patient would be stable and ready to be transferred to rehabilitation for continuing care and recovery from her cardiac surgery. at this time the patient's physical exam reveals a temperature of 96.6, heart rate of 85 (atrial fibrillation), blood pressure of 139/91, respiratory rate of 18, and o2 saturation of 95% on room air. weight is 60 kilograms. laboratory data reveals a white count of 8, hematocrit of 37, and platelets of 172. pt is 15, ptt is 27, and inr is 1.5. sodium is 146, potassium is 5.5, chloride is 104, co2 is 30, bun is 43, creatinine is 1.4, and glucose is 113. in general, in no acute distress. neurologically, alert and oriented. moves all extremities. follows commands. a nonfocal exam. pulmonary reveals diminished at the bases without any rales or rhonchi. cardiovascular reveals irregularly irregular, s1 and s2, with no murmurs. the sternum is stable. incision with steri-strips, clean and dry, no drainage or erythema. the abdomen is soft and nontender with normal active bowel sounds. the extremities are warm and well perfused with 1+ edema. discharge disposition: the patient is expected to be discharged to an extended care facility. condition on transfer: good. discharge diagnoses: 1. status post mitral valve replacement with a #27 mosaic valve. 2. mitral regurgitation. 3. paroxysmal atrial fibrillation. 4. hypertension. 5. chronic obstructive pulmonary disease. 6. hypercholesterolemia. 7. left retinal artery embolus. 8. cardiomyopathy. 9. pulmonary hypertension. 10. rheumatic heart disease. 11. hysterectomy. die followup: the patient is to have followup in the clinic in 2 weeks, followup with dr. in 2 to 3 weeks, and followup with dr. in 4 weeks. medications on discharge: include remeron 15 mg at bedtime, amiodarone 400 mg daily, protonix 40 mg daily, lasix 20 mg b.i.d. x 2 weeks and then 20 mg daily, colace 100 mg b.i.d., aspirin 81 mg daily, warfarin as directed to maintain a target inr of 2 to 2.5 (the patient received 1 mg on the ), percocet 5/325 1 to 2 tablets every 4 to 6 hours as needed (for pain), lisinopril 5 mg daily, lopressor 50 mg b.i.d., potassium chloride 20 meq daily. , m.d. procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of mitral valve with tissue graft transfusion of packed cells transfusion of other serum transfusion of platelets diagnoses: other iatrogenic hypotension pure hypercholesterolemia unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of malignant neoplasm of other parts of uterus rheumatic heart failure (congestive) primary pulmonary hypertension intestinal disaccharidase deficiencies and disaccharide malabsorption mitral stenosis with insufficiency 

Answer: The patient is high likely exposed to