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 / ace inhibitors attending: chief complaint: chest discomfort major surgical or invasive procedure: aortic valve replacement (25 mosaic porcine) cardiac catheterization history of present illness: year old female complaining of chest discomfort with long-standing history of aortic stenosis followed by serial echo's. most recent echo showed severe aortic stenosis along with mitral and tricuspid valve disease. past medical history: aortic stenosis mitral and tricupsid regurgitation hypertension glaucoma left breat cancer status post mastectomy macular degeneration gastroesophageal reflux disease colon polyps surgery: bilateral vein stripping, tonsillectomy, total hip replacement, appendectomy, pacemaker implanted for bradycardia social history: denies history of smoking. denies alcohol use. lives alone. family history: non-contributory physical exam: vitals: 76 178/80 57" 54kg general: frail elderly female in no acute distress skin: unremarkable heent: unremarkable neck: supple, full range of motion chest: clear to auscultation bilaterally. well healed pacemaker and mastectomy scars heart: regular rate and rhythm with 4/6 holosystolic murmur abd: soft, non-tender, non-distended, +bowel sounds ext: warm, well-perfused, -edema neuro: grossly intact, non-focal pertinent results: cath: 1. selective coronary angiography of this right dominant system demonstrated moderate single vessel coronary artery disease. the lmca had a 20% stenosis at the origin. the lad was a tortuous vessel with slow flow consistent with microvascular dysfunction. the was plaquing in the proximal to mid vessel up to 40%. the d1-d4 were small in caliber. the lcx had a high om1 (functionally a ramus) with proximal 30% plaquing, a patent high om2. the remainder of the lcx system was absent. the rca was heavily calcified with a proximal 30% stenosis. there was a modest rpda with a stenosis at the origin of 50%. there were modest caliber rpl1 and rpl 2 with tortuous terminal branches. there was slow flow consistent with microvascular dysfunction. 2. resting hemodynamics revealed elevated right and left ventricular filling pressures at 14 and 22 mmhg, respectively. the mean pcwp was 21 mmhg. the mean pa pressure was 27 mmhg (phasic 50/20 mmhg). the cardiac index was mildly depressed at 2 l/min/m2. there was severe systemic arterial hypertension with a mean pressure of 138 mmhg (phasic 200/98 mmhg). there was sever aortic stenosis with a mean gradient of 42 mmhg and a calculated aortic valve area of 0.5 cm2 (based on a measured vo2 and no known aortic insufficiency). 3. left ventriculography showed a mildly depressed ef of 51%. there was anterolateral and apical hypokinesis. 4. hemodynamics: moderate pulmonary hypertension; severe systemic systolic arterial hypertension; low cardiac output with severe aortic stenosis by gradient and ; dobutamine not administrated given severe systemic systolic arterial hypertension. beat-to-beat variation in "pcw" tracing, many without any end-diastolic gradient, but other beats with pa morphology early; unable to confirm good pcw position by oxymetry. 25-30 mmhg pulsus paradoxus. bp rx metoprolol iv and analgesics. carotid u/s: right ica stenosis <40% left ica stenosis <40%. echo: pre-bypass: the left atrium is normal in size. no mass/thrombus is seen in the left atrium or left atrial appendage. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. there are simple atheroma in the aortic root. there are simple atheroma in the ascending aorta. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). no aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. the tricuspid regurgitation jet is eccentric and may be underestimated. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. post-bypass: for the post-bypass study, the patient was receiving phenylephrine infusion. a well-seated bioprosthetic valve is seen in the aortic position. peak gradient = 18 mmhg. no aortic regurgitation is seen. regional and global left ventricular systolic function are normal. no aortic dissection. wbc rbc hgb hct mcv mch mchc rdw plt ct pnd pnd pnd pnd pnd pnd pnd pnd 29.3* 11.3* 2.98* 9.3* 28.0* 94 31.2 33.3 14.7 496*# 15.0* 3.17* 9.6* 29.1* 92 30.3 32.9 14.8 318 17.5* 3.32* 10.4* 30.8* 93 31.2 33.7 15.1 295 glucose urean creat na k cl hco3 angap pnd pnd pnd pnd pnd pnd pnd 21* 1.1 4.4 100 24* 1.1 135 4.1 99 30 10 87 21* 1.1 135 4.3 98 28 13 brief hospital course: mrs. was admitted on following her cardiac catheterization. in addition to her cardiac cath she underwent echocardiogram, carotid ultrasound and usual pre-operative work-up - please see result section for details. on she was brought to the operating room where she underwent an aortic valve replacement. given that she was an inpatient for more than 24 hours prior to surgery, vancomycin was given for perioperative antibiotic coverage. please see operative report for surgical details. following surgery she transferred to the cvicu for invasive monitoring in stable condition. she was weaned from sedation, awoke neurologically intact and extubated on postoperative day two without incident. later on this day she appeared to be doing well and was transferred to the telemetry floor for further care. chest tubes and epicardial pacing wires were removed per protocol and without complication. over the next several days she continued clinical improvements with diuresis. she tolerated beta blockade and maintained stable hemodynamics. she was medically cleared for discharge to rehab facility on post-op day six. at discharge, her bp was 108-138/60-70 with hr 64(v-paced)) and room air oxygen saturations of 95%. all surgical incisions appeared clean, dry and intact. at discharge, she remained fluid overloaded and will continue to require diuresis. diuretics should be titrated accordingly, with an ideal weight of approximately 52kg. medications on admission: metoprolol 25mg , xalatan eye drops, omeprazole, lasix 20mg daily, irbesartan 150mg daily, raloxifene 60mg daily, aspirin 81mg daily, vitamin d3, multivitamin, azopt eye drops discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. dorzolamide 2 % drops sig: two (2) drop ophthalmic (2 times a day). 4. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 6-8 hours as needed for pain. 8. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. 9. furosemide 40 mg tablet sig: one (1) tablet po once a day: titrate according to weight/fluid status - ideal weight approximately 52 kg - should remain on low dose lasix at discharge from rehab. 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. discharge disposition: extended care facility: aberjona nursing center - discharge diagnosis: aortic stenosis mild coronary artery disease mitral and tricupsid regurgitation hypertension glaucoma left breat cancer status post mastectomy macular degeneration gastroesophageal reflux disease colon polyps surgery: bilateral vein stripping, tonsillectomy, total hip replacement, appendectomy, pacemaker implanted for bradycardia discharge condition: fair 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 and sechedule the following appointments dr. in 4 weeks pcp () in weeks cardiologist () in weeks md procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters open and other replacement of aortic valve with tissue graft combined right and left heart angiocardiography diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux intermediate coronary syndrome congestive heart failure, unspecified unspecified essential hypertension acute on chronic diastolic heart failure other chronic pulmonary heart diseases personal history of malignant neoplasm of breast other specified forms of chronic ischemic heart disease atrioventricular block, complete macular degeneration (senile), unspecified multiple involvement of mitral and aortic valves cardiac pacemaker in situ occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction diseases of tricuspid valve 

Answer: The patient is high likely exposed to