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: past medical history: this is an 82-year-old woman who has had a history of atrial fibrillation for the past 20 years. in , she was admitted to with congestive heart failure. a cardiac catheterization was performed at that time which revealed 2 to 3+ mitral regurgitation with a small atrial septal defect, as well as no flow-limiting coronary artery disease. since that admission, she has done well symptomatically until recently when she was admitted to again with congestive heart failure and lower extremity edema. she diuresed her while she was there, and then she was transferred to for further evaluation. an echocardiogram was performed on ; at which time the ejection fraction was noted to be 55%. the left atrium was markedly dilated with a left-to-right shunt noted across the intra-atrial septum. a secundum atrial septal defect was also present. there was 3+ mitral regurgitation, 1+ aortic insufficiency, and 2+ tricuspid regurgitation at that time. she was discharged home, taken off of her coumadin, and had been managed with lovenox, and she was to be admitted with her date of admission on for a repeat cardiac catheterization with mitral valve surgery to follow the next day. past medical history: (this is an 82-year-old woman with a past medical history significant for) 1. atrial fibrillation. 2. mitral regurgitation. 3. atrioseptal defect. 4. gastroesophageal reflux disease. 5. chronic obstructive pulmonary disease who has a remote history of cigarette smoking (quitting 20 years ago). past surgical history: past surgical history is significant for lens implants. allergies: the patient had drug allergies to accupril and an angiotensin medication (the exact medication unknown). medications on admission: (the patient's medications on admission were) 1. lasix 40 mg p.o. b.i.d. 2. hydralazine 10 mg p.o. q.i.d. 3. zantac 150 mg p.o. b.i.d. 4. isordil 10 mg p.o. t.i.d. 5. lovenox 60 mg p.o. b.i.d. (the last dose given on ). hospital course: she underwent a mitral valve replacement with a 31-mm mosaic porcine valve as well as left atrial atherectomy and atrial septal defect closure with left-sided maze procedure on . the total cardiopulmonary bypass time for this procedure was 124 minutes, and the total cross-clamp time was 92 minutes. the patient was transferred in stable condition, being arteriovenous paced at 80 beats per minute, to the cardiac surgery recovery unit on neo-synephrine at 0.5 mcg/kg per minute and propofol at 25 mcg/kg per minute. on postoperative day one, the patient was extubated at approximately 5 o'clock in the morning without complications. the patient was afebrile, being arteriovenous paced at 80 beats per minute. the patient's white blood cell count of 18.4, hematocrit was 30.6, and platelet count was 153. otherwise, electrolytes were stable. on postoperative day two, the patient remained afebrile. her vital signs were stable, and a junctional rhythm at 68, saturating at 94% on 2 liters nasal cannula. white blood cell count was down to 18.1, hematocrit was down to 26.4, and the platelet count was 138. electrolytes were normal. physical examination was unremarkable with a plan to begin lasix and to transfer to the floor. cardiology/electrophysiology service was consulted for the patient's persistent atrial fibrillation at which time they recommended to continue with beta blocker for now and coumadin with an inr goal of 2 to 3. they also stated that they would discuss with dr. regarding antiarrhythmic therapy, future cardioversion, and possible future electrophysiology procedures. on postoperative day three, the patient was afebrile. heart rate was 68. in atrial fibrillation. otherwise, vital signs were stable. white blood cell count was 18.1. the plan was to consult with cardiology regarding coumadin and amiodarone use. cardiology consulted with the patient again at that time; at which time they suggested intravenous heparin until her inr was greater than 2 with a goal of 2 to 3, to utilize a low-dose lopressor for high heart rates (for example, greater than 80 to 90), and to maintain it for 24 hours if the beta blocker was started for bradycardia, and if the patient required beta blocker and became bradycardic the patient may need a pacemaker. they also recommended to follow up with a private cardiologist after the patient was discharged. on postoperative day four, the patient was still afebrile. in atrial fibrillation at 77 beats per minute. otherwise, physical examination was unremarkable. the plan was to discharge the patient when her inr was greater than 2, and to administer 5 mg of coumadin today and then 2.5 mg of coumadin. inr at that time was 1.6. on postoperative day five, the patient was still afebrile. in a normal sinus rhythm at 71 beats per minute. the patient received a total of 7.5 mg of coumadin the night prior, and the plan was to continue to monitor the patient's inr with a plan for discharge when inr was greater than 2. condition at discharge: the patient was discharged on postoperative day six (which was ) in stable condition. physical examination on discharge: physical examination upon discharge was unremarkable. the patient was in sinus rhythm at 73 beats per minute and afebrile. inr was 2.4. white blood cell count was 15, and hematocrit was 25.2, and a platelet count of 142. discharge status: the patient was discharged to home. medications on discharge: (the patient was discharged on the following medications) 1. coumadin 3 mg p.o. q.d. (with a goal inr of 2.5 to 3). 2. lasix 20 mg p.o. b.i.d. 3. potassium chloride 20 meq p.o. b.i.d. 4. sarna lotion (for her skin rash). 5. ranitidine 150 mg p.o. b.i.d. 6. percocet one to two tablets p.o. q.4h. as needed (for pain). die instructions/followup: 1. the patient was to follow up with the clinic in two weeks; call office for appointment. 2. the patient was to follow up with dr. in four weeks; call office for appointment. 3. the patient was to follow up with dr. in three weeks; call office for appointment. 4. the patient was to follow up with dr. in two weeks; call office for appointment. discharge diagnoses: 1. mitral regurgitation, atrial fibrillation, and atrial septal defect. 2. status post mitral valve replacement, atrial septal defect closure, and left-sided maze procedure. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures other and unspecified repair of atrial septal defect open and other replacement of mitral valve with tissue graft extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures other and unspecified repair of atrial septal defect open and other replacement of mitral valve with tissue graft diagnoses: esophageal reflux mitral valve disorders congestive heart failure, unspecified atrial fibrillation ostium secundum type atrial septal defect other emphysema 

Answer: The patient is high likely exposed to