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: sulfa (sulfonamides) attending: chief complaint: chest pain major surgical or invasive procedure: : . epic supra porcine aortic valve replacement coronary artery bypass graft surgery with left internal mammory artery to the left anterior descending, reverse saphenouse vein graft to the posterior descending artery history of present illness: this is an 88 year old female with known severe aortic stenosis. notable for she was recently hospitalized at for a fall and underwent workup for anemia. workup was negative for gi bleed via colonoscopy/endoscopy. she is relatively asymptomatic except for exertional leg discomfort. she denies dyspnea, chest pain, syncope, presyncope, orthopnea, pnd and pedal edema. given the severity of her aortic stenosis, she is now referred for surgical evaluation. past medical history: aortic stenosis hypertension dyslipidemia peripheral vascular disease carotid disease basilar artery aneurysm history of sick sinus syndrome s/p pacemaker implant osteoporosis lower extremity neuropathy history of syncope - last episode 2-3 years ago history of anxiety/panic disorder macular degeneration chronic venous insufficiency history of colon cancer anemia s/p recent falls sigmoid diverticulosis/small gastric ulcer - recently noted on colonoscopy/endoscopy history of shingles s/p pacemaker implantation s/p bilateral total knee replacements s/p colon resection s/p back surgery s/p laparoscopic cholecystectomy s/p cataract surgery social history: -tobacco history: 30 pack year history, quit in . -etoh: social -illicit drugs: none family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission: pulse: 60 resp: 16 o2 sat: 97% b/p right: 161/68 left: 155/68 height: 5'4" weight: 152# general: elderly female in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom - no jvd chest: lungs clear bilaterally heart: rrr irregular murmur 4/6 systolic murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: trace varicosities: superfical varicosities noted on lower extremities. gsv appears suitable neuro: grossly intact pulses: femoral right: 2 left: 1 - *****bilateral bruits**** dp right: decreased left: decreased pt : decreased left: decreased radial right: 1 left: 1 carotid bruit right: none left: yes pertinent results: : tte pre-cpb:1. the left atrium is mildly dilated. no spontaneous echo contrast is seen in the left atrial appendage. no thrombus is seen in the left atrial appendage. no thrombus is seen in the right atrial appendage no atrial septal defect is seen by 2d or color doppler. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. lvef= 60 %. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the ascending aorta. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. the ncc is immobile and heavily calcified. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. post-cpb: on infusion of nitroglycerine. av pacing. well-seated bioprosthetic valve in the aortic position. no ai. gradient is now peak 15 mmhg. = 1.5 cm2. normal biventricular systolic function. mild mr, tr as before. aortic contour is normal post decannulation. 08:00am blood wbc-9.0 rbc-4.07* hgb-11.8* hct-36.2 mcv-89 mch-28.9 mchc-32.5 rdw-16.2* plt ct-344 05:20am blood wbc-13.6* rbc-4.03* hgb-11.9* hct-36.1 mcv-90 mch-29.5 mchc-32.9 rdw-17.0* plt ct-303# 08:00am blood glucose-78 urean-35* creat-0.9 na-128* k-4.4 cl-91* hco3-27 angap-14 05:20am blood glucose-148* urean-27* creat-0.8 na-132* k-4.3 cl-98 hco3-27 angap-11 06:25am blood wbc-9.9 rbc-3.93* hgb-11.8* hct-35.1* mcv-89 mch-30.1 mchc-33.6 rdw-16.7* plt ct-411 06:25am blood glucose-108* urean-36* creat-1.0 na-132* k-5.4* cl-96 hco3-28 angap-13 06:25am blood wbc-9.9 rbc-3.93* hgb-11.8* hct-35.1* mcv-89 mch-30.1 mchc-33.6 rdw-16.7* plt ct-411 06:55am blood k-5.4* 06:25am blood glucose-108* urean-36* creat-1.0 na-132* k-5.4* cl-96 hco3-28 angap-13 brief hospital course: this is an 88 year old female with know aortic stenosis and peripheral vascular disease who initially presented with chest pain. she underwent cardiac catherization and was found to have 2 vessel coronary artery disease. she had a preoperative workup with included a hepatology consult for elevated transaminase. preoperative chest ct revealed multiple less than 3 mm lung nodules for which follow up in one year is recommended. she was brought to the operating room on for aortic valve replacement with a . medical biocor tissue valve and a coronary artery bypass surgery x2 with left internal mammary artery graft to left anterior descending, reverse saphenous vein graft to the posterior descending artery. see operative note for full details. she weaned from bypass on neo synephrine and propofol infusions. she was weaned from all vasoactive medications and extubated on post operative day 1 without incident. the ep service interrogated her permanent pacemaker on the night of surgery and parameters were good. she went into atrial fibrillation on postoperative day 2 and was started on amiodarone with conversion to sinus rhythm. her oral doses were decreased after she was complaining of nausea. beta blockers were begun as was diuresis. she was transferred to the step down unit in stable condition on post operative day 3. her foley needed to be reinserted due to urinary retention and was subsequently removed on postoperative day 4 and passed her voiding trial. she has poor intake and was started on nutritional supplements. chest tubes and pacing wires were removed per cardiac surgery protocol. she continued to work with physical therapy to increase strength and endurance. she developed recurrent atrial fibrillation on pod 5 with a ventricular rate of 100-120. hydralazine was discontinued and lopressor increased. she converted to sinus rhythm and remained there for 24 hours. coumadin was not begun. she was ready for discharge on and was discharged to . arrangments were made for outpatient followup. medications are as listed elsewhere. medications on admission: cilostazol 100 aggrenox 25/200 tabs, one tab twice daily alendronate 70 mg weekly citalopram 10 mg daily furosemide 20 mg daily gabapentin 600 mg qhs diltiazem 120 mg daily lorazepam 0.5mg prn pravastatin 40mg qd zolpidem 5mg prn qhs metamucil one tsp daily vit. d/calcium carbonate mvi 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. cilostazol 100 mg tablet sig: one (1) tablet po bid (2 times a day). 4. multivitamin tablet sig: one (1) tablet po daily (daily). 5. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 6. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 7. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 8. pravastatin 20 mg tablet sig: two (2) tablet po daily (daily). 9. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 10. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constip. 11. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fever/pain. 12. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 13. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day). 14. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed for constipation. 15. psyllium oral 16. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 17. lorazepam 0.5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for sleep. 18. furosemide 40 mg tablet sig: one (1) tablet po once a day for 2 weeks. discharge disposition: extended care facility: - discharge diagnosis: aortic stenosis coronary artery disease s/p aortic valve replacement s/p coronary artery bypass grafts hypertension hyperlipidemia s/p cholecystectomy h/o colon cancer s/p permanent transvenous pacemaker implant chronic venous insufficiency peripheral vaacular disease cerebrovascular disease discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with incisions: sternal - healing well, no erythema or drainage leg (left) - healing well, no erythema or drainage. 1+ edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments provider: , md () on: at 1:15 please call to schedule: primary care: dr. () in weeks cardiologist: dr. in weeks device clinic at in weeks **needs chest ct followup in 1 year for multiple lung nodule finding** **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters angiocardiography of left heart structures diagnostic ultrasound of heart (aorto)coronary bypass of one coronary artery cardioplegia open and other replacement of aortic valve with tissue graft right heart cardiac catheterization diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation aortic valve disorders peripheral vascular disease, unspecified mononeuritis of lower limb, unspecified other and unspecified hyperlipidemia anxiety state, unspecified osteoporosis, unspecified macular degeneration (senile), unspecified personal history of malignant neoplasm of large intestine cardiac pacemaker in situ other diseases of lung, not elsewhere classified acute diastolic heart failure knee joint replacement venous (peripheral) insufficiency, unspecified other specified retention of urine nonspecific abnormal results of function study of liver 

Answer: The patient is high likely exposed to