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: the patient is a 65 year old woman who was in her usual state of health until when she began to experience decreased exercise tolerance. she also developed substernal chest pain in for which she was brought to the emergency room of . she ruled in for a myocardial infarction and was found to be in mild congestive heart failure at that time. she was also found to have mitral regurgitation and atrial fibrillation. she has continued to have decreased exercise tolerance since her myocardial infarction and was referred to dr. for evaluation of mitral valve repair. a cardiac echocardiogram done in , showed a left atrial enlargement, right atrial enlargement and ejection fraction of 55%, focal root and ascending aortic calcifications, three plus mitral regurgitation and mild tricuspid regurgitation. mild pulmonary hypertension. cardiac catheterization done in , showed a right dominant system with occlusion of the distal left anterior descending status post thrombectomy and percutaneous transluminal coronary angioplasty of the distal left anterior descending at that time. past medical history: 1. mitral regurgitation. 2. atrial fibrillation. 3. congestive heart failure. 4. hypothyroidism. 5. status post myocardial infarction. 6. asthma. 7. chronic bronchitis. 8. mild cataracts. 9. borderline hypertension. 10. diverticulosis. 11. osteoarthritis. 12. gallstone pancreatitis. 13. incision of pilonidal cyst. 14. carpal tunnel release. 15. cholecystectomy. medications: 1. amiodarone 200 mg q. day. 2. diovan 80 mg q. day. 3. coumadin 5 mg q. day. 4. aspirin 325 q. day. 5. folate 1 q. day. 6. levoxyl 100 micrograms q. day. 7. multivitamin one tablet q. day. 8. vitamin e, no dose specified. 9. vitamin c, no dose specified. 10. calcium, no dose specified. 11. azatadine 10 mg q. day. 12. glucosamine no dose specified. 13. detrol with also no dose specified. allergies: no known drug allergies, although demerol does cause nausea and vomiting. family history: mother died at 88 of congestive heart failure. father died at 83 of congestive heart failure. four sisters, all with hypertension and hypercholesterolemia. occupation is a nurse, formerly at . she lives alone here in , . denies tobacco use, rare alcohol use. no other recreational drug use. physical examination: height 5'1", weight 164 pounds, heart rate 80 and sinus rhythm; blood pressure 120/80; respiratory rate 16. in general, in no acute distress. appears stated age. skin is well hydrated, no rashes or lesions. heent: pupils equally round and reactive to light. extraocular movements are intact. normal buccal mucosa. neck is supple; no jugular venous distention or thyromegaly with a left cervical lymph node. chest with bibasilar crackles; no wheezes or rhonchi. heart is regular rate and rhythm with s1 and s2, with a ii/vi ejection murmur heard best at the apex, radiating to the left axilla. abdomen is soft, mildly obese, nontender, nondistended. mid-abdominal scar which is well healed. extremities are warm with no edema or cyanosis. mild varicosities of bilateral lower extremities. neurologic is cranial nerves ii through xii grossly intact. no motor or sensory deficits. pulses: femoral two plus bilaterally, dorsalis pedis one plus bilaterally; posterior tibial one plus bilaterally. radial two plus bilaterally. carotids are two plus with no bruits. laboratory: white blood cell count 4.7, hematocrit 37.5, platelets 291. sodium 138, potassium 4.4, chloride 101, co2 29, bun 20, creatinine 0.8, inr 3.0. chest x-ray with no pleural effusions, resolution of congestive heart failure pattern. degenerative changes of skeletal structures, left atrial enlargement consistent with history of mitral valve disease. no active pulmonary process. electrocardiogram is sinus rhythm, rate of 66, pr is 180; qrs 100, qt 464. t waves in iii and f with non-specific st changes. hospital course: as stated previously, the patient was a direct admission to the operating room where she underwent a mitral valve replacement with a #31 mechanical valve and a mays. her bypass times was 140 minutes with a cross clamp time of 103 minutes. please see the operating report for full details and summary. she had an mitral valve replacement and mays. she tolerated the procedure well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient was in a sinus rhythm at 74 beats per minute with a mean arterial pressure of 64. she had neo-synephrine at one point at 5 mics per kg per minute and propofol at 20 mics per kg per minute. the patient did well in the immediate postoperative period, however, within an hour of arrival in the intensive care unit, she did start to have a problem with excessive chest tube bleeding. her act was mildly elevated for which she was treated with protamine. her inr was mildly elevated for which she was treated with fresh frozen plasma. in addition, the patient received two units of packed red blood cells and a bag of platelets, following which the patient's chest tube drainage dissipated. the patient remained hemodynamically stable throughout that period. on postoperative day one, the patient continued to be hemodynamically stable. her sedation was discontinued at that time. she was weaned from the ventilator and successfully extubated. her chest tubes and swan-ganz catheter however were left in place at that time for further monitoring. on postoperative day two, the patient remained on a low dose neo-synephrine infusion to maintain an adequate blood pressure. she remained hemodynamically stable. her beta blockade was begun in the late afternoon of postoperative day two following a weaning of her neo-synephrine as was her diuretic therapy. additionally, the patient was begun on coumadin on postoperative day two. on postoperative day three, the patient remained hemodynamically stable off of all vasoactive intravenous infusions. her chest tubes were removed as was her temporary pacing wires and she was transferred to the floor for continuing postoperative care and cardiac rehabilitation. over the next several days, the patient had an uneventful postoperative course. she received coumadin daily with an attempt to increase her inr to the therapeutic range of 3.0 to 3.5. additionally she was on a heparin infusion during that period of time. with the assistance of the nursing staff and the physical therapy staff, the patient's activity level was increased. on postoperative day seven, the patient's inr had increased to 1.9. up to that point, she had received coumadin 5 mg times three consecutive days, followed by coumadin 7.5 mg on and 30th. at this point, we anticipate that the patient's inr will be in the mid 2.0 range on saturday, , and at that point she will be considered for discharge to home with daily inr checks until she reaches her goal inr of 3.0 to 3.5. at the time of this dictation, the patient's physical examination is as follows: vital signs with temperature of 99.0 f., heart rate 70 in sinus rhythm; blood pressure 95/45; respiratory rate 20; o2 saturation of 96% on room air. weight preoperatively was 73 kilograms. at discharge her weight is 75.8 kilograms. laboratory data was white blood cell count of 8.7, hematocrit 29, sodium 142, potassium 4.5, chloride 106, co2 31, bun 12, creatinine 0.7, glucose 89. inr on , is 1.9. on physical she is alert and oriented times three, moves all extremities and follows commands. respiratory is clear to auscultation bilaterally. cardiac is regular rate and rhythm with s1, s2 with mechanical click. sternum is stable. incision with steri-strips, open to air, clean and dry. abdomen is soft, nontender, nondistended with normoactive bowel sounds. extremities are warm and well perfused with less than one plus edema bilaterally. discharge medications: 1. metoprolol 12.5 mg twice a day. 2. furosemide 20 mg q. day times two weeks. 3. potassium chloride 20 meq q. day times two weeks. 4. enteric coated aspirin 81 mg q. day. 5. amiodarone 400 mg q. day. 6. levoxyl 100 micrograms q. day. 7. warfarin as directed with goal inr of 3.0 to 3.5; warfarin doses 04/26 was 5 mg, was 5 mg, 5 mg, 7.5 mg; on 7.5 mg. 8. acetaminophen 650 mg q. six p.r.n. 9. percocet 5/325 one to two q. four to six hours also p.r.n. condition at discharge: the patient's condition on discharge is good. discharge diagnoses: 1. mitral regurgitation status post mitral valve replacement with a #31 mechanical valve. 2. atrial fibrillation status post mays procedure. 3. history of congestive heart failure. 4. hypothyroidism. 5. asthma. 6. chronic bronchitis. 7. cataracts. 8. borderline hypertension. 9. diverticulosis. 10. osteoarthritis. 11. gallstone pancreatitis. 12. status post cholecystectomy. 13. status post excision of pilonidal cyst. 14. status post carpal tunnel release. 15. coronary artery disease status post percutaneous transluminal coronary angioplasty of the left anterior descending. discharge status: the patient is to be discharged to home with visiting nurses. discharge instructions: 1. follow-up in the wound clinic in two weeks. 2. to follow-up with dr. in three weeks. 3. follow-up with dr. in four weeks. 4. additionally, the patient's inr is to be followed by dr. , telephone number . her first inr check is to be done by the visiting nurses the day following discharge. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube excision or destruction of other lesion or tissue of heart, open approach insertion of temporary transvenous pacemaker system arterial catheterization open and other replacement of mitral valve pulmonary artery wedge monitoring transfusion of packed cells transfusion of other serum transfusion of platelets diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified atrial fibrillation other chronic pulmonary heart diseases hemorrhage complicating a procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation old myocardial infarction mitral stenosis unspecified chronic bronchitis 

Answer: The patient is high likely exposed to