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: this is a 65 year old woman with atrial fibrillation who was on coumadin, however, with an inr of 1.2. she was in her general state of good health the night prior to admission at around 8 pm when she was last found on the floor. the patient speaks only cantanese and the history was acquired through an interpreter. she has had atrial fibrillation chronically but has not been compliant with her medications in the past. she also has a history of rheumatic heart disease. medications on admission: coumadin, lopressor and amiodarone past medical history: atrial fibrillation, she was cardioverted . she also has a history of rheumatic heart disease. physical examination: blood pressure 121/76, heart rate 91, oxygen 97, temperature afebrile, respiratory rate 26. her chest showed bilateral rales with wheezing. cardiovascular, regular rate and rhythm. no murmur. abdomen soft, nontender, nondistended. extremities, no cyanosis, clubbing or edema. neurological, somnolent, able to tell the location and name in cantanese. naming, did not open eyes for naming. cards, repetitively mumbling. follows commands to touch, right index finger to left ear with right and leg, and opened her eyes briefly. cranial nerves, pupils are equal, round, and reactive, 4 mm to 3 mm. fundi, unable to visualize secondary to forced eye closing. extraocular motions, conjugated deviation to the right, able to move eyes over midline. left field does not respond to visual threat. cranial nerves vii, mild decrease in nasolabial fold, tongue deviates to the left. motor, spastic tone in the left lower extremity, left upper extremity was flaccid with extensive tone on pain. left arm, no spontaneous movement, left lower extremity, triple flexion, with spontaneous movements in the right upper extremities and right lower extremities. lifts right upper extremity on command finger-to-nose, no ataxia on right heel-to-shin, not done. gait not examined. sensory, extension on pain in the left upper extremity, triple flexion on pain, withdrawing grimace on the right. hospital course: the patient was seen in the emergency department and tpa was initiated at 2 am after informed consent was obtained from the son. was aware that there was a high risk of bleed. her magnetic resonance imaging scan prior to the tpa showed a right middle cerebral artery occlusion. head computerized tomography scan showed no ischemic sign but the right middle cerebral artery was hyperdense. the patient was then admitted to the intensive care unit and was followed there for two days until she was transferred to the floor. cardiology was consulted because it was found that she was actually in atrial fibrillation with a low inr. they recommended holding amiodarone until she was in normal sinus rhythm and started the patient on heparin and restarting coumadin in addition. the patient was stable and transferred out to the floor on . on transfer to the floor the patient had some decrease in oxygen saturations and was given an albuterol nebulizer with a subsequent increase in her heart rate. at that point in spite of the lopressor her heart rate continued in the 100s to 120s and her pressure was in the low 100s. the following day she was started on digoxin loaded with subsequent improvement in her blood pressure to the 120s. thus, she was continued on digoxin 0.125 p.o. q.d. as well as on lopressor. carotid dopplers are pending as of , but preliminary read was negative. no significant stenosis. in addition she had a cardiac echocardiogram done to evaluate her cardiac function which showed on of left atrium moderately dilated, right atrium elongated, right ventricular systolic function depressed, mitral leaflets moderately thickened. mitral valve shows characteristic rheumatic deformity with huge commissures and tethering of leaflet motion, moderate mitral stenosis, moderate to severe tricuspid regurgitation and deterioration of ventricular function, pulmonary artery pressure was higher than the echocardiogram of . the ejection fraction on this echocardiogram was read as 25-35% on this echocardiogram. the patient was kept on her heparin drip and was therapeutic throughout and started on coumadin. she improved with regard to her mental status and was able to eat a soft mechanical diet. for cardiac status captopril was started as well for afterload reduction. on she had full strength on the right side, deltoid, biceps, triceps and iliopsoas and her left side remained flaccid. magnetic resonance imaging scan showed a right ica occlusion with basal ganglia infarct, likely cardioembolic secondary to her atrial fibrillation. discharge diagnosis: 1. right basal ganglia infarct with right ica occlusion 2. atrial fibrillation discharge medications: 1. captopril 6.25 p.o. t.i.d. 2. lopressor 12.5 mg b.i.d. 3. heparin drip at 600/hr 4. digoxin .125 mg p.o. q.d. 5. aspirin as per cardiology 6. zantac 150 mg p.o. b.i.d. discharge status: discharged to rehabilitation. , m.d. dictated by: medquist36 procedure: injection or infusion of thrombolytic agent diagnoses: atrial fibrillation cerebral artery occlusion, unspecified with cerebral infarction 

Answer: The patient is high likely exposed to