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: promethazine/codeine attending: chief complaint: chest pain and syncope major surgical or invasive procedure: s/p avr(19mm mosaic porcine valve)/aortic endarterctomy s/p pacer placement history of present illness: this 84wf presented to with cp and was in af. she was treated with lopressor and dilt and became asystolic. she was resuscitated and transferred to . she was found to have aortic stenosis and is now admitted for avr. past medical history: aortic stenosis recent afib htn pseudogout of r knee hypothyroidism gerd, egd breast cancer s/p left mastectomy s/p hysterectomy osteoporosis on evista aortic stenosis djd hand iron deficiency anemia left shoulder impingement syndrome spinal stenosis: mri showed severe stenosis of spinal canal and recesses at l4-l5 osteoarthritis: right lower extremity pain and lower back pain paronychia actinic keratosis on r face social history: social history is significant for the absence of current tobacco use. she previously smoked 1 ppd, but quit 40 years ago. there is no history of alcohol abuse. she lives at home with a boarder. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: elderly wf in nad avss heent: nc/at, oropharynx benign neck: supple, from, no lymphadenopathy or thyromegaly, carotids 2+ bilat. with rad murmur lungs: clear to a+p cv: rrr w/ iii/vi sem abd: +bs, soft, nontender, without masses or hepatosplenomegaly ext: without c/c/e, pulses 2+= bilat. throughout neuro: nonfocal pertinent results: 07:15am blood wbc-13.2* rbc-3.61* hgb-11.0* hct-32.2* mcv-89 mch-30.4 mchc-34.0 rdw-14.0 plt ct-294 09:04am blood pt-24.2* inr(pt)-2.4* 07:15am blood glucose-99 urean-19 creat-1.1 na-139 k-4.1 cl-99 hco3-34* angap-10 radiology preliminary report chest (pa & lat) 6:12 pm chest (pa & lat) reason: eval for pleural effusions medical condition: 84 year old woman s/p avr reason for this examination: eval for pleural effusions chest history: avr. two views. comparison with the previous study done . small bilateral pleural effusions and subsegmental atelectasis or scarring at the right base are again demonstrated. the patient is status post median sternotomy and avr as before. a bipolar transvenous pacemaker remains in place. aorta is mildly tortuous and calcified. mediastinal structures are unchanged. the bony thorax is grossly intact. there are degenerative arthritic changes in the spine. impression: small pleural effusions. status post avr. no significant change. dr. dr. brief hospital course: the pt. was admitted and underwent elective avr(19mm mosaic porcine valve)/aortic endarterectomy. the cross-clamp time was 52 mins., total bypass timewas 72 mins. the pt. tolerated the procedure well and was transferred to the cvicu in stable condition on propofol and neo. she had a stable post op night and was extubated on pod#1. she was quite lethargic but eventually was more alert. her chest tubes were d/c'd on pod#2 and was transferred to the floor on pod#4. she had intermittent af and was treated with beta blockers. on pod#5 she had a 10 second pause and was paced with her temporary epicardial wires. ep was consulted and on pod#7 she underwent permanent pacer placement. she was restarted on coumadin for afib. she continued to have intermittent rapid a fib and her beta blocker was increased. her inr became supratherapeutic and her coumadin was held. her inr came down and she was discharged on 1 mg daily. she was discharged to rehab in stable condition on pod#11. medications on admission: thyroid 15mg po 5x/week. asa 81 mg po daily ascorbic acid 500 mg po bid calcium carbonate 1500mg po tid vitamin d3 400 mg po daily raloxifene 60 mg po daily prilosec 20 mg po daily lopressor 12.5 mg po daily hexavitamin 1 po daily simvistatin 40 mg po daily lisinopril 5 mg po daily discharge medications: 1. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po q12h (every 12 hours) for 5 days. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 5. raloxifene 60 mg tablet sig: one (1) tablet po daily (). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. hydrocortisone 2.5 % cream sig: one (1) appl rectal tid (3 times a day). 8. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 9. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day) for 5 days. 10. thyroid 30 mg tablet sig: 0.5 tablet po 5x/week (,mo,we,th,sa). 11. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. 12. cefazolin 1 g iv q12h pacer duration: 3 days 13. hydralazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 14. metoprolol tartrate 50 mg tablet sig: 2.5 tablets po tid (3 times a day). 15. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 3 days: then decrease dose to 400 mg po daily for 7 days, then decrease to 200 mg po daily. 16. coumadin 1 mg tablet sig: one (1) tablet po once a day: check daily pt, dose for inr goal of .5. 17. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed. discharge disposition: extended care facility: & rehab center - discharge diagnosis: aortic stenosis htn hypothyroidism gerd s/p breast ca, s/p l mastectomy s/p tah osteoporosis iron deficiency anemia spinal stenosis discharge condition: good. discharge instructions: follow medications on discharge instructions. do not drive for 4 weeks. do not lift more than 10 lbs for 2 months. after pacer dressing is off (7 days), shower daily, let water flow over wounds. do not use lotions, powders, or creams on wounds. call our office for temp. >101.5, sternal drainage. followup instructions: provider: clinic phone: date/time: 9:00 make an appointment with dr. for 1-2 weeks. make an appointment with dr. for 4 weeks. procedure: extracorporeal circulation auxiliary to open heart surgery initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle open and other replacement of aortic valve with tissue graft endarterectomy, aorta procedure on single vessel diagnoses: esophageal reflux congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism atherosclerosis of aorta atrial fibrillation aortic valve disorders personal history of malignant neoplasm of breast osteoporosis, unspecified iron deficiency anemia, unspecified sinoatrial node dysfunction personal history of irradiation, presenting hazards to health stricture and stenosis of esophagus postmastectomy lymphedema syndrome candidiasis of skin and nails acquired absence of breast and nipple 

Answer: The patient is high likely exposed to