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: vicodin / darvocet-n 100 / morphine / lactose / anti-histamines attending: chief complaint: direct admit for percutaneous arotic valve placement major surgical or invasive procedure: aortice corevalve placement history of present illness: mrs. is an active year old woman with a history of hypertension, hyperlipidemia, previous breast ca and critical aortic stenosis. she hadsignificant improvement in symptoms following aortic balloonvalvuloplasty , but has had gradual progression in symptoms overthe last 2-3 months and is currently nyha class symptoms. she is deemed to be extreme risk for avr so is enrolled in the corevalve protocol for percutaneous valve placement. . she states she has no sob at rest or during sleep, sleeps with 2 pillows. she is able to ambulate around her home without sig sob but gets doe with 1 flight of stairs and walking more than about 20 feet. sob resolves with rest. denies cough, sputum production, fevers, chills or signs of infection. no recent leg pain or redness, swelling, or symptoms of claudication. . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, ankle edema, palpitations, syncope or presyncope. she has a history of falls but describes these as mechanical only. past medical history: 1. cardiac risk factors: -diabetes, +dyslipidemia, +hypertension 2. cardiac history: 1. severe aortic stenosis s/p valvuloplasty x2 2. dyslipidemia 3. hypertension -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: past medical history: 4. breast ca (left partial mastectomy, on arimidex) 5. lactose intolerance 6. severe osteoporosis 7. cervical arthritis 8. carpal tunnel syndrome 9. blind right eye- r eye prosthesis 10. cataract in left eye 11. colon ca s/p bowel resection 12. gerd 13. multiple falls past surgical history: - aortic valvuloplasty x2. last - left breast partial mastectomy - right intertrochanteric hip fracture s/p open reduction, internal fixation with dhs construct. - right open carpal tunnel release - left total knee replacement - bilateral cataract surgery - wide excision of lesion of left lower leg. (non-malignant) - partial colectomy for a malignant polyp in social history: her son is dr. , a cardiologist. -tobacco history: none -etoh: none -illicit drugs: none independent with adl's, lives alone. she is active for her age. she enjoys bridge, and socializing with her friends family history: father died of mi at 65 physical exam: general: elderly lady in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. right eye is prosthesis, left pupil sluggish. left eye with eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of 12 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. 4/6 systolic murmur radiating to bilat carotids. no thrills, lifts. no s3 or s4. lungs: pos kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. no abdominal bruits. extremities: no c/c/e. no femoral bruits. feet warm skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 1+ popliteal 1+ dp 2+ pt 2+ left: carotid 2+ femoral 1+ popliteal 1+ dp 2+ pt 2+ . day of discharge: right groin with quarter sized hematoma at puncture site, no ecchymosis or tenderness, no erythema. positive bruit. left groin with mild ecchymosis, no tenderness or hematoma. cv: rrr, 1/6 systolic murmur at lusb, no radiation resp: crackles left base, clears with cough, no wheezes abd: soft, nt extremeties: no edema pertinent results: i. labs a. admission 07:30am blood wbc-4.2 rbc-3.61* hgb-11.5* hct-32.7* mcv-91 mch-31.8 mchc-35.2* rdw-13.6 plt ct-181 11:15am blood pt-13.0 ptt-29.4 inr(pt)-1.1 11:39am blood fibrino-326 11:15am blood glucose-100 urean-34* creat-0.8 na-137 k-4.1 cl-101 hco3-29 angap-11 11:15am blood alt-17 ast-23 ck(cpk)-91 alkphos-79 totbili-0.4 11:15am blood albumin-3.9 11:15am blood %hba1c-5.7 eag-117 05:19am blood tsh-2.0 b. discharge 06:15am blood wbc-5.0 rbc-3.32* hgb-10.6* hct-30.5* mcv-92 mch-32.0 mchc-34.9 rdw-13.4 plt ct-175 06:15am blood plt ct-175 06:15am blood glucose-85 urean-28* creat-0.9 na-135 k-4.2 cl-101 hco3-30 angap-8 c. urine 10:29pm urine color-yellow appear-clear sp -1.011 10:29pm urine blood-neg nitrite-neg protein-100 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-neg 10:29pm urine rbc-<1 wbc-1 bacteri-few yeast-none epi-<1 ii. microbiology blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient urine urine culture-pending inpatient staph aureus screen staph aureus screen-final inpatient staph aureus screen staph aureus screen-final inpatient staph aureus screen not processed inpatient staph aureus screen staph aureus screen-final inpatient staph aureus screen not processed inpatient urine urine culture-final inpatient mrsa screen mrsa screen-final inpatient iii. cardiology a. admission ecg cardiology report ecg study date of 3:05:26 pm sinus rhythm. left atrial abnormality. left ventricular hypertrophy with st-t wave changes. since the previous tracing of precordial lead qrs voltage is less prominent. read by: , w. intervals axes rate pr qrs qt/qtc p qrs t 66 192 88 8 b. echo () pre valve deployment moderate to severe spontaneous echo contrast is seen in the body of the left atrium. moderate to severe spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no atrial septal defect is seen by 2d or color doppler. there is moderate symmetric left ventricular hypertrophy. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). with normal rv free wall contractility. there are simple atheroma in the ascending aorta. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is mild valvular mitral stenosis (area 1.5-2.0cm2). mild to moderate (+) mitral regurgitation is seen. drs , and were notified in person of the results on at 930 am. post valve deployment stented aortic valve seen extending from the lvot into the proximal aorta. trace to mild central aortic insufficiency present. the peak gradient across the aortic valve is 17 mm hg and the mean gradient is 9 mm hg. mild mitral insufficiency seen. drs , and were notified of the post deployment findings. c. c. cath: final report pending d. post-core valve echo the left atrium is normal in size. the left atrium is elongated. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). there is a mild resting left ventricular outflow tract obstruction. right ventricular chamber size and free wall motion are normal. an aortic corevalve prosthesis is present. the aortic valve prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. trace to mild aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is severe mitral annular calcification. there is mild functional mitral stenosis (mean gradient 6 mmhg) due to mitral annular calcification. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normally-functioning corevalve aortic valve prosthesis. trace to mild central jet of aortic regurgitation. mild symmetric left ventricular hypertrophy with normal global and regional biventricular systolic function. iv. radiology a. pre-op cxr exam: chest frontal and lateral views. clinical information: 89-year-old female with severe aortic stenosis, preop for percutaneous aortic valve replacement. comparison: , reference also made to the scout from cardiac ct and coronary cta from . findings: frontal and lateral views of the chest are obtained. prominent right hilum is without significant change from the scout view from , and likely represents prominent confluence of vessels. no focal consolidation, pleural effusion, or pneumothorax is seen. the cardiac silhouette remains borderline to mildly enlarged and the thoracic aorta tortuous. degenerative changes are seen along the spine. impression: 1. unchanged prominence of the right hilum, most likely reflecting vascular structures. 2. no acute cardiopulmonary process. ### pending studies: blood culture x 2 ( and ) brief hospital course: -year-old female with critical as but decent functional capacity admitted electively for percutaneous aortic valve replacement. . # critical as: patient admitted for corevalve placement that was successful. she maintained adequate hemodynamics and remained in normal sinus rhythm without complications at groin site except a small hematoma as documented on discharge exam. post-op she was found to have wide pulse pressure (>100). a cxr at the time revealed "corevalve device overlying the lv outflow tract and proximal aortic root, tip of the internal pacemaker at the level of the rv, no pneumothorax, pulmonary edema or pleural effusions". she was extubated on without difficulty. except for an episode of afib, she did not experience sob or lightheadedness or palpitations at rest. she was quickly able to ambulate on the floor of the icu without sob or lightheadedness. she was transferred to the floor and continued to work with pt. telemetry showed a brief episode of 2:1 wenkebach for which she remained in the hospital for further observation with no further subsequent episodes. she was discharged with a koh monitor. # htn: at home, she takes very small of acei and bb. she had significant hypertension post-op and was placed on nitro gtt which was stopped on during an episode of afib with hypotension. after converting to sinus she was treated with escalating of enalapril and her metoprolol was stopped. given sbp in the 170s-180s, her enalapril was uptitrated to 12.5 mg po bid with sbp in the 150s on discharge. # fever patient had a low-grade fever of 100 the day prior to discharge. a urinalysis was bland, and blood culture was drawn. there were no focal signs or symptoms of infection except a sore throat. her vital signs were stable, and she was afebrile on discharge. she wanted to leave the hospital, so she was told to report back to the hospital should she have further fevers. # rhythm: in nsr until when she developed an episode of afib in the setting of diuresis. she was hypotensive to the sbp 70s. she was treated with amiodarone 150mg iv bolus x2 resulting in conversion to sinus rhythm with the second dose. she was started on an amio gtt which was changed to amiodarone po. she was discharged on amiodarone 200 mg po qd. # hyperlipidemia: no recent lipid numbers available, she was continued on her statin. # pump. preserved ef. doe and orthopnea thought tight as vs chf. has been stable on low dose furosemide. states she follows low na diet at home and prepares many meals. she was kept on strict daily weights and i/os. she was diuresed for uop >100 until . she was continued on clopidogrel, enalapril, atorvastatin, furosemide, and aspirin 81. her metoprolol was discontinued. # hx of left breast ca, s/p partial mastectomy . not an active issue she was continued on arimidex. # transitions of care - outpatient safety labs for potassium given increased acei dosage - outpatient follow-up with cardiology and pcp monitoring with koh given episode of wenkebach during hospitalization medications on admission: alendronate 70 mgs once weekly anastrazole 1 mgs daily lipitor 10 mgs qhs enalapril 2.5 mgs, 0.5 tabs , 0.25 tab at night prn for high bp furosemide 10 mgs daily metoprolol 12.5 mgs daily, 18.75 mg at night acetaminophen 325 mgs prn ascorbic acid 500 mgs daily calcium citrate-vit d3 315mgs-200 unit tablet 2 tabs multivitamin 1 tab daily. glucosamine chondroiten ds 1 tab preservision one tab discharge medications: 1. outpatient lab work please check chemistry 10 panel within 10 days of discharge fax results to pcp: , . address: ,, , phone: fax: 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*12* 3. alendronate 70 mg tablet sig: one (1) tablet po qsun (every sunday). 4. anastrozole 1 mg tablet sig: one (1) tablet po daily (daily). 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. enalapril maleate 5 mg tablet sig: 2.5 tablets po bid (2 times a day). disp:*150 tablet(s)* refills:*2* 7. atorvastatin 10 mg tablet sig: one (1) tablet po once a day. 8. furosemide 20 mg tablet sig: 0.5 tablet po daily (daily). 9. ascorbic acid 500 mg tablet sig: one (1) tablet po daily (daily). 10. acetaminophen 325 mg tablet sig: one (1) tablet po twice a day as needed for pain. 11. calcium 500 + d 500 mg(1,250mg) -200 unit tablet sig: two (2) tablet po twice a day. 12. preservision 7,160-113-100 unit-mg-unit tablet sig: one (1) tablet po bid (2 times a day). 13. multivitamin tablet sig: one (1) tablet po daily (daily). 14. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 15. glucosamine chondroitin maxstr oral 16. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal (2 times a day). disp:*1 bottle* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnosis: aortic stenosis s/p corevalve placement hypertension secondary diagnosis: breast cancer dyslipidemia osteoprosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you had a corevalve aortic valve replacement to repair severe aortic stenosis. subsequent echocardiograms show the valve is well placed and functioning as expected. you transiently had a type of heart block, a problem with the electrical system of the heart which is gone now. you also developed atrial fibrillation transiently which is also now gone. we want you to wear a " of hearts" monitor and send telephone transmissions twice daily to monitor for any further arrhythmias. your blood pressure was high after the corevalve placement so we increased your enalapril to lower your blood pressure. please refer to the attached discharge insruction after aortic valve implantation for activiy and follow up instructions. please weight yourself every day in the morning, call dr. if weight increases more than 3 pounds in 1 day or 5 pounds in 3 days. . we made the following changes to your medicines: 1. start taking every day for at least 3 months and possibly longer. do not miss or stop taking unless dr. or tells you it is ok. 2. increase your enalapril to 12.5 mg twice daily to control your high blood pressure. 3. start taking amiodarone to prevent the atrial fibrillation from returning. 4. stop taking metoprolol as the amiodarone will slow your heart rate as well. 5. start taking aspirin 81 mg (baby dose) to work with the to prevent blood clots. 6. start taking fluticasone nasal spray to prevent post nasal drip. you can stop taking this when your sore throat and cough improves. followup instructions: department: medical specialties when: thursday at 10:00 am with: bone density testing building: campus: east best parking: garage department: medical specialties when: thursday at 11:00 am with: , m.d. building: sc clinical ctr campus: east best parking: garage department: radiology when: tuesday at 12:50 pm with: radiology building: campus: east best parking: garage . name: , m. address: ,, , phone: appointment: monday at 11am department: cardiac services when: friday at 2:00 pm with: , md building: sc clinical ctr campus: east best parking: garage department: cardiac surgery when: friday at 1 pm with: , md building: lm campus: west best parking: garage department: cardiac services when: friday at 2:00 pm with: , md campus: west best parking: garage department: cardiac services when: friday at 11:00 am and dr. at 12:00 noon with: echocardiogram building: sc clinical ctr campus: east best parking: garage procedure: combined right and left heart cardiac catheterization intraoperative cardiac pacemaker open and other replacement of aortic valve with tissue graft aortography percutaneous balloon valvuloplasty diagnoses: other iatrogenic hypotension esophageal reflux congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation hematoma complicating a procedure aortic valve disorders personal history of malignant neoplasm of breast other and unspecified hyperlipidemia other specified cardiac dysrhythmias osteoporosis, unspecified chronic systolic heart failure personal history of malignant neoplasm of large intestine acquired absence of organ, eye examination of participant in clinical trial unspecified cataract cervical spondylosis without myelopathy carpal tunnel syndrome postprocedural fever 

Answer: The patient is high likely exposed to