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 74 year old female who was transferred from an outside hospital to undergo a cardiac catheterization. the patient had been complaining of shortness of breath with one flight of stairs exertion. she also complained of some left arm discomfort during her dyspneic episodes, however, did not complain of any chest pain. she denies any nausea or vomiting. she does complain of a baseline dyspnea on exertion of approximately one mile. she denies any paroxysmal nocturnal dyspnea, orthopnea or syncope. past medical history: 1. rheumatic heart disease, rheumatic fever at age 13. 2. atrial fibrillation. 3. hypertension. 4. insulin dependent diabetes mellitus. 5. history of gallstones. 6. history of infiltrating ductal carcinoma of the left breast. medications on admission: lasix 40 mg p.o.q.d., zestril 10 mg p.o.q.d., tamoxifen 10 mg p.o.q.d., coumadin and insulin r 10 units and insulin n 25 units q.a.m., insulin r 5 units q. lunch and insulin n 20 units q.p.m. allergies: procainamide (rash). physical examination: on physical examination, the patient was afebrile with stable vital signs. cardiovascular: irregularly irregular, iii/vi systolic ejection murmur at left upper sternal border and ii/vi apical holosystolic murmur. abdomen: soft, nontender, nondistended, extremities: no clubbing or cyanosis, 1+ pedal edema bilaterally. hospital course: the patient underwent cardiac catheterization on , which revealed an aortic valve area of 0.59 with a valve gradient of 34.6, mitral valve area 0.9. based on these numbers, mitral valve replacement and aortic valve replacement were suggested and the patient was referred to dr. for replacement of her aortic and mitral valves. on , the patient underwent aortic valve replacement and mitral valve replacement with a 21 mm carbomedics aortic valve and a 27 mm carbomedics mitral valve. the patient tolerated the procedure well, without any complications, and was transferred to the intensive care unit in stable condition. she was extubated postoperatively and, on postoperative day number one, was doing well. she remained afebrile with stable vital signs. she required small amounts of neo-synephrine for blood pressure support, which was able to be weaned off with transfusion of one unit of packed red blood cells. her glucose was controlled with an insulin drip. the patient was transferred to the floor later in the afternoon of postoperative day number one. physical therapy was consulted and the patient underwent ambulatory assistance and teaching. she was noted to do fairly well, however, continued to require some assistance and some oxygen therapy support while ambulating. on postoperative day number two, the patient remained stable. her coumadin dose was continued and her inr was set to a goal of approximately 3. on postoperative day number three, her inr was noted to be 1.6 and her coumadin was continued. on postoperative day number four, her inr remained 1.6 and, thus, her coumadin dose was increased to 7.5 mg times one days. she remained afebrile in rate controlled atrial fibrillation with stable blood pressures. at this point, she was maintained on 25 mg of lopressor twice a day and captopril 6.25 mg p.o.t.i.d. blood sugars were controlled with her home insulin doses and a sliding scale. on postoperative day number three, the patient's hematocrit was noted to be low again, at 21.6, and she was transfused two units of packed red blood cells. her hematocrit the following day was appropriately increased to 27.8. the patient is currently postoperative day number four, afebrile with stable vital signs. her hematocrit is 27.8 and her last inr was 1.6. she has continued to be coumadinized for a goal inr of approximately 3. the patient is working with physical therapy and will likely be ready to be discharged home on . her main issue at this point is her anticoagulation. her inr will be monitored on postoperative day number five. a short addendum will follow. condition on discharge: stable. discharge diagnosis: mitral stenosis and aortic stenosis, status post mitral valve replacement and aortic valve replacement. secondary diagnosis: atrial fibrillation. hypertension. insulin dependent diabetes mellitus. history of infiltrative ductal carcinoma of left breast. discharge medications: lopressor 25 mg p.o.b.i.d. captopril 6.25 mg p.o.t.i.d. lasix 20 mg p.o.q.d. potassium chloride 20 meq p.o.q.d. tamoxifen 10 mg p.o.b.i.d. percocet one to two tablets p.o.q.4-6h.p.r.n. colace 100 mg p.o.b.i.d. coumadin dose varying from 2 to 5 mg p.o.q.d. for a goal inr of 3. insulin r 10 units q.a.m. and 25 of n, insulin r 5 units q. lunch and nph 20 units q.p.m. discharge instructions: the patient will continue to take coumadin. her inr will be followed by her primary care physician. patient should return to clinic in approximately three weeks. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery other electric countershock of heart open and other replacement of aortic valve open and other replacement of mitral valve diagnoses: anemia, unspecified congestive heart failure, unspecified unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation old myocardial infarction ventricular fibrillation multiple involvement of mitral and aortic valves diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to