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: sulfa(sulfonamide antibiotics) / codeine attending: chief complaint: chest pain major surgical or invasive procedure: replacement of ascending aortic aneurysm and hemiarch and aortic valve replacement with a 21mm st. mechanical valve history of present illness: ms. is a 64 year old female with known murmur as a child but as adult is not obvious. during her work-up for a colonoscopy in she was again noted to have a murmur and had a trans-esophageal echocardiogram which revealed a dilated ascending aorta of 5.2cm with possible subaortic valvular membrane valve was not well visualized. she experiences occasional episodes of left sided chest pain but no flagrant cardiac symptoms. past medical history: - hypertension recently in - ascending aortic aneurysm - diverticulosis - costochondritis - recent hand tremor ? early parkinsons - varicose vein removal from her right upper leg - surgery for a left ovarian cyst and for a - benign left breast lesion - umbilical hernia repair. - c-section social history: ms. lives with her husband and works as a registrar of probate. she denies smoking and drinks less than one alcoholic beverage per week. family history: she has no family history of heart disease. physical exam: pulse:68 resp:16 o2 sat:96% b/p right:97/65 left:92/57 height: 5ft 6" weight: 156 general: skin: warm dry intact heent: ncat perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none lower extremities neuro: grossly intact pulses: femoral right: +2 left:+2 dp right: +2 left:+2 pt : +2 left:+2 radial right:+2 left:+2 carotid bruit: right: none left:none pertinent results: cxr : there is interval decrease in minimally visible currently right apical pneumothorax. bilateral pleural effusions are re-demonstrated, grossly unchanged. heart size and mediastinum are unchanged in appearance. there is no pulmonary edema. echocardiography report conclusions pre-bypass: the left atrium is normal in size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is moderately dilated. there are simple atheroma in the ascending aorta. the aortic arch is markedly dilated. there are simple atheroma in the aortic arch. the aortic valve is bicuspid. the aortic valve leaflets are moderately thickened. there is no aortic valve stenosis. moderate to severe (3+) aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. post-bypass: left ventricular function is preserved with an estimated ef-55%. there are no apparent wall motion abnormalities. there is a well seated mechanical aortic valve. no peri-valvular leaks are visible. washing jets are present. the peak and mean gradients are 30/13mmhg at a co of 5.2. trivial mr+tr remain. there is no echocardiographic evidence of aortic dissection post decannulation. the remainder of the exam is unchanged. . 09:00am blood wbc-6.8 rbc-3.04* hgb-9.5* hct-29.1* mcv-96 mch-31.3 mchc-32.8 rdw-13.5 plt ct-552* 06:35am blood wbc-6.5 rbc-2.83* hgb-8.6* hct-26.6* mcv-94 mch-30.3 mchc-32.3 rdw-13.5 plt ct-418 06:10am blood wbc-6.3 rbc-2.58* hgb-7.9* hct-24.7* mcv-96 mch-30.7 mchc-32.1 rdw-13.3 plt ct-349 09:00am blood pt-22.3* ptt-70.0* inr(pt)-2.1* 06:35am blood pt-20.5* ptt-60.2* inr(pt)-1.9* 06:10am blood pt-17.1* ptt-42.9* inr(pt)-1.6* 08:40am blood pt-15.4* inr(pt)-1.4* 06:20am blood pt-15.6* ptt-29.3 inr(pt)-1.5* 06:15am blood pt-21.4* inr(pt)-2.0* 07:50am blood pt-38.8* inr(pt)-3.8* 02:50pm blood pt-52.6* inr(pt)-5.2* 08:55am blood pt-52.2* ptt-42.5* inr(pt)-5.2* 06:15am blood pt-18.5* inr(pt)-1.7* 01:20am blood pt-12.7* ptt-25.7 inr(pt)-1.2* 09:00am blood glucose-96 urean-16 creat-0.7 na-138 k-4.1 cl-102 hco3-25 angap-15 06:10am blood glucose-103* urean-20 creat-0.6 na-140 k-4.3 cl-106 hco3-30 angap-8 06:20am blood glucose-145* urean-13 creat-0.7 na-139 k-4.1 cl-103 hco3-28 angap-12 06:35am blood mg-2.2 06:10am blood mg-1.8 brief hospital course: the patient was brought to the operating room on where she underwent ascending aortic aneurysm and hemiarch replacement and aortic valve replacement with a st. mechanical valve. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. ms. was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. warfarin was initiated for the mechanical aortic valve. the patient was evaluated by the physical therapy service for assistance with strength and mobility. heparin drip was initiated to bridge anticoagulation with coumadin. hospital stay was prolonged awaiting therapeutic inr for the mechanical valve. she did become supratherapeutic with an inr >5. this was allowed to drift down and eventually achieved the desired range of . by the time of discharge on pod 10 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged home in good condition with appropriate follow up instructions. medications on admission: preadmission medications listed are correct and complete. information was obtained from webomr. 1. lisinopril 10 mg po daily 2. aspirin 81 mg po daily 3. metoprolol succinate xl 50 mg po daily 4. evening primrose *nf* (evening primrose oil) 100 oral daily 5. ubidecarenone-omega 3-vit e *nf* 25-150-200 mg-mg-unit oral daily 6. vitamin b complex *nf* (b complex vitamins;<br>vit b comp-c-fa-iron-vit e) 500 mg-400 mcg- 18 mg iron oral daily discharge medications: 1. aspirin 81 mg po daily 2. ferrous sulfate 325 mg po daily rx *ferrous sulfate 325 mg (65 mg iron) 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 3. metoprolol tartrate 12.5 mg po tid hold for sbp<95 or hr<55 and notify ho if held rx *metoprolol tartrate 25 mg 0.5 (one half) tablet(s) by mouth three times a day disp #*90 tablet refills:*0 4. ranitidine 150 mg po bid rx *ranitidine hcl 150 mg 1 tablet(s) by mouth twice a day disp #*60 tablet refills:*0 5. tramadol (ultram) 50 mg po q4h:prn pain rx *tramadol 50 mg 1 tablet(s) by mouth every four (4) hours disp #*60 tablet refills:*0 6. warfarin 3 mg po daily16 dose may change daily for goal inr 2.5-3.0, dr. to manage rx *warfarin 3 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 7. evening primrose *nf* (evening primrose oil) 100 oral daily 8. ubidecarenone-omega 3-vit e *nf* 25-150-200 mg-mg-unit oral daily 9. vitamin b complex *nf* (b complex vitamins;<br>vit b comp-c-fa-iron-vit e) 500 mg-400 mcg- 18 mg iron oral daily discharge disposition: home with service facility: community health and counceling discharge diagnosis: ascending aortic aneurysm pmh: hypertension, ascending aortic aneurysm, diverticulosis, costochondritis, recent hand tremor ? early parkinsons, varicose vein removal from her right upper leg, surgery for a left ovarian cyst and for a benign left breast lesion, umbilical hernia repair, c-section discharge condition: alert and oriented x3 nonfocal ambulating, gait steady sternal pain managed with oral analgesics sternal incision - healing well, no erythema or drainage edema: none discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: you are scheduled for the following appointments: surgeon dr. , md phone: date/time: 1:00 in the medical building cardiologist dr. , md phone: date/time: 1:20pm please call to schedule the following: pcp: . , md phone: **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr coumadin for mechanical avr goal inr 2.5-3.0 first draw then please do inr checks monday, wednesday, and friday for 2 weeks results to cardiac surgery over the weekend. dr. will assume coumadin management beginning monday, procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve resection of vessel with replacement, thoracic vessels diagnoses: abnormal coagulation profile unspecified essential hypertension thoracic aneurysm without mention of rupture aortic valve disorders anticoagulants causing adverse effects in therapeutic use congenital insufficiency of aortic valve 

Answer: The patient is high likely exposed to