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: amoxicillin / lisinopril attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: aortic valve replacement with a . medical biocor tissue valve. history of present illness: 74 year old female with worsening dyspnea on exertion referred for cardiac catheterization and then referred for surgical evaluation for aortic valve replacement past medical history: hypertension hyperlipidemia diabetes mellitus cad s/p stenting of rca and lad at aortic stenosis right bundle branch block chronic right lower extremity edema histiocystosis in , s/p chemo and radiation to abdomen area stress incontinence gout s/p cholecystectomy s/p tonsillectomy social history: lives with:husband and son occupation:retired tobacco:quit ; 1ppd since age 14 etoh:denies family history: father died of mi age 78 mother died of mi age 75 sister died of mi age 59 physical exam: pulse:75sr resp:20 o2 sat:98% ra b/p right:156/75 left:155/70 height:5'5" weight:250 lbs general: wdwn in nad skin: warm, dry and intact. chronic venous stasis changes of bilateral le's. left leg is larger then right. heent: ncat, perrla, eomi, sclera anicteric, op benign. no jvd. edentulous. neck: supple full rom . thyromegally noted left side > right chest: lungs clear bilaterally heart: rrr, iv/vi sem abdomen: soft non-distended non-tender bowel sounds + obese. extremities: warm , well-perfused + edema 2+ left 1+ right. chronic venous stasis changes. varicosities: supeficial noted on standing neuro: grossly intact, mae, slow but steady gait pulses: femoral right:2 left:2 dp right:trace left:trace pt :trace left:trace radial right:1 left:1 carotid bruit transmitted vs brui bilaterally pertinent results: 07:38am hgb-10.4* calchct-31 07:38am glucose-99 lactate-1.4 na+-140 k+-4.3 cl--108 11:00am pt-13.9* ptt-35.4* inr(pt)-1.2* 11:00am plt count-269 11:00am wbc-17.5*# rbc-2.83*# hgb-8.0*# hct-24.6*# mcv-87 mch-28.2 mchc-32.5 rdw-16.3* 11:58am urea n-29* creat-1.1 chloride-113* total co2-23 04:27am blood wbc-11.3* rbc-3.55* hgb-9.8* hct-30.6* mcv-86 mch-27.5 mchc-31.8 rdw-16.0* plt ct-421 04:27am blood plt ct-421 04:27am blood pt-21.0* inr(pt)-1.9* 04:27am blood glucose-86 urean-49* creat-1.5* na-140 k-3.7 cl-97 hco3-33* angap-14 04:27am blood alt-52* ast-44* ld(ldh)-311* alkphos-158* amylase-133* totbili-0.4 04:27am blood lipase-220* 04:27am blood albumin-3.1* mg-2.4 chest (pa & lat) clip # final report history: status post avr, to evaluate for pleural effusion. findings: in comparison with the study of , there is little change in the bibasilar pleural effusions, more prominent on the left. engorgement of pulmonary vessels is consistent with elevated pulmonary venous pressure in this patient with mild enlargement of the cardiac silhouette. central catheter remains in place. the study and the report were reviewed by the staff radiologist. dr. dr. approved: tue 9:06 am echocardiography report indication: aortic valve disease. coronary artery disease. left ventricular function. preoperative assessment. echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.0 cm <= 5.6 cm left ventricle - ejection fraction: 45% to 50% >= 55% aorta - annulus: 2.1 cm <= 3.0 cm aorta - ascending: 2.9 cm <= 3.4 cm aortic valve - mean gradient: 62 mm hg findings right atrium/interatrial septum: pfo is present. left-to-right shunt across the interatrial septum at rest. left ventricle: mild symmetric lvh. normal lv cavity size. mild global lv hypokinesis. mildly depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: severely thickened/deformed aortic valve leaflets. significant as is present (not quantified) mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. moderate mitral annular calcification. mild thickening of mitral valve chordae. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions prebypass a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is mild global left ventricular hypokinesis (lvef = 45-50 %). overall left ventricular systolic function is mildly depressed right ventricular chamber size and free wall motion are normal. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. significant aortic stenosis is present (not quantified). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. postbypass left ventricular systolic function has improved. lvef > 55%. rv systolic function is preserved. there is a well seated, well functioning bioprosthesis in the aortic position. no aortic insufficiency is visualized. the study otherwise remains unchanged from prebypass. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 11:02 brief hospital course: admitted same day surgery and underwent aortic valve replacement. see operative report for further details. she received cefazolin for perioperative antibiotics. post operatively she was transferred to the intensive care unit for management. in the first twenty four hours she was weaned from sedation, awoke neurologically intact and was extubated without complications. in addition she had oliguria with rise in creatitine from baseline 1.1 to 1.6 peak due to hypovolemia, in which she received volume after echocardiogram revealed unchanged left ventricular function. she remained in the intensive care unit for pulmonary management and had required bipap for few hours on post operative day one and was started on bumex drip for diuresis with response. she developed atrial fibrillation that was treated with amiodarone and beta blockers, and she was started on coumadin for anticoagulation. on she had right upper quadrant abdominal pain with elevated amylase and lipase, surgery was consulted, she was made npo and monitored. her pain resolved on its own, and her diet was resumed. her activity level was slow to progress and after she was transferred to the floor. physical therapy worked with her on strength and mobility. on pod 8 she was ready for transfer to rehabilitation for continued strenghth and activity management. medications on admission: allopurinol 100mg po bid amlodipine 10mg po daily bumetanide 2mg po daily glyburide 2.5mg po bid levothroxine 50 mcg po daily lisinopril 2.5mg po daily metformin 500mg po daily metoprolol succinate 50mg po daily actos 15mg po daily simvastatin 40mg po daily asa 325mg po daily ferrous sulfate 324 mg po daily mvi 1 tab daily discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 4. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 5. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): 200mg x7 days then 200mg qd. 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. glyburide 2.5 mg tablet sig: one (1) tablet po bid (2 times a day). 8. bumetanide 2 mg tablet sig: one (1) tablet po daily (daily). 9. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 10. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 11. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) treatment inhalation q6h (every 6 hours) as needed for wheezing. 12. warfarin 1 mg tablet sig: as directed tablet po once a day: 1mg on then adjust dose to keep inr 2.0-2.5. discharge disposition: extended care facility: aberjona nursing center - discharge diagnosis: aortic stenosis s/p avr( tissue) post operative atrial fibrillation hypertension hyperlipidemia diabetes mellitus cad s/p stenting of rca and lad at aortic stenosis right bundle branch block chronic right lower extremity edema histiocystosis in , s/p chemo and radiation to abdomen area stress incontinence gout post operatively elevated creatinine post operatively elevated amylase and lipase discharge condition: alert and oriented x3 nonfocal ambulating, with assistance sternal pain managed with tylenol prn sternal wound healing well 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 until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge followup instructions: provider: , md phone: date/time: 1:00 please call to schedule appointments primary care dr in weeks cardiologist dr. in weeks pt/inr for coumadin dosing - three times a week until on steady dose - goal inr 2.0-2.5 for atrial fibrillation procedure: extracorporeal circulation auxiliary to open heart surgery open and other replacement of aortic valve with tissue graft diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified atrial fibrillation aortic valve disorders percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia right bundle branch block morbid obesity 

Answer: The patient is high likely exposed to