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: penicillins attending: chief complaint: shortness of breath major surgical or invasive procedure: mitral valve repair with quadrangular resection of posterior p2 leaflet and annuloplasty with cg future ring, model number 638r, size 28 mm. history of present illness: 52 year old female with a history of mitral valve prolapse who presented to the osh ed with chest pain radiating to right neck and acute shortness of breath for 2 days- found to have chf. an ekg showed nsr. a murmer was auscultated. a stat echo was done that revealed a flail posterior mv leaflet with 4+ wide open mr. she is currently on nitro @ 10mcg/min and nipride @ 9ml. she was also given iv push 20mg lasix and 0.25mg iv ativan and (4) 81mg aspirin tablets. blood cultures were sent. the patient is currently stable without chest pain. transferred to for cardiac catheterization which showed cardiac catheterization: date: pcw=25 pa=57/29 severe pulmonary hypertension severe mitral regurgitation by v-waves to 45 mmhg normal coronaries past medical history: mitral valve prolapse depression palpitations migraine headaches anxiety cervical radiculopathy past surgical history: cesarean section x2 depression past surgical history: cesarean section x2 normal coronaries social history: last dental exam: lives with:boyfriend occupation:pharmacy assitant tobacco:denies, quit 22 years ago, hx 2ppdx2-3years etoh:occasional family history: non contributory physical exam: pulse:96 resp:16 o2 sat:97/ra b/p: 138/81 height:5'4" weight:135 lbs general:nad, alert, cooperative skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally appears tachypneic heart: rrr irregular murmur - iii-iv/vi systolic murmur across precordium abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none x neuro: grossly intact pulses: femoral right: +1 left:+1 dp right:+2 left:+2 pt :+2 left:+2 radial right:+2 left:+2 carotid bruit right/left:murmur radiates into both carotids pertinent results: 05:00am blood wbc-7.1 rbc-2.55* hgb-8.5* hct-24.7* mcv-97 mch-33.4* mchc-34.5 rdw-13.3 plt ct-169 12:06pm blood pt-13.6* ptt-27.5 inr(pt)-1.2* 05:00am blood glucose-111* urean-20 creat-1.1 na-136 k-4.1 cl-99 hco3-29 angap-12 , f 52 radiology report chest (pa & lat) study date of 10:07 am , fa6a 10:07 am chest (pa & lat) clip # reason: f/u rt effusion medical condition: 52 year old woman with mvrepair reason for this examination: f/u rt effusion final report history: mitral valve repair, to assess for change. findings: in comparison with the study of , intact midline sternal wires are again seen. there is continued bilateral pleural effusion with extensive atelectatic changes at the bases. some indistinctness of pulmonary vessels is suggestive of elevated pulmonary venous pressure in this patient with a prosthetic valve and enlargement of the cardiac silhouette. echocardiography report , (complete) done at 10:56:25 am final referring physician information , - department of cardiac s , 2a , status: inpatient dob: age (years): 52 f hgt (in): 64 bp (mm hg): 100/60 wgt (lb): 135 hr (bpm): 82 bsa (m2): 1.66 m2 indication: mitral regurgitation icd-9 codes: 424.0 test information date/time: at 10:56 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2010aw04-: machine: echocardiographic measurements results measurements normal range left atrium - long axis dimension: *5.0 cm <= 4.0 cm left atrium - four chamber length: 5.2 cm <= 5.2 cm left ventricle - septal wall thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.5 cm <= 5.6 cm left ventricle - ejection fraction: 55% >= 55% findings left atrium: dilated la. no spontaneous echo contrast or thrombus in the la/laa or the ra/raa. right atrium/interatrial septum: normal ra size. no asd by 2d or color doppler. right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending, transverse and descending thoracic aorta with no atherosclerotic plaque. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: severely thickened/deformed mitral valve leaflets. myxomatous mitral valve leaflets. partial mitral leaflet flail. moderate to severe (3+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. 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. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. no tee related complications. the patient appears to be in sinus rhythm. patient. conclusions pre-bypass: the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. right ventricular chamber size and free wall motion are normal. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque to40 cm from the incisors. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are severely thickened/deformed. the mitral valve leaflets are myxomatous. there is partial p2 mitral leaflet flail with torn chords. moderate to severe (3+) mitral regurgitation is seen. there is no pericardial effusion. dr. was notified in person of the results before surgical incision. post_bypass: preserved biventricualr systolic function. intact thoracic aorta. there is a mitral annular ring, stable and well functioning with transmitral mean gradient of 6 mm of hg. there is no mitral regurgitation. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 13:43 , f 52 cardiology report cardiac cath study date of brief history: 52 year old female with past medical history of mitral valve prolapse transferred from an outside hospital for emergernt evalation of severe mitral regurgitation in the setting of new flail leaflet on echocardiogram. indications for catheterization: severe acute mr chf procedure: right heart catheterization: was performed by percutaneous entry of the right femoral vein, using a 7 french pulmonary wedge pressure catheter, advanced to the pcw position through an 8 french introducing sheath. cardiac output was measured by the fick method. left heart catheterization: was performed by percutaneous entry of the right femoral artery, using a 5 french angled pigtail catheter, advanced to the left ventricle through a 5 french introducing sheath. coronary angiography: was performed in multiple projections using a 5 french jl4 and a 5 french jr4 catheter, with manual contrast injections. conscious sedation: was provided with appropriate monitoring performed by a member of the nursing staff. hemodynamics results body surface area: 1.66 m2 hemoglobin: 13.2 gms % fick **pressures right atrium {a/v/m} 17/16/12 right ventricle {s/ed} pulmonary artery {s/d/m} 61/26/39 pulmonary wedge {a/v/m} 26/31/26 left ventricle {s/ed} 121/20 aorta {s/d/m} 124/84/93 **cardiac output heart rate {beats/min} 90 rhythm nsr o2 cons. ind {ml/min/m2} 125 a-v o2 difference {ml/ltr} 43 card. op/ind fick {l/mn/m2} 4.8/2.9 **resistances systemic vasc. resistance 1350 pulmonary vasc. resistance 217 **% saturation data (nl) svc low 76 pa main 69 ao 95 other hemodynamic data: the oxygen consumption was assumed. **arteriography results morphology % stenosis collat. from **right coronary 1) proximal rca normal 2) mid rca normal 2a) acute marginal normal 3) distal rca normal 4) r-pda normal 4a) r-post-lat normal 4b) r-lv normal **arteriography results morphology % stenosis collat. from **left coronary 5) left main normal 6) proximal lad normal 6a) septal-1 normal 7) mid-lad normal 8) distal lad normal 9) diagonal-1 normal 10) diagonal-2 normal 11) intermedius normal 12) proximal cx normal 13) mid cx normal 13a) distal cx normal 14) obtuse marginal-1 normal 15) obtuse marginal-2 normal 16) obtuse marginal-3 normal technical factors: total time (lidocaine to test complete) = 52 minutes. arterial time = 17 minutes. fluoro time = 6.8 minutes. irp dose = 257 mgy. contrast injected: non-ionic low osmolar (isovue, optiray...), vol 55 ml premedications: midazolam 1 mg iv fentanyl 50 mcg iv anesthesia: 1% lidocaine subq. anticoagulation: other medication: tng 0.5 mcg/min cardiac cath supplies used: - allegiance, custom sterile pack - merit, left heart kit - merit, right heart kit - , pulmonary wedge pressure catheter comments: 1. coronary angiography in this right dominant system demonstrated no angiographic evidence of cad. the lmca, rca, lad, and lcx are all normal. 2. resting hemodynamics revealed elevated left and right filling pressures with an rvedp of 17mm hg and lvedp of 20mm hg. moderate pulmonary hypertension was present with a pasp of 61mm hg. pcwp tracings showed large v waves to 31 mmhg suggestive of significant mitral regurtgitation. the cardiac index was preserved at 2.9 l/min. 3. left ventriculography was deferred. final diagnosis: 1. coronary arteries are normal. 2. severe mitral regurgitation. 3. normal ventricular function. 4. moderate primary pulmonary hypertension. attending of record: , m. referring physician: , . fellow: , invasive attending staff: , m. brief hospital course: the patient underwent cardiac cath which revealed severe pulmonary hypertension and clean coronary arteries. cardiac surgery was consulted and she had dental clearance. on she underwent mitral valve repair with a 28mm cg future ring. her cross clamp time was 53 minutes and total bypass time was 69 minutes. she was transferred to the cvicu on neo and propofol in stable condition. she was extubated on the post operative day and was transferred to the floor on pod#1. her chest tubes and wires were discontinued and on pod#3 she was discharged to home in stable condition. medications on admission: effexor xr 150mg daily xanax 0.5 mg twice a day as needed albuterol inhaler as needed multivitamin discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*100 tablet, delayed release (e.c.)(s)* refills:*2* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 4. venlafaxine 75 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po daily (daily). disp:*60 capsule, sust. release 24 hr(s)* refills:*0* 5. multivitamin tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*0* 7. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*1* 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 9. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 10. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 11. lasix 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 7 days. disp:*7 tab sust.rel. particle/crystal(s)* refills:*0* 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). discharge disposition: home with service facility: vna discharge diagnosis: severe mitral regurgitation depression palpitations migraine headaches anxiety cervical radiculopathy discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 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 females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr. at 1:30 pm cardiologist: dr. @1:30 pm **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters open heart valvuloplasty of mitral valve without replacement diagnoses: mitral valve disorders congestive heart failure, unspecified other chronic pulmonary heart diseases depressive disorder, not elsewhere classified anxiety state, unspecified acute systolic heart failure 

Answer: The patient is high likely exposed to