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: this is a 79 year old female patient with known coronary artery disease and aortic stenosis who has had increasing symptoms of dyspnea on exertion, paroxysmal nocturnal dyspnea and chest discomfort. she was referred to for cardiac catheterization. past medical history: significant for known coronary artery disease, known aortic stenosis which has been followed by serial echocardiography, most recent echocardiogram revealed severe aortic stenosis, 3+ mitral regurgitation and a left ventricular ejection fraction of 35 to 40%. the patient also has a history of moderate left ventricular dysfunction. she has a history of admissions to the hospital for congestive heart failure. she is status post right carotid endarterectomy in . she has a history of hypertension, hypercholesterolemia. she is a smoker with a 60 pack year history who has recently cut back. she has a history of bronchitis, pneumonia in this year. her electrocardiogram revealed an intravenous conduction delay with a left anterior hemiblock. she is status post right hip fracture and has a history of a transient ischemic attack in the past. she also has an alcohol intake of two drinks per day per patient. medications on admission: lisinopril 20 mg q.d.; coumadin; norvasc 5 mg b.i.d.; toprol xl 100 q.d.; nitroglycerin patch q.h.s. allergies: the patient states no known drug allergies. laboratory data: laboratory values on admission to the hospital revealed a white blood cell count of 15,000, hematocrit of 37.6, platelet count of 405,000, calcium 4.5, bun 34, creatinine 1.3 and an inr of 4.1. the patient was taken to the cardiac catheterization laboratory where she underwent right and left heart catheterization. this revealed left ventricular end diastolic pressure of 38 with pulmonary hypertension. it also revealed significant two vessel coronary artery disease, critical aortic stenosis with an aortic valve area measured at 0.45. the patient had some hemodynamic instability and clinically with a pulmonary edema. due to the history of peripheral vascular disease, it was not possible to place an intra-aortic balloon pump in the cardiac catheterization laboratory so she was taken somewhat urgently to the operating room by dr. . in the operating room she underwent coronary artery bypass graft times two with a vein graft to the left anterior descending and a vein to the posterior descending artery. she also had an aortic valve replacement with a 21 mm mosaic valve placed in the aortic position. on the night of surgery while the patient remained hemodynamically stable, she was weaned from the mechanical ventilator and successfully extubated. it was noted upon extubation that the patient was not moving her right arm or her right leg and that she was not able to speak. subsequently neurology consultation was obtained. it was felt that she had had a cerebrovascular accident and the patient the following morning, was taken for computerized tomography scan of her head which revealed an acute infarction in the distribution of the left middle cerebral artery. the neurology service was continuing to follow her. they recommended to begin anticoagulation when the patient was stable from a surgical standpoint and was ready to be anticoagulated. the patient continued to progress from a postoperative standpoint in the appropriate fashion. she was begun on beta blockers on postoperative day #1. she was started on subcutaneous heparin, begun on gastrointestinal prophylaxis with zantac and colace. her chest tubes were discontinued and the patient has made adequate postoperative recovery from the hemodynamic standpoint. on postoperative day #4, , the patient underwent a swallow evaluation to see that it was safe to feed the patient orally and she did well with good function for oral and pharyngeal swallow and ability for pureed food as well as nectar thick liquids. their recommendation was not to give the patient any water, juice or thin liquids at all, so that she would be safe to have pureed or nectar thick liquids to take by mouth. the patient has been begun on a diet. she has been taking it fairly well. the patient has been evaluated for rehabilitation facilities, for stroke rehabilitation program and is felt to be ready to leave the hospital at this time. discharge status: condition today on is as follows, the patient is afebrile, her heartrate is 97, atrial fibrillation. her blood pressure is 131/59. the patient's respiratory rate is 18. her oxygen saturation is 96% on 3 liter nasal cannula. most recent laboratory values from today are as follows, white blood cell count 18,500, hematocrit 34.1, platelet count 293. pt 16.4, inr 1.8, ptt 43.6, that is on a heparin drip. sodium 145, potassium 4.0, chloride 109, carbon dioxide 24, bun 23, creatinine 1.0, glucose 114. on physical examination the patient is awake and responsive although nonverbal. the patient is still having no movement of her right upper extremity and difficult coordinating her right lower extremity but she can move her left side well. the patient's lungs are clear to auscultation bilaterally. cardiac examination, irregular rhythm and atrial fibrillation. her abdomen is benign. medications on discharge: () 1. the patient remains on an intravenous heparin drip with ptt of 43. she is going to be started on coumadin today. her inr is 1.8 and she will receive 1 mg of coumadin today and follow up target inr of 2 to 2.5 for peripheral vascular disease and stroke prophylaxis. 2. tylenol 650 mg p.o. q. 4 hours prn 3. colace 100 mg p.o. b.i.d. 4. albuterol 1 to 2 puffs q. 6 hours prn 5. levofloxacin 500 mg p.o. q.d. for presumed tracheobronchitis with an elevated white blood cell count 6. aspirin 325 mg p.o. q.d. 7. heparin which is infusing at 500 units/hour 8. metoprolol 75 mg p.o. b.i.d. 9. saliva substitute as needed discharge disposition: the patient remains stable for a cardiac and pulmonary standpoint and is appropriate to return from the hospital to rehabilitation facility with the projected discharge date of . discharge condition: good. discharge diagnosis: 1. aortic stenosis status post aortic valve replacement 2. coronary artery disease, status post coronary artery bypass graft 3. cardiovascular accident 4. chronic atrial fibrillation 5. hypertension , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries intraoperative cardiac pacemaker insertion of endotracheal tube open and other replacement of aortic valve with tissue graft aortography monitoring of cardiac output by other technique diagnoses: coronary atherosclerosis of native coronary artery atherosclerosis of native arteries of the extremities with intermittent claudication atrial fibrillation rheumatic heart failure (congestive) cardiogenic shock other complications due to other vascular device, implant, and graft mitral valve insufficiency and aortic valve stenosis acute bronchitis iatrogenic cerebrovascular infarction or hemorrhage 

Answer: The patient is high likely exposed to