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: metformin attending: chief complaint: angina major surgical or invasive procedure: aortic valve replacement (19mm bovine pericardial) dc synchronous cardioversion history of present illness: this 70 year old hispanic female presented with an episode of chest pain radiating to left arm lasting 3 minutes which resolved without intervention. she presented to her primary care doctor the next day and was scheduled for outpatient cardiac catherization. this revealed critical aortic stenosis with a valve area of 0.5 cm2. she was now transferred for surgical evaluation. past medical history: aortic stenosis cornary artery disease s/p pda stent mitral regurgitation renal vascular hypertension s/p angioplasty and stenting of left renal artery peripheral vascular disease diabetes mellitus -type 2 hypercholesterolemia hyperthyroidism treated with radioactive iodine hypothyroidism depression s/p appendectomy s/p hysterectomy s/p bilateral cataract surgery social history: last dental exam: 1 year ago lives with: alone (family lives in ) occupation: disability tobacco: denies etoh: denies family history: noncontributory physical exam: admission: pulse: 88 resp: 20 o2 sat: 100 b/p right: 150/80 left: height: weight: general: skin: dry intact heent: perrla eomi neck: supple full rom no lymphadenopathy chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + no palpable masses extremities: warm cool, well-perfused edema none varicosities: superficial bilateral neuro: alert and oriented x3, nonfocal pulses: femoral right: +2 left: +2 dp right: +1 left: +1 pt : +1 left: +1 radial right: +2 left: +2 carotid bruit right: murmur left: murmur pertinent results: 08:15pm glucose-192* urea n-15 creat-1.2* sodium-142 potassium-4.9 chloride-107 total co2-25 anion gap-15 08:15pm alt(sgpt)-33 ast(sgot)-25 ld(ldh)-217 ck(cpk)-53 alk phos-99 amylase-107* tot bili-0.3 08:15pm lipase-39 08:15pm ck-mb-notdone ctropnt-<0.01 08:15pm albumin-4.7 calcium-9.8 phosphate-2.7 magnesium-2.2 08:15pm %hba1c-6.9* 08:15pm tsh-1.6 08:15pm wbc-11.1* rbc-4.93 hgb-14.0 hct-42.1 mcv-85 mch-28.3 mchc-33.1 rdw-14.5 08:15pm plt count-276 08:15pm pt-12.0 ptt-24.1 inr(pt)-1.0 05:39am blood wbc-11.7* rbc-4.11* hgb-11.8* hct-35.6* mcv-87 mch-28.7 mchc-33.1 rdw-17.8* plt ct-649* 05:39am blood plt ct-649* 03:08am blood pt-14.3* ptt-39.9* inr(pt)-1.2* 05:23am blood glucose-71 urean-16 creat-0.8 na-139 k-3.5 cl-106 hco3-24 angap-13 03:08am blood alt-150* ast-41* ld(ldh)-279* alkphos-166* amylase-53 totbili-0.7 radiology report chest (pa & lat) study date of 10:50 am final report echocardiography report , tte (focused views) done at 2:44:29 pm preliminary referring physician information , s. department of anesthesia and cr , 407 , status: inpatient dob: age (years): 70 f hgt (in): 65 bp (mm hg): 135/65 wgt (lb): 180 hr (bpm): 80 bsa (m2): 1.89 m2 indication: poor oxygenation in the setting of ards icd-9 codes: 518.82 test information date/time: at 14:44 interpret md: , md test type: tte (focused views) son: , md doppler: limited doppler and color doppler test location: west echo lab contrast: none tech quality: suboptimal tape #: 2009w000-0:00 machine: other echocardiographic measurements results measurements normal range left atrium - four chamber length: 4.8 cm <= 5.2 cm right atrium - four chamber length: 4.8 cm <= 5.0 cm left ventricle - lateral peak e': *0.07 m/s > 0.08 m/s left ventricle - septal peak e': *0.05 m/s > 0.08 m/s left ventricle - ratio e/e': *17 < 15 mitral valve - e wave: 1.0 m/sec mitral valve - a wave: 1.3 m/sec mitral valve - e/a ratio: 0.77 mitral valve - e wave deceleration time: *295 ms 140-250 ms findings left atrium: normal la size. no spontaneous echo contrast in the body of the la. right atrium/interatrial septum: normal ra size. left ventricle: normal lv cavity size. normal regional lv systolic function. suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. tdi e/e' >15, suggesting pcwp>18mmhg. doppler parameters are most consistent with c/w grade ii (moderate) lv diastolic dysfunction. right ventricle: normal rv chamber size. mild global rv free wall hypokinesis. abnormal septal motion/position. aortic valve: aortic valve not well seen. mitral valve: mitral valve leaflets not well seen. moderate mitral annular calcification. tricuspid valve: tricuspid valve not well visualized. pulmonic valve/pulmonary artery: pulmonic valve not well seen. pericardium: no pericardial effusion. general comments: suboptimal image quality - poor echo windows. suboptimal image quality - poor parasternal views. suboptimal image quality - poor subcostal views. suboptimal image quality - bandages, defibrillator pads or electrodes. suboptimal image quality as the patient was difficult to position. suboptimal image quality - body habitus. suboptimal image quality - ventilator. the patient appears to be in sinus rhythm. conclusions the left atrium is normal in size. no spontaneous echo contrast is seen in the body of the left atrium. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). transmitral doppler and tissue velocity imaging are consistent with grade ii (moderate) lv diastolic dysfunction. right ventricular chamber size is normal. with mild global free wall hypokinesis. there is abnormal septal motion/position. the aortic valve is not well seen. the mitral valve leaflets are not well seen. there is no pericardial effusion. preliminary report developed by a cardiology fellow. not reviewed/approved by the attending echo physician. assigned to , md, interpreting physician ?????? caregroup is. all rights reserved. two view chest comparison: . indication: status post valve surgery. findings: interval removal of right subclavian vascular catheter with no evidence of pneumothorax. extensive consolidation and adjacent loculated pleural effusion in the left lung have slightly improved. however, an area of ill-defined consolidation in the right upper and mid lung has slightly worsened. prominent lucency adjacent to left heart border probably represents an area of spared lung parenchyma based upon correlation with recent ct of . small right pleural effusion is unchanged. impression: multifocal consolidation, slightly improved on the left but worse on the right, most likely due to multifocal pneumonia. moderate partially loculated left pleural effusion and small dependent right pleural effusion. dr. approved: tue 12:04 pm brief hospital course: she was transferred for aortic valve replacement. a urinary tract infection was treated with ampicillin and "plavix washout" occured. she was prepared for surgery. on aortic valve replacement was performed. see operative note for details. in summary she had aortic valve replacement with #19 bovine pericardial valve. her bypass time was 76 minutes with a crossclamp of 56 minutes. she weaned from bypass on epinephrine and neosynephrine. later milrinone was added. she stabilized and was extubated on . on she had a wide complex tacchycardia which was treated with amiodarone. electrophysiology was consulted, saw the patient and made recommendations. she required reintubation and pressors support for cardioversion. amiodarone was continued. she developed bilateral infiltrative xrays, consistent with ards. her cardiovascular status remained stable, pressors were weaned and milrinone was off completely by and the swan ganz catheter was removed. tube feedings were instituted. she remained in sr and amiodarone was changed to an oral formulation. bronchoscopy was performed on , but there was no indication of an endobronchial process, only mild inflammation of the airways. she was weaned from the ventilator and extubated that weekend. tube feeds continued via dobhoff tube, a swallowing evaluation was done and the dophoff was ultimately removed. she had an elevated wbc and her central lines were changed, she was treated with broad spectrum antibiotics and the white count resolved. a picc line was placed for iv abx for pna/ards and removed prior to discharge. transferred to the floor on pod #18 after her pulmonary status stabilized. at that time it was determined that she would benefit from additional rehab prior to returning home. she was cleared for discharge by dr. to rehabilitation for increased strength and mobility on pod# 23. all follow up appointments were advised. medications on admission: diovan 160 mg daily crestor 40 mg daily zetia 10 mg daily lasix 40 mg daily atenolol 100 mg daily glipizide xl 2.5 mg daily imdur 30 mg daily plavix 75 mg daily levothyroxine 75 mg daily felodipine er 5 mg daily plavix - last dose: discharge medications: 1. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): 200mg x1 week then 200mg qd. 6. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 7. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 8. clonidine 0.1 mg tablet sig: one (1) tablet po tid (3 times a day). 9. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 10. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 11. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 13. acetaminophen 325 mg tablet sig: two (2) tablet po every six (6) hours as needed for pain/temp. 14. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 15. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 16. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily). 17. insulin glargine 100 unit/ml solution sig: twenty (20) units subcutaneous qam. 18. insulin regular human 100 unit/ml solution sig: sliding scale injection qac&hs. 19. combivent 18-103 mcg/actuation aerosol sig: two (2) inhalation four times a day. 20. crestor 40 mg tablet sig: one (1) tablet po once a day. 21. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). 22. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wz. 23. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wz. discharge disposition: extended care facility: - wood mill - discharge diagnosis: coronary artery disease s/p pda stent aortic stenosis s/p aortic valve replacement mitral regurgitation renovascular hypertension s/p angioplasty and stenting of left renal artery peripheral vascular disease diabetes mellitus type 2 hypercholesterolemia hyperthyroidism - s/p ablative therapy hypothyroidism depression urinary tract infection postoperative atrial fibrillation postoperative respiratory failure postoperative renal failure discharge condition: good discharge instructions: no lotions, creams or powders on any incision shower daily and pat incisions dry no driving for one month no lifting greater than 10 pounds for 10 weeks call for fever greater than 100, redness, drainage, or weight gain of 2 pounds in 2 days or 5 pounds in one week followup instructions: see dr. in weeks () see dr. in weeks see dr. in 4 weeks () please call for all appts. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances other electric countershock of heart arterial catheterization open and other replacement of aortic valve with tissue graft closed [endoscopic] biopsy of bronchus insertion or replacement of epicardial lead [electrode] into epicardium diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery pure hypercholesterolemia urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation peripheral vascular disease, unspecified depressive disorder, not elsewhere classified chronic kidney disease, unspecified atrioventricular block, complete atherosclerosis of renal artery cardiac arrest alkalosis bacteremia mitral valve insufficiency and aortic valve stenosis other postablative hypothyroidism 

Answer: The patient is high likely exposed to