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: ceclor / dilaudid / latex attending: chief complaint: known aortic valve fibroelastoma major surgical or invasive procedure: excision of aortic valve fibroelastoma history of present illness: this is a 53 year old nurse who had bladder suspension surgery at . postoperatively, she had some chest tightness and a cardiac workup ensued. an echo was done that revealed a mass on the non- coronary cusp of the aortic valve that measured approximately 1.3cm and was confirmed by tee. a stress mibi was also done at which was negative for ischemia. she was afebrile and serial blood cultures done to r/o endocarditis were negative, however she was given prophylactic iv antibiotics. she was transferred to for further cardiac workup. she was cared for by dr. who is of the opinion that the mass is a fibroelastoma, given the location of the tumor and lack of clinical symptoms of endocarditis. it has been recommended that this tumor be removed to prevent a thromboembolic event and the patient has been referred to dr. for surgery. as part of her pre-surgical workup, she has now been referred for cardiac catheterization. symptomatically, the patient reports palpitations. during her hospitalization she was noted to have ventricular ectopy/trigeminy but did not have any sustained arrhythmias. she denies any chest pain or dyspnea. past medical history: 1. cardiac risk factors: -diabetes, -dyslipidemia, -hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: - gerd - basal cell carcinoma on face s/p excision - irritable bowel syndrome - stress incontinence s/p bladder sling - s/p breast biopsy - s/p lap chole social history: works as a nurse hospital. lives with husband. -tobacco history: 20 pack-yr smoking hx, quit 13 yrs ago -etoh: occassional wine -illicit drugs: none family history: father died of early mi at 51, mother of dementia. no other hx of arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: pulse:67 resp: 18 o2 sat: 97%ra b/p 112/75 height: 5 feet 3 weight: 185 lbs general:a&ox3, nad skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular -pvcs noted on tele murmur grade ______ abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema _____ varicosities: none neuro: grossly intact pulses: femoral right: left: dp right: 2+ left:2+ pt : left: radial right: left: carotid bruit-none right: left: pertinent results: echo pre-bypass: no spontaneous echo contrast 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 thicknesses are normal. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). 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. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. a 1.3 x 0.9 cm mass is present on the ventricular aspect of the noncoronary cusp of the aortic valve. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results at time of surgery. post-bypass: the patient is in sinus rhythm. the patient is on no inotropes. biventricular function is unchanged. the aortic valve mass is no longer present. there is no aortic stenosis or regurgitation. mitral regurgitation is unchanged. the aorta is intact post-decannulation. i certify that i was present for this procedure in compliance with hcfa regulations. complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 04:25 10.9 3.34* 9.8* 29.5* 88 29.3 33.1 13.8 158 source: line-ij basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 04:25 158 source: line-ij basic coagulation (fibrinogen, dd, tt, reptilase, bt) fibrino 09:27 2561 note new reference range as of lab use only 04:25 source: line-ij chemistry renal & glucose glucose urean creat na k cl hco3 angap 04:05 12 0.5 139 4.1 103 cxr : findings: following removal of left chest drain tubes, there is no evidence of pneumothorax. interval increase in the retrocardiac density reflects increased left lower lung atelectasis. pleural effusion if any, is minimal on the left side. atelectasis is present at the right lung base and unchanged since prior study. right internal jugular line ends at mid/lower svc. status post avr with intact sternal sutures. moderately enlarged heart size, mediastinal and hilar contours are stable. there are no discrete lung opacities concerning for pneumonia brief hospital course: the patient was admitted to the hospital and brought to the operating room on where the patient underwent removal of aortic valve mass. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. cefazolin was used for surgical antibiotic prophylaxis. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. by the time of discharge on pod #3 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to home in good condition with appropriate follow up instructions. medications on admission: amitriptyline 10 mg hs prn:right upper quadrant spasms, pantoprazole 40 daily, aspirin 325 mg daily, docusate sodium 100 mg daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 weeks. disp:*14 capsule(s)* refills:*0* 2. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 4. amitriptyline 10 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)) as needed for stomach spasm. disp:*60 tablet(s)* refills:*0* 5. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home with service facility: , discharge diagnosis: gerd, basal cell cancer on face s/p excision, stress incontinence s/p bladder sling, s/p breast biopsy, s/p lap choleycystectomy, appendectomy, c section, previous problems with anesthesia: vomitting post anesthesia/dilaudid discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram incisions: sternal - healing well, no erythema or drainage edema: trace 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. office will call with appt cardiologist:dr office will arrange for you please call to schedule appointments with your primary care dr. in weeks **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 coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization open heart valvuloplasty of aortic valve without replacement diagnoses: anemia, unspecified esophageal reflux other and unspecified angina pectoris personal history of other malignant neoplasm of skin obesity, unspecified leukocytosis, unspecified benign neoplasm of heart body mass index 33.0-33.9, adult 

Answer: The patient is high likely exposed to