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: the patient is a 63 year old woman with a history of rheumatic heart disease. she has known aortic and mitral valve disease. her last echocardiogram was done on which revealed an ejection fraction of 60%. moderately severe mr enlarged la were demonstrated as well as moderate to severe aortic stenosis with an estimated valve area of 0.9 cm squared. there was also significant pulmonary hypertension with pa pressures estimated at 64 mmhg. most recent ett was negative in and performed for brief complaints of chest discomfort. clinically patient reports that she is very active. she walks several miles a day, cross country skiis and is able to cut and stack wood for her fireplace. over the past three weeks, however, she has noticed decrease in activity tolerance along with chest pain and mild shortness of breath that occurs with vigorous exertion. she reports that this discomfort can take up to several hours to resolve. she has never taken nitroglycerin. she is now referred for cardiac catheterization. patient denies claudication, orthopnea, edema, pnd, lightheadedness. past medical history: hypertension. hypercholesterolemia. smoking history, quit 20 years ago. insulin dependent diabetes mellitus. rheumatic heart disease. autoimmune iron disease. hypothyroidism. osteoporosis. bilateral carotid bruit without significant carotid disease. breast cancer status post chemotherapy and surgery. past surgical history: status post left mastectomy in . cholecystectomy in . medications on admission: miacalcin nasal spray, levoxyl 200 mcg q.d., lipitor 10 mg q.d., enalapril 5 mg q.d., celebrex 200 mg b.i.d., protonix 40 mg q.d., folate 1 mg q.d., nph 15 units q.h.s., regular and humalog insulin sliding scale. physical examination: in general, the patient was an elderly woman who appeared younger than her stated age and was in no acute distress. vital signs were stable, afebrile. height was 5'2", weight 122 pounds. heent was normocephalic, atraumatic, eomi, perrl, anicteric. throat was clear. neck was supple, midline, without masses or lymphadenopathy. chest was clear to auscultation bilaterally. cardiovascular was regular rate and rhythm with a to 3/6 systolic ejection murmur. abdomen was soft, nondistended, nontender without masses or organomegaly. extremities were warm, not cyanotic, not edematous times four. neuro was grossly intact. laboratory data: on admission cbc was 12/11.6/35.4/336. chemistries 138/4.1/104/27/13/0.7. inr was 1.1. hospital course: the patient had cardiac catheterization performed on which revealed 3+ mitral valve regurgitation, calcification of the aortic valve, ejection fraction of 61%, severe aortic stenosis, normal coronary arteries. patient now presents for elective valve repair. on patient was taken to the operating room and had aortic valve placement with a 21 mm pericardial valve and mitral valve repair with a 28 mm annuloplasty band. patient was subsequently taken to the csru for close monitoring. patient did well and was initially a-paced for blood pressure support. drips, chest tubes and pacing wires were discontinued as her clinical condition allowed. the patient had a largely unremarkable postoperative course and was subsequently transferred to the floor on postoperative day two. on the floor her status was again unremarkable and patient was ambulating well on her own without physical therapy. patient did test her own blood sugar glucoses and maintained her own blood sugars with her own sliding scale. she is very aggressive about this and took her finger sticks at least eight times a day. ultimately, patient was discharged on postoperative day four, tolerating a regular diet, had adequate pain control on p.o. pain meds and had been cleared for home by physical therapy. the patient was placed on a 10 day course of levaquin for an elevated white count of 50 and x-ray finding of some right lower lobe atelectasis as well as increased clinical sputum production. patient remained afebrile. physical examination on discharge, in general, in no acute distress. vital signs temperature 98.0, heart rate 68, blood pressure 119/57, respirations 18, 95% in room air. chest was clear to auscultation bilaterally. cardiovascular regular rate and rhythm. there was no sternal click or sternal wound drainage. patient did have 1+ peripheral edema. labs on discharge included cbc with white count of 25.4 down from 26.2, hematocrit 24.1, platelets 235. chemistries 131/4.9/99/25/30/1.1/65. magnesium 1.7. condition on discharge: good. disposition: to home. discharge diet: diabetic. discharge medications: 1. lasix 20 mg b.i.d. times seven days. 2. potassium chloride 20 meq b.i.d. times seven days. 3. aspirin 325 mg q.d. 4. lopressor 12.5 b.i.d. 5. levaquin 500 mg q.d. times eight days for a 10 day course. 6. lipitor 10 mg q.d. 7. levothyroxine 200 mcg q.d. 8. nph 15 units q.p.m. 9. percocet 5/325 one to two q.four hours p.r.n. 10. colace 100 mg b.i.d. die instructions: the patient is to continue her tight blood sugar control as well as a diabetic diet. she should follow up with her cardiologist in one to two weeks to address the need for continued diuresis as well as adjustment of cardiac medications at that time. patient should follow up with dr. in four weeks' time. patient was instructed to continue levaquin as well as encourage incentive spirometry for possible mild respiratory infection. , m.d. dictated by: medquist36 procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft annuloplasty diagnoses: pure hypercholesterolemia unspecified essential hypertension unspecified acquired hypothyroidism personal history of malignant neoplasm of breast osteoporosis, unspecified mitral valve insufficiency and aortic valve stenosis diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled rheumatic heart disease, unspecified 

Answer: The patient is high likely exposed to