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: past medical history: 1. status post mechanical mitral valve replacement for rheumatic heart disease. 2. atrial fibrillation. 3. osteoporosis. 4. possible seizure disorder. 5. history of strokes with no residual deficits. allergies: the patient has no known drug allergies. admission medications: 1. synthroid. 2. lanoxin. 3. lisinopril. 4. methylphenidate. 5. coreg. 6. zoloft. 7. tums. 8. coumadin as needed to maintain an inr greater than 2.5. 9. ditropan. social history: she lives with her husband in . she is italian and immigrated to the united states over 30 years ago and formerly worked as a medical assistant. physical examination on admission: vital signs: temperature 97.4, heart rate 60, blood pressure 110/64, respirations 20, 02 saturation of 95% on room air. general: the patient was a middle-aged woman sitting in a wheelchair in no apparent distress. heent: peerl, eomi, and anicteric sclerae. lungs: clear to auscultation bilaterally. heart: irregularly/irregular. she has a soft grade ii systolic murmur at the base. abdomen: soft, nontender, nondistended with positive bowel sounds. extremities: no edema. hospital course: the patient was admitted and because her inr was greater than 1.5 she remained in the hospital for three days before her inr was less than 1.5 and a lumbar puncture was able to be performed. following her lumbar puncture, she did have slight improvement in her symptoms, specifically that her speech was greater quantity and she seems to be quicker in her movements. she is also more descriptive in her speech. it was felt that with this improvement she may need to have a vp shunt placed and neurosurgery was consulted. the neurosurgical team saw her and felt that a vp shunt would likely be helpful; however, they did feel that she would be at risk of significant problems given her need for anticoagulation in lieu of her mechanical valve. the decision was then made to proceed with the vp shunt. on , a right vp shunt was placed. the patient tolerated the procedure and was transferred back to ii after normal recovery in the pacu. the patient continued to recover normally from her vp shunt placement until the morning of when she experienced worsening shortness of breath with a rapid heart rate. a cardiology consult was called and they felt that if the chest x-ray was consistent with chf she should be diuresed with lasix and possibly she could be started on iv diltiazem if her heart rate did not slow. at the time, her heart rate was in the 120s, irregular. it was also suggested that she be restarted on her heparin and coumadin not only for her mechanical valve but also for the atrial fibrillation. in light of her respiratory status and rapid rate, she was transferred to the medical intensive care unit because of her atrial fibrillation and rate increase to 140 with a blood pressure drop to 80/palpable with a saturation of 90% on 100% nonrebreather. a transthoracic echocardiogram was performed which showed a left thrombus in the left atrium and no valve motion. the patient was then transferred to the pacu where she was intubated and a central line and arterial line were placed. she was then brought to the operating room for an urgent procedure including a left atrial thrombectomy and a redo sternotomy with a redo mitral valve replacement with a #25 carbomedics mechanical valve. she was transferred to the crsu on dobutamine, milrinone, levophed, neo-synephrine. she was intubated, sedated, and had an intra-aortic balloon pump. throughout the operative night, she was weaned off her propofol drip and remained calm and followed commands appropriately. she did stay in a tachy-atrial fibrillation with frequent ventricular ectopy in the overnight period. her balloon pump remained in place and she maintained a cardiac index on milrinone of greater than 2.8 with a mixed venous gas of 74% or greater. later on postoperative day number one, she was weaned from her dobutamine and continued on the milrinone. she was noted to have a decreasing platelet count and hit antibody screen was sent off. she was kept intubated during the stay partly for small amounts of thick yellow secretions. she also was started on an amiodarone drip to help with her ventricular ectopy and atrial fibrillation. on her second postoperative day, she did remain intubated and more of her drips were weaned off. by postoperative day number three, she was extubated and her intra-aortic balloon pump was discontinued without incident. it was noted that her platelet count did continue to decrease and another hit screen was sent and she was found to have hit antibody positive. therefore, her heparin drip was discontinued and she was started on argatroban as per the hematology service. on the following day, , her inr was elevated to 4.7 and this was thought to be secondary to the argatroban and this drip was held. a transthoracic echocardiogram was performed and she was noted to have a functioning valve with decreased biventricular dysfunction which was unchanged from preoperatively. on the evening of , she was noted to have a decrease in her level of consciousness and was noted to be disoriented. she was sent for a ct scan of her head and was found to have a small right frontal subdural hematoma. at the same time, lfts were sent and these were noted to be elevated. at this point, her argatroban was discontinued completely and for anticoagulation, she was started on .................... per hematology service. on the following day, , she received a gi consult for her elevated lfts. it was felt that this could possibly be due to coincidence with the argatroban but as many of the medications that are cleared hepatically that were stopped were. also, at this point, she had a self-limited run of v-fib and an ep consult was called for an aicd placement secondary to a run of v-fib in lieu of her low ejection fraction. on , she received a repeat head ct to evaluate her subdural hematoma which showed no changes. at this point, she remained stable and she remained in the crsu while awaiting aicd placement. the delay in this placement was secondary to elevated inr for which on , she received 1 mg of vitamin k. by , her inr was less than 1.5 and she was able to go to the electrophysiology laboratory for aicd placement. she did receive a dose of coumadin the night of and was started back on her .................... drip on the morning of . also, it was felt that her amiodarone would not be needed anymore and this was discontinued. following her aicd placement, she was transferred to ii and started on ancef for 48 hours and then keflex for 72 hours. following this, she was encouraged to increase her p.o. intake. she worked aggressively with physical therapy and continued to improve slowly. she did have her pacing wires discontinued by having them cut at the skin and be left in place. on , her inr was 2.7 and her .................... drip was able to be discontinued. she will receive 1 mg of coumadin on the night prior to discharge and if her inr continues to be greater than 2.5 and less than 3.5 on the morning of discharge then she will be able to be discharged to a rehabilitation facility. discharge physical examination: vital signs: stable with a temperature of 97.9, heart rate 105, blood pressure 104/60, respirations 18, room air saturation 96%. she appears in no apparent distress. heart: irregularly/irregular. lungs: clear to auscultation bilaterally. abdomen: soft, nontender, nondistended. extremities: no clubbing, cyanosis or edema. her sternal incision was clean, dry, and intact and her sternum was stable. her other wounds were clean, dry, and intact and healing well. discharge medications: 1. percocet one to two tablets q. four to six hours p.r.n. pain. 2. aspirin 325 mg p.o. q.d. 3. levothyroxine 88 micrograms one tablet p.o. q.d. 4. zoloft 50 mg p.o. b.i.d. 5. levetiracetam 500 mg p.o. b.i.d. 6. diphenhydramine, 25 mg p.o. q.h.s. p.r.n. 7. keflex 500 mg p.o. q. six hours times 48 hours. 8. lopressor 25 mg p.o. b.i.d. 9. captopril 6.25 mg p.o. t.i.d. disposition: she will be discharged in good condition. discharge diagnosis: 1. status post vp shunt on . 2. status post redo mitral valve replacement with a #25 carbomedics mechanical valve on . 3. heparin-induced thrombocytopenia. 4. subdural hematoma on the right. 5. status post aicd placement on . 6. atrial fibrillation. 7. rheumatic heart disease. 8. possible seizure disorder. 9. status post cerebrovascular accidents without residuals. 10. osteoporosis. follow-up: she should follow-up with her primary care physician, . in one week, with dr. in one to two weeks and with dr. in four weeks. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified spinal tap incision of lung extracorporeal circulation auxiliary to open heart surgery insertion of endotracheal tube ventricular shunt to abdominal cavity and organs arterial catheterization open and other replacement of mitral valve implant of pulsation balloon implantation or replacement of automatic cardioverter/defibrillator, total system [aicd] nonoperative removal of heart assist system diagnoses: congestive heart failure, unspecified atrial fibrillation paroxysmal ventricular tachycardia ventricular fibrillation surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation subdural hemorrhage communicating hydrocephalus infection and inflammatory reaction due to cardiac device, implant, and graft 

Answer: The patient is high likely exposed to