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 54 year old man who has a history of atrial fibrillation diagnosed in . he was asymptomatic at the time, and it is unclear exactly when his atrial fibrillation began. the patient was started on coumadin and has been on metoprolol for rate control. approximately a year ago, the patient had a failed cardioversion at an outside facility. the patient had an exercise stress test which was negative. an echocardiogram showed a mildly dilated left atrium with mild left ventricular hypertrophy. the patient was referred to and dr. for a pulmonary vein ablation. the patient was admitted currently for this procedure. he had a transesophageal echocardiogram prior to the procedure, and it disclosed a dilated left atrium with no evidence of thrombus. during the procedure, the patient was noted to have a systolic blood pressure down to the seventies, and a pericardial effusion was noted. an emergent pericardiocentesis was performed, with removal of 480 cc of sanguinous fluid. it was thought that the patient had a perforation during the procedure, leading to pericardial effusion and tamponade. while in the electrophysiology laboratory, the patient received intravenous fluids and one unit of packed red blood cells with improvement in his blood pressure and normalization of the pulsus paradoxus. a pericardial drain was also placed for drainage of any further accumulation of fluid. the patient was transferred to the ccu for further monitoring and management. past medical history: 1. migraines. 2. umbilical hernia. 3. atrial fibrillation. medications: 1. metoprolol 25 mg b.i.d. 2. coumadin 10-15 mg q day. 3. imitrex p.r.n. 4. cafergot p.r.n. allergies: no known drug allergies. social history: the patient is married and works as a consultant. occasional alcohol. no tobacco or other drug use. family history: the patient has several uncles with atrial fibrillation. however, there is no history of sudden cardiac death in the family. physical examination: vital signs: temperature 96.2, blood pressure 114/67, heart rate 74, respiratory rate 16, oxygen saturation 100% on assist control 800 by 12 on 100% o2. general: the patient is intubated and sedated. heent: normocephalic, atraumatic. pupils are equal, round, and reactive to light. endotracheal tube was in place. neck: no jugular venous distention. cardiovascular: regular rate and rhythm with normal s1 and s2 and no murmur, rub or gallops. there is a pericardial drain in place. lungs: clear to auscultation anteriorly. abdomen: benign. extremities: no edema. good distal pulses. the patient has a right arterial femoral artery sheath. labs on admission: cbc shows a white count of 9.6, hematocrit 38.6, platelet count 166. chem-7 is within normal limits except for a bicarbonate of 22. inr is 1.3. the last arterial blood gases showed ph 7.29, pco2 41 and po2 of 304 on the ventilator settings of assist control 800 cc x 14 breaths per minute at 100% fio2 and 5 of peep. electrocardiogram: post-procedure electrocardiogram showed normal sinus rhythm with sinus arrhythmia with normal interval and normal axis. there was a left atrial enlargement. summary of hospital course by issue: 1. cardiac tamponade. the patient had a pericardial drain placed in the e.p. laboratory for continual drainage of the pericardial fluid to prevent tamponade. initially the pericardial drain put out approximately 400 cc over the first 12 - 24 hours. however, this output slowly tapered off. a repeat echocardiogram was done, which did not show any significant new fluid accumulation. the drain was removed at that time. during the hospital course, the patient's hematocrit remained stable. initially, the patient's anticoagulation was held for several days after the removal of the pericardial drain. it was then restarted. there were no further signs of pericardial tamponade. 2. atrial fibrillation. the patient was in normal sinus rhythm briefly after the pulmonary vein ablation procedure. however, the morning after being admitted to the ccu, the patient reverted back into atrial fibrillation with a rapid rate. he received several doses of intravenous lopressor for rate control. he was then restarted on lopressor p.o. as he could not be anticoagulation with coumadin initially, he was only placed on aspirin. since the patient had reverted back to atrial fibrillation, he was taken for another attempt at d.c. cardioversion. this was performed the day prior to discharge, and was only successful temporarily. after a brief period in normal sinus rhythm, the patient reverted back to atrial fibrillation. the patient was continued on toprol xl for rate control at that point, after the failed cardioversion. he was restarted on anticoagulation with coumadin. the patient was also started on p.o. amiodarone. he was to take 400 mg b.i.d. x two weeks, then 400 mg once a day for one week, at which point he would be re-evaluated by the electrophysiology service for a possible repeat d. c. cardioversion. 3. respiratory status. the patient arrived to the ccu intubated due to the procedure. his sedation with propofol was quickly weaned off, and he was changed over to pressor support and then extubated without any complications. he did have some hypoxia after being extubated. it was thought that this was secondary to splinting from the pain that he was having due to the pericardial drain that was in place. once his pain improved and the patient was able to take deep inspirations, his oxygenation improved. 4. pain control. the patient was in a significant amount of pain while his pericardial drain was in place, due to the irritation. he was maintained on high doses of narcotics for pain relief, though he never achieved complete relief until the pericardial drain was removed. 5. cardiomyopathy. the echocardiogram done showed that the patient had an ejection fraction of 20-25%. this was thought possibly secondary to chronic atrial fibrillation. the patient was started on an ace inhibitor for afterload reduction and treatment of heart failure. he was discharged on zestril 5 mg q day. he had no signs or symptoms of acute heart failure or decompensation. 6. code status. the patient was full code on admission and at discharge. discharge status: the patient was discharged home. discharge condition: the patient was in good condition. he was hemodynamically stable. discharge diagnoses: 1. atrial fibrillation. 2. pericardial effusion. discharge medications: 1. aspirin 81 mg q day. 2. lopressor 75 mg q day. 3. zestril 5 mg q day. 4. coumadin 7.5 mg q h.s. 5. amiodarone 400 mg b.i.d. for one week, then 400 mg once a day for the following three weeks. discharge instructions and followup plans: the patient was to have his inr checked in two to three days after discharge for adjustment of his coumadin to a goal inr of . the patient was to call dr. office to follow up in appointment in about one month for possible repeat cardioversion. he is also to see his primary care physician in two to four weeks. , m.d. dictated by: medquist36 procedure: diagnostic ultrasound of heart pericardiocentesis catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach atrial cardioversion cardiac mapping diagnoses: other primary cardiomyopathies mitral valve disorders congestive heart failure, unspecified atrial fibrillation unspecified disease of pericardium 

Answer: The patient is high likely exposed to