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: compazine attending: chief complaint: syncope & lightheadedness. major surgical or invasive procedure: central line with temporary pacing wires placed. central line removal pacemaker replacement history of present illness: - is a 33 yo female with a past medical history of congenital asd and vsd c/b complete heart block s/p pacer at age 9 months old who presented to osh lighheadedness and one episode of syncope. she reports that she has been feeling lightheaded for 2.5 weeks. the lightheadedness is not associated with postural changes. it is unrelated to exertion. last night she had her first episode of syncope. she had loc for approximately 6 sec. it was witnessed by her sister who caught her. she denied tonic/clonic movements, tongue biting, confusion, bowel or bladder incontinence. she reported palpitations but denies any associated chest pain, pressure or shortness of breath. her pacer was last placed 12 years ago. she reports that she saw her cardiologist approx 2-3 months ago for concern regarding hand numbness and was told that the pacer was working well. at the osh she was found to have symptomatic pauses up to 6 seconds in duration without ventricular pacing at those times. the most recent one occured on the ride over. head ct was negative at osh. she was transferred for temporary pacer and evaluation of her pacemaker. . on review of systems, positive for rhinorrhea for 2 days. daughter with uri. she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems as above is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, or palpitations. past medical history: 1. cardiac risk factors: no diabetes, no dyslipidemia, no hypertension 2. cardiac history: -cabg: n/a -percutaneous coronary interventions: n/a -pacing/icd: first ppm placed at age 9mo in . since then she has had 5 different pacers placed. the most recent one is a dual-chamber pacemaker placed in no. in her left chest. 3. other past medical history: # asd & vsd - s/p repair as an infant # complete heart block - pacemaker dependent since age 9 months. social history: she is single. she has 2 children ages 2 & 12. -tobacco history: ppd for 22 years. 11py -etoh: none -illicit drugs: none family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: general: wdwn in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 8 cm. cardiac: scar in left chest with device below. rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. extremities: no c/c/e. wwp skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ pertinent results: ekg: av paced hr 60 . telemetry: paced rhythm hr 60. frequent long pauses. . 2d-echocardiogram: n/a ett: n/a cardiac cath: n/a hemodynamics: n/a . cxr: pacer in left chest with leads in rv & ra & epicaridium. no acute cp process. . laboratory data: (from osh) ucg neg at osh 136 22 9 -----------------< 93 4 105 0.6 lfts wnl wbc 7.7 hgb 11.1 hct 34.0 plt 317 . admission labs 01:01am wbc-10.0 hgb-11.0* hct-33.9* plt ct-337 01:01am neuts-62.0 lymphs-26.9 monos-5.0 eos-5.4* baso-0.7 01:01am pt-12.2 ptt-29.6 inr(pt)-1.0 01:01am glucose-107* urean-13 creat-0.9 na-140 k-3.9 cl-107 hco3-23 angap-14 01:01am calcium-9.2 phos-4.2 mg-2.0 iron labs: 05:12am iron-49 caltibc-369 ferritn-11* trf-284 discharge labs: 05:30am wbc-6.7 hgb-9.4* hct-29.3* plt ct-286 05:30am neuts-50.4 lymphs-38.1 monos-5.0 eos-6.0* baso-0.5 05:30am pt-12.5 ptt-28.6 inr(pt)-1.1 05:30am glucose-85 urean-7 creat-0.6 na-139 k-4.2 cl-106 hco3-27 angap-10 05:30am calcium-8.6 phos-4.2 mg-1.9 brief hospital course: 33 yo female with congenital asd & vsd s/p repair with complete heart block since she was an infant who presents with syncope. # heart block with pacer malfunction: pt has history of complete heart block and is dependent on her pacemaker. pt is paced in 60s with frequent long (6 sec) symptomatic pauses indicating malfunctioning pacemaker. pt had temporary pacing wire placed on the night of admission. she had her pacemaker replaced on : new rv lead ( 4076)-->left subclavian; generator change--> enrhythm; old rv lead-->insulation breech and conductor fracture near header. cxr shows correct placement of the leads and no pneumothorax. the patient was started on iv cefazolin after the placement and switched to po abx on discharge. # coronaries: no history of cad. no symptoms of cp # pump: no history of chf. pt euvolemic on exam. # tob use: advised smoking cessation. pt provided with smoking cessation materials. medications on admission: none discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* 2. colace 100 mg capsule sig: one (1) capsule po twice a day. 3. ibuprofen 400 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain for 6 days. tablet(s) 4. keflex 500 mg capsule sig: one (1) capsule po four times a day for 5 days. disp:*20 capsule(s)* refills:*0* 5. tylenol 325 mg tablet sig: two (2) tablet po every six (6) hours as needed for pain for 7 days. discharge disposition: home discharge diagnosis: pacer malfunction discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: you were admitted for evaluation of symptoms of syncope and lightheadedness. you were found to have a malfunctioning pacer. it was discovered that your pacer was not firing appropriately and needed to be adjusted. during your hospitalization your pacer was replaced so that it should work appropriately for several years at minimum without difficulty. however, you should continue to follow up with your cardiologist to ensure that the pacer is working correctly. medications added during this hospitalization: percocet, ibuprofen & tylenol as needed for pain. do not drink alcholol or drive while taking percocet. colace for constipation while taking percocet. keflex - an antibiotic to prevent infection. followup instructions: please follow up with dr. , the ep cardiologist who replaced your pacemaker next week. please call ( to schedule an appointment for next week. he mentioned that he would try to arrange for an appointment for you on . his office is located at , , , please make a follow up appointment with your primary care doctor in the next 1-2 weeks as well. md procedure: venous catheterization, not elsewhere classified insertion of temporary transvenous pacemaker system replacement of any type pacemaker device with dual-chamber device replacement of transvenous atrial and/or ventricular lead(s) [electrode] diagnoses: tobacco use disorder atrioventricular block, complete surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation syncope and collapse mechanical complication due to cardiac pacemaker (electrode) personal history of surgery to heart and great vessels, presenting hazards to health 

Answer: The patient is high likely exposed to