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: patient recorded as having no known allergies to drugs attending: chief complaint: supraventricular tachycardia major surgical or invasive procedure: tee history of present illness: 52m with no pmh reporting 12 days of increased abdominal girth and 5 days of lower extremity swelling, presented to his pcp today and found to have a supraventricular tachycardia to 140 on ekg. he reports having a cough with yellow sputum which occurred shortly before he noticed his increased abdominal size. he denied ever feeling palpitations or chest pain, but did report shortness of breath with the cough. he took robitussin and his shortness of breath and cough resolved. upon presentation to his pcp and discovery of his supraventricular tachycardia, he was brought to where he was given diltiazem 45mg iv and metoprolol 7.5mg without effect. bedside echo at the time showed lvh with an ejection fraction of 10%. . he was transferred to ed where vitals were 99.5 145 165/98 20 97%ra. he was given lopressor 5mg iv x1 without effect, followed by adenosine 12mg which broke his rhythm and showed atrial flutter with 4:1 block. his rate returned to 145. he was placed on a nitro drip and given aspirin 325mg x1. . on review of systems, he 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. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. past medical history: hypertension social history: -tobacco history: cigars up to 2 weeks ago -etoh: drinks a pint of whiskey 4 nights weekly family history: mother died in the 80's of "heart problems" for many years, she was 65yo at the time. physical exam: vs: t= 98.9 bp= 170/90 hr= 139 rr=12 o2 sat= 93% 3l 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 up to angle of jaw. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, 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, obese, distended, pitting edema. extremities: 2+ pitting edema b/l. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ pertinent results: 05:20pm ck-mb-6 probnp-7235* 05:20pm ctropnt-0.02* 05:20pm alt(sgpt)-55* ast(sgot)-53* ck(cpk)-418* alk phos-68 tot bili-1.1 05:20pm glucose-130* urea n-19 creat-1.4* sodium-134 potassium-5.1 chloride-101 total co2-20* anion gap-18 05:20pm wbc-9.8 rbc-4.49* hgb-14.6 hct-44.6 mcv-99* mch-32.4* mchc-32.7 rdw-14.1 cxr: impression: findings consistent with mild volume overload. more confluent opacity in the lung bases may be due to soft tissue attenuation, atelectasis, and/or focal pneumonia. repeat radiography following appropriate diuresis recommended to assess for underlying infection. if clinically feasible, consider pa and lateral views in the radiology suite for a more sensitive evaluation. cardiomegaly is also noted. ekg: atrial flutter with a ventricular rate of 139. left axis deviation. marked j point elevation with early repolarization in anterior precordial leads. diffuse non-diagnostic repolarization abnormalities elsewhere. no previous tracing available for comparison. tee echo: the left atrial appendage emptying velocity is depressed (<0.2m/s). a probable thrombus is seen in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is severely depressed (lvef= 15-20 %). right ventricular chamber size is normal. with moderate global free wall hypokinesis. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque to 30 cm from the incisors. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. impression: probable thrombus in left atrial appendage. severely depressed -ventricular systolic function. brief hospital course: 52m with no past medical history presenting with new onset systolic congestive heart failure and atrial flutter with alternating 4:1 and 2:1 block. . # atrial flutter: his atrial flutter may have begun nearly two weeks ago when he first developed cough and increased abdominal girth. he was initially in a 2:1 block with a hr in the 140s-150s and his cardiac enzymes were negative. his rhythm was initially resistant to diltiazem drip and metoprolol. an electrophysiology consult was obtained and the plan was to proceed with tee to rule out atrial clot prior to ablation of the circuit. a tee was performed which showed probable thrombus in the left atrial appendage and the ablation was therefore cancelled. he was then started on metoprolol 75mg qid and verpamil 60mg which managed to push his rhythm into 4:1 block with a hr in the 80s to 100s. he was also digoxin loaded, but the digoxin was discontinued because he had 2 prolonged pauses in his rhythm with the vagal stimulation of passing gas and it was felt that digoxin was making this more pronounced. for his left atrial appendage clot he was started on heparin iv as a bridge to coumadin. he will continue the bridging at home with lovenox and will have his inr measured on . he will follow-up with electrophysiology in 1 month as an outpatient for repeat tee and possible ablation if there is no clot seen. until then he will remain of metoprolol 150mg and verpamil 60mg for rate control. . # acute systolic congestive heart failure: he appears to have predominantly right sided heart failure with absence of crackles, along with presence of jvp, abdominal edema, and increased abdominal girth. echo showed ef=15-20%. bnp elevated to 7000. etiologies may include cardiomyopathy induced by alcohol, viral infection from previous upper respiratory infection, or tachycardia induced cardiomyopathy. he diuresed well with lasix 20mg iv. . # hypertension: he was started on metoprolol and lisinopril. . # coronary artery disease prevention: will start on aspirin 81mg. consider checking lipid profile with pcp as an outpatient. . code: code status was confirmed as full. . comm: (sister) medications on admission: none discharge medications: 1. outpatient lab work please measure inr, pt, ptt, , k, cl, co2, bun, cr on . please fax results to office of dr. at fax # . 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*90 tablet, chewable(s)* refills:*2* 3. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. verapamil 40 mg tablet sig: 1.5 tablets po q12h (every 12 hours). disp:*90 tablet(s)* refills:*2* 5. metoprolol tartrate 50 mg tablet sig: three (3) tablet po q 12h (every 12 hours). disp:*180 tablet(s)* refills:*2* 6. coumadin 2 mg tablet sig: two (2) tablet po once a day. disp:*60 tablet(s)* refills:*2* 7. outpatient lab work please have na, k, cl, co2, bun, cr measured on . please fax results to at 8. lovenox 100 mg/ml syringe sig: one (1) syringe subcutaneous every twelve (12) hours for 8 doses: inject twice a day on . inject the morning of . await results of labs on before administering further injections. disp:*8 syringe* refills:*0* discharge disposition: home discharge diagnosis: atrial flutter systolic congestive heart failure left ventricular hypertrophy discharge condition: good. ambulating. 95% on room air. lower extremity edema present. abdominal edema present. discharge instructions: you were admitted to the hospital with a rapid heart rhythm called atrial flutter and congestive heart failure. you were given medications to slow down your heart rate. you also underwent a trans-esophageal echocardiograpy to evaluate for presence of blood clots in your heart. blood clots were present, and it was decided to give you blood thinners named coumadin and lovenox to allow disintegration of this clot. you should continue these medications for 4 weeks. you should return here to meet with the electrophysiologists in 4 weeks for consideration of ablation totreat your atrial flutter. the electrophysiologist will contact you to set up this appointment in 4 weeks. you will need to have labs drawn on , and . you will be given a prescription to have these labs drawn. please call dr. office to arrange this lab draw. . please start taking aspirin 81mg po daily please start taking metoprolol 150mg po every 12 hours please start taking verapimil 60mg po every 12 hours please start taking coumadin 4mg po daily please start taking lovenox 100mg sc every 12 hours. take this medication until instructed otherwise by your primary care doctor. . please be sure to have your labs drawn on and , and to have these results faxed to your primary care doctor. followup instructions: please call your pcp at to set up an appointment for next week. . the electrophysiologists at will contact you to set up an appointment in 4 weeks. procedure: diagnostic ultrasound of heart diagnoses: congestive heart failure, unspecified unspecified essential hypertension atrial flutter acute systolic heart failure other second degree atrioventricular block cardiomegaly other ill-defined heart diseases 

Answer: The patient is high likely exposed to