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: no known allergies / adverse drug reactions attending: chief complaint: sob major surgical or invasive procedure: pulmonary vein isolation history of present illness: 64-year-old male with pmhx of cad s/p des to prox lad in & , htn, hld & paroxysmal atrial fibrillation s/p pvi who presents with acute chf exacerbation secondary to excessive fluid resuscitation during pvi today. patient received 3.3l of fluid during procedure and urine output was only 300ml. he received lasix iv 40mg x 2 with minimal effect. given patient's borderline hypotension, he was transferred to the ccu for diuresis and close monitoring. patient complains of worsening doe & orthopnea (two pillows at baseline; now sleeping basically upright) over the past 2 days prior to admission. of note, he reports that he was instructed to stop taking his metolazone 2-3 weeks ago for poor renal function, but continued taking furosemide 80mg . denies any recent dietary indiscretion and states that he has been compliant with his medications. . on review of systems, (+): per hpi, intermittent lightheadedness, completed a course of antibiotics for pneumonia about 3 weeks prior to admission (-): 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. . cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, ankle edema, palpitations, syncope or presyncope. . in the pacu, initial vs were bp 96/59, hr 72, 93% on shovel mask. patient was still mildly sedated, but able to carry on a conversation past medical history: 1. cardiac risk factors: (-)diabetes, (+)dyslipidemia, (+)hypertension 2. cardiac history: (see below) -cabg: none. -percutaneous coronary interventions: des to prox lad in and des to prox lad in -pacing/icd: none. 3. other past medical history: cad s/p des to prox lad in and des to prox lad in paroxysmal atrial fibrillation s/p dccv & with early reversion to atrial fibrillation nonsustained ventricular tachycardia noted on holter chf - (lvef 60% in - 29% since ) hypertension hyperlipidemia obstructive sleep apnea - does not use cpap gout dysphasia (per dr. note) : left wrist fx w/external fixation cough syncope (per dr. note) social history: patient is disabled and married, and has 2 grown children. -tobacco history: denies. -etoh: 2 beers/week. -illicit drugs: denies. family history: his brother died of an mi at age 50. another brother has hypertension. his father had a stroke at age 75. no 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 *** cm. 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, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominal bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: labs on admission: 07:00am pt-26.1* inr(pt)-2.5* 07:00am plt count-238 07:00am neuts-77.7* lymphs-15.9* monos-3.8 eos-2.1 basos-0.5 07:00am wbc-12.7* rbc-5.45 hgb-16.7 hct-48.0 mcv-88 mch-30.7 mchc-34.8 rdw-14.8 07:00am glucose-141* urea n-55* creat-2.5* sodium-139 potassium-4.8 chloride-99 total co2-26 anion gap-19 07:50am sodium-140 potassium-3.9 chloride-101 12:37pm freeca-1.09* 12:37pm hgb-14.7 calchct-44 12:37pm glucose-171* lactate-1.5 na+-138 k+-5.3 12:37pm type-central ve o2-76 po2-25* pco2-68* ph-7.23* total co2-30 base xs--1 intubated-intubated 08:04pm pt-32.0* ptt-27.4 inr(pt)-3.2* 08:04pm plt count-192 08:04pm neuts-88.9* lymphs-6.6* monos-3.9 eos-0.3 basos-0.4 08:04pm wbc-15.0* rbc-5.00 hgb-15.4 hct-45.2 mcv-90 mch-30.8 mchc-34.0 rdw-15.2 08:04pm calcium-9.0 phosphate-4.8* magnesium-2.1 08:04pm ck-mb-6 ctropnt-0.48* 08:04pm ck(cpk)-219 08:04pm glucose-109* urea n-57* creat-3.1* sodium-143 potassium-4.9 chloride-104 total co2-29 anion gap-15 imaging: echo the left atrium is moderately dilated. the right atrium is markedly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is top normal/borderline dilated. there is severe global left ventricular hypokinesis (lvef = 20 %) with relative preservation of the basal inferolateral wall. no masses or thrombi are seen in the left ventricle. the right ventricular cavity is moderately dilated with depressed free wall contractility. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: severe global left ventricular systolic dysfunction. moderate right ventricular dilation and dysfunction. moderate mitral and tricuspid regurgitation. moderate pulmonary hypertension. chest xray pa/l moderate cardiomegaly is unchanged since . there is no evidence of pleural effusion. bilateral apical pleural thickening is mild. brief hospital course: 64-year-old male with pmhx of cad s/p des to prox lad in & , htn, hld & paroxysmal atrial fibrillation s/p pvi who presents with acute chf exacerbation secondary to excessive fluid resuscitation and ineffective diuresis during pvi today. . # pump/acute decompensated chf: lvef decreased significantly from 55-60% () to 29% (). no evidence of ischemia on ekg and patient denies any chest pain. worsening of lv function likely secondary to tachycardia-induced cardiomyopathy in the context of persistent atrial fibrillation. current chf exacerbation most likely triggered by fluid overload from ivf during pulmonary vein isolation in the context of already worsening chf since prior to admission (after stopping metolazone for 2 weeks). last chf exacerbation was . patient denies any dietary indiscretion or medication non-compliance. he was diuresed with furosemide gtt and metolazone which was eventually switched to po torsemide. his creatinine continued to trend down in this setting. he was discharged on 40 mg torsemide daily. . # coronaries/cad: patient has had 2 to proximal lad, in and . he denies any recent chest pain or acs. no changes on ekg suggestive of ischemia. continue aspirin 81mg, simvastatin 20mg. started on spironolactone. his metoprolol was restarted and uptitrated to control his rapid afib. . # rhythm: h/o paroxysmal atrial fibrillation s/p failed dccv & with early reversion to atrial fibrillation (2 days). had pulmonary vein isolation with successful conversion to sinus rhythm. he has failed sotalol and amiodarone. has been on atenolol in the past. metoprolol and amiodarone were restarted and he was cardioverted but this did not last more than 20 secs. given a transaminitis, the amiodarone was stopped. he continued in rapid afib for several days. metoprolol then uptitrated to 100mg tid, however he continued with high heart rates. he was restarted on amiodarone for rate and rhythm control. he was started on warfarin 2 mg daily for anticoagulation with inr check scheduled for . . # leukocytosis: patient recently completed antibiotic course for infiltrate on cxr. currently with no clinical signs of infection; no cough, dysuria, fevers or chills. he did not reveal signs of infection. we did start him on a combivent inhaler prn for shortness of breath. # pnd/orthopnea: patient noticed increasing symptoms of pnd and orthopnea despite diuresis noting that he frequently began waking up at night with sob. a chest xray was performed that revealed resolution of pulmonary edema. we did start him on a combivent inhaler prn for shortness of breath. . # htn: patient is currently relatively hypotensive, so metoprolol and diltiazem were being held on admission while he was being diuresed. diltiazem was discontinued at time of discharge, and he was restarted on 150 mg metoprolol daily. . # hyperlipidemia: continued simvastatin & fish oil. fenofibrate held as not on formulary. . # gout: not currently an issue. patient takes colchicine as needed. tolmetin was discontinued given renal failure. pcp may consider starting allopurinol given > 4-5 episodes of gout per year. . fen: no ivf, replete electrolytes prn, low sodium/heart healthy medications on admission: colchicine - ( by other provider) - 0.6 mg tablet - 1 tablet(s) by mouth once daily as needed for gout diltiazem hcl - ( by other provider) - 360 mg capsule, extended release - 1 capsule(s) by mouth once daily fenofibrate micronized - ( by other provider) - 134 mg capsule - 1 capsule(s) by mouth once daily furosemide - ( by other provider) - 40 mg tablet - 2 tablet(s) by mouth twice daily metolazone - ( by other provider) - 5 mg tablet - 1 tablet(s) by mouth once daily metoprolol tartrate - ( by other provider) - 25 mg by mouth twice daily potassium chloride - ( by other provider) - 60 meq capsule, extended release twice daily simvastatin - ( by other provider) - 20 mg tablet - 1 tablet(s) by mouth once daily tadalafil - ( by other provider) - 10 mg tablet - 1 tablet(s) by mouth as needed tolmetin - ( by other provider) - 400 mg capsule - 1 capsule(s) by mouth once daily for gout as needed warfarin - ( by other provider) - 5 mg tablet - 1 tablet(s) by mouth once daily or as directed medications - otc aspirin - ( by other provider) - 81 mg tablet, chewable - 1 tablet(s) by mouth once daily omega-3 fatty acids - ( by other provider) - 1,000 mg capsule - 1 capsule(s) by mouth once daily . discharge medications: 1. colchicine 0.6 mg tablet sig: one (1) tablet po once a day as needed for gout. 2. fenofibrate oral 3. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 4. cialis 10 mg tablet sig: one (1) tablet po once a day as needed. 5. aspirin 81 mg tablet sig: one (1) tablet po once a day. 6. fish oil 1,000 mg capsule sig: one (1) capsule po once a day. 7. metoprolol succinate 50 mg tablet extended release 24 hr sig: three (3) tablet extended release 24 hr po daily (daily). disp:*90 tablet extended release 24 hr(s)* refills:*2* 8. warfarin 2 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 9. lorazepam 0.5 mg tablet sig: one (1) tablet po at bedtime as needed for sob, anxiety. disp:*60 tablet(s)* refills:*0* 10. torsemide 20 mg tablet sig: two (2) tablet po once a day. disp:*60 tablet(s)* refills:*2* 11. spironolactone 25 mg tablet sig: 0.5 tablet po once a day. disp:*15 tablet(s)* refills:*2* 12. multivitamin tablet sig: one (1) tablet po once a day. 13. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 2 weeks. disp:*56 tablet(s)* refills:*0* 14. combivent 18-103 mcg/actuation aerosol sig: two (2) puffs inhalation four times a day. disp:*1 inhaler* refills:*2* 15. amiodarone 200 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 16. outpatient lab work please check chem-7 on with results to dr. 17. spacer please provide spacer x1 to use with inhaler discharge disposition: home discharge diagnosis: atrial fibrillation s/p pvi heart failure - systolic dysfunction coronary artery disease hypertension dyslipidemia osa - intolerant to cpap discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had a pulmonary vein isolation for recurrent atrial fibrillation. this procedure went well but it took a few days for the rhythm to convert to a normal sinus rhythm. in the meantime, you were restarted on amiodarone and your medicines were adjusted. you were having trouble breathing and we gave you diuretics to remove extra fluid in your lungs. you now weigh 208 pounds and this should be considered yoour ideal or "dry" weight. please weigh yourself every day and talk to dr. if you notice your weight increases more than 3 pounds in 1 day or 5 pounds in 3 days. dr. can then go up or down on your diuretic dose. at this point, we feel that your shortness of breath is not cardiac related and you should talk to dr. about repeating the pulmonary function tests. you will go home on an inhaler and a sleeping pill to help you at night. we made the following changes to your medicines: 1. start warfarin 2mg daily to prevent blood clots after your ablation. please get your inr checked on thursday at dr. office. 2. start taking amiodarone to keep you in a normal sinus rhythm. you will need to have your liver function tests, your pulmonary tests and thyroid tests followed regularly when you are on this medicine. 3. start taking lorazepam as needed for shortness of breath. the pulmonologists here suggest that you use your cpap as much as possible and follow up with the doctor the cpap. you should also get pulmonary function tests through dr. . 4. increase your metoprolol to 150 mg daily 5. start a combivent inhaler to prevent your shortness of breath 6. stop taking furosemide, take torsemide 40 mg instead 7. start taking spironolactone to help keep the fluid off. 8. stop taking diltiazem, metolazone, tolmetin, and potassium. followup instructions: name: , j. location: medical group address: , , phone: when: thursday, , 2:30pm name: , location: heart center of address: ,2nd fl, , phone: when: , , 3:30pm procedure: excision or destruction of other lesion or tissue of heart, endovascular approach atrial cardioversion cardiac mapping diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified gout, unspecified atrial fibrillation percutaneous transluminal coronary angioplasty status nausea with vomiting other and unspecified hyperlipidemia hypotension, unspecified acute on chronic systolic heart failure other abnormal blood chemistry 

Answer: The patient is high likely exposed to