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: this is a 77 year old female with past medical history of congestive heart failure and coronary artery disease, who was in her usual state of health prior to admission. on the night she was admitted patient was having increased chest pain that actually awoke her from sleep. she described the pain as , sharp, substernal pain that radiated down her left arm. she denied shortness of breath, nausea, vomiting, diaphoresis or heart palpitations. patient became concerned. she notified ems. ems gave patient one sublingual nitroglycerin with immediate improvement in her symptoms. she was then transferred to emergency room for further evaluation. in the emergency room patient was given an aspirin that she was unable to chew and she ended up gagging on the aspirin. shortly after gagging on the aspirin patient appeared to have a vagal reaction and actually went into asystole. she was given one dose of atropine and her cardiac rhythm returned to atrial flutter with variable block patterns. patient is a very poor historian and was unable to give any additional history. at that time it was discussed at great length with her son about possible options to include a temporary pacer. the son chose not to have any cardiac intervention done, understanding the risks involved. he stated that in the past his mother had been offered procedures that she had refused. patient was then admitted to the ccu for further observation. review of systems: she had been complaining of some visual field defects. she states "it is like a shade came down over my right eye." she was seen by an ophthalmologist for this complaint who told her that it was likely she had a vascular event. in the past she had been offered anticoagulation for her significant history of a-flutter/a-fib which she had refused. past medical history: coronary artery disease, status post two myocardial infarctions. congestive heart failure with an echo in that showed approximately 20% ejection fraction with moderate to severe mitral regurgitation and right ventricle hypokinesis. she also had ischemic cardiomyopathy. meniere disease. paroxysmal atrial fibrillation. transient ischemic attacks. hyperlipidemia. anxiety. medications on admission: zestril 10 mg q.d., lasix 40 mg q.d., valium p.r.n., zaroxolyn p.r.n. allergies: the patient has an allergy to beta blockers, the reaction is unclear. she also has an allergy to barbiturates and digoxin, again the reactions are unclear. family history: mother passed away from a cerebrovascular accident. social history: the patient denied alcohol or smoking. laboratory data: on admission sodium was 136, potassium 4.1, chloride 98, bicarb 27, bun 21, creatinine 1, glucose 117. white blood count 6.4, hematocrit 35.7, platelet count 180. differential showed 59 neutrophils, 2 basophils, 28 lymphocytes, 6 monocytes, 1 eosinophil. coags showed pt of 12.6, ptt 23.3, inr 1.1. physical examination: on admission the patient was afebrile, heart rate 83 beats per minute and regular, blood pressure 117/77, respiratory rate 16 breaths per minute, o2 sat was 98% on 2 liters. in general, this was a very frail, elderly appearing female who was slightly confused, mumbling and was not coherent. mucous membranes were dry. pupils were equally round and reactive to light. cranial nerves ii-xii were grossly intact. patient was oriented to place and name only. pulmonary exam revealed bibasilar crackles. she had decreased respiratory effort. abdomen was soft, nondistended, nontender with positive bowel sounds. heart was regular rate and rhythm with s1, s2 and s3. extremities were without cyanosis, clubbing or edema. hospital course: this is a 77 year old woman with a history of coronary artery disease, congestive heart failure, left bundle branch block with a-flutter who is not anticoagulated, status post multiple tias. she presented to the emergency room with new onset chest pain that radiated down her left upper extremity. at the time she was refusing any intervention. she was admitted to the ccu for further observation. 1. cardiac. the patient was admitted and her cardiac enzymes were followed. initial ck was 82 with troponin of 3.0. second ck was 458, mb 88, troponin 34.3. shortly after receiving these results, patient became bradycardiac down into the 20s to 30s. after emergent discussion with her son, the decision was made to place a temporary pacemaker. dr. discussed the severity of the patient's situation and her slow ventricular escape rate of approximately 20 and the son agreed to have the placement despite her previous wishes not to have this done. the son stated that she was scared of the procedure, but that she wanted to live and that she was just not thinking clearly at the time she presented to the emergency room. during placement of the temporary pacemaker, patient went into ventricular fibrillation arrest for which she received defibrillation shocks and then patient when into asystole for which patient was then emergently intubated. atropine was administered and a temporary pacemaker was placed. she returned to a paced rhythm of approximately 80 beats per minute. an emergent echo was performed at bedside which showed severe global left ventricular and right ventricular hypokinesis. there was no pericardial effusion noted. on the third day of admission, patient was taken to the electrophysiology lab and a biventricular lead pacer was placed. patient had the pacer placed at 80 beats per minute. she was successfully extubated. following extubation she complained of some chest pain around the incision site at which time the pacer configuration was changed to pace at about 70 beats per minute. pacer was performing well until the fifth day of hospital admission at which point she went into v-tach/v-fib cardiac arrest. patient was quickly defibrillated and intubated for airway protection. after a lengthy discussion with her son, it was determined that patient would go to the cardiac cath lab. cardiac cath revealed a 99% lesion in the lad which was successfully stented. patient was then transferred back to the ccu for further management. for her coronary artery disease she was placed on aspirin 325 mg q.d., plavix 75 mg q.d. for 30 days, low dose beta blocker and statin. her ace inhibitor was being held until her creatinine returned to approximately 1.5. for her congestive heart failure patient was placed on low dose beta blocker. she received lasix to relieve her pulmonary symptoms. for her rhythm she received a biventricular lead pacer for which she will follow up with ep for further management. 2. pulmonary. the patient was intubated on two occasions for airway protection. she was easily liberated from the ventilator on both occasions without complications. 3. renal. the patient presented to the emergency room with creatinine of 1.0. following her cardiac arrest and the dye load, patient went into acute renal failure with creatinine of 2.4. all nonsteroidals and ace inhibitors were held. patient's creatinine gradually improved over her course of stay. patient should have an ace inhibitor added to her regimen once her creatinine returns to approximately 1.5. 4. id. the patient was placed on vancomycin following placement of the biventricular pacer. her cultures remained negative throughout her stay. 5. hematology/oncology. the patient is anemic at baseline. during her stay she received 2 units of packed red blood cells. it appeared that she had a minor reaction following the transfusion with a temperature of approximately 101. 6. endocrine. the patient had elevated blood sugars, approximately 150 to 200, during her stay. when discussed with patient, she stated she is not a diabetic and refused further blood sugars along with any additional insulin or hypoglycemics. this issue should be addressed at some point as it appears that the patient is a diabetic. 7. fluids, electrolytes and nutrition. during her stay the patient had to have potassium supplements several times. of concern is her refusal at times to take p.o. intake. in addition to her diet, she should have nutritional supplements to include boost shakes with each meal. her potassium should be followed closely. 8. rehab. the patient is extremely deconditioned and will need inpatient rehabilitation to return to her baseline. physical therapy worked with the patient while in the hospital. this should continue on an outpatient basis. condition on discharge: stable. we have had extensive discussions with her son about his mother's current status and the possibility that she may have daily arrhythmia. followup: she is to follow up with dr. , her general cardiologist, within two weeks. she should follow up with her primary care physician within one month. she should follow up with dr. in approximately one month. discharge instructions: increase nutritional intake. work with physical therapy to gradually build up her strength. follow up with her cardiologist and primary care physician. to the hospital for any heart palpitations, chest pain, upper extremity or jaw pain or shortness of breath. she should have her potassium followed closely. she should discuss the use of digoxin and coumadin with her primary cardiologist, dr. . discharge medications: 1. aspirin 325 mg q.d. 2. plavix 75 mg for 21 additional days. 3. lipitor 10 mg q.d. 4. metoprolol 12.5 b.i.d. 5. amiodarone 200 mg q.d. 6. protonix 40 mg q.d. , md dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of non-drug-eluting coronary artery stent(s) angiocardiography of left heart structures injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter insertion of endotracheal tube initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle revision of lead [electrode] diagnoses: pneumonia, organism unspecified mitral valve disorders congestive heart failure, unspecified acute myocardial infarction of other anterior wall, initial episode of care atrial flutter atrioventricular block, complete cardiac arrest ventricular fibrillation mechanical complication due to cardiac pacemaker (electrode) 

Answer: The patient is high likely exposed to