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: sob, lightheadedness, weakness, leg heaviness major surgical or invasive procedure: placement of right interior jugular central line transesophageal echocardiogram dc cardioversion with conscious sedation history of present illness: mr. is a 51yo m w/ pmh of htn and afib dx one week ago who presented to his pcp today / sob, leg heaviness, lightheadedness, weakness and fatigue. found to be hypotensive (sbp in 60s) and bradycardic (hr 30s). ems was called and transported him to the er. in the er, he was given atropine x2, glucagon, calcium and 1.5l ns. ekgs showed bradycardia at rate of ~30, with no definite p waves, but a baseline suggestive of afib/flutter. no qwaves, no st or t wave changes. he was still hypotensive so a r ij was placed and he was started on a dopamine gtt at 15 mcg/hr. . was diagnosed w/ afib about a week ago. had a persistent chest cold for approx. 3 weeks, went to see his pcp who examined him and found him to be in rapid afib w/ hr of 170s by ekg. from his pcp's office, he was sent to the er at . he was admitted and was finally rate controlled in the ed (to hr of 96) after 35mg iv diltiazem and 60mg po diltiazem. was d/c on atenolol and diltiazem on and represented to the er on via ems because of sob, lightheadedness, and 3 episodes of chest pressure at home. he was observed overnight, r/o mi by 3 sets of neg ce and had a stress test which was negative. he was then sent home on . he decided at that point that perhaps his symptoms were due to his warfarin so he started taking 2mg qhs instead of 5mg qhs as instructed. he continued to take the atenolol and diltiazem as instructed. today, he felt well when he woke up but began to have symptoms of lightheadedness, sob, and leg heaviness about an hour after he took his medications. he went to his pcp's office, as he had a previously scheduled appointment, and she called ems who brought him here. . ros: denies cp, palpitations, headache, nausea, vomiting or any sort of pain associated w/ these episodes; no pnd, orthopnea currently (though did complain of those a week ago); no f/c, no further symptoms of his chest cold (no cough, rhinorrhea or sore throat); no diarrhea, constipation or brbpr, no urinary sx past medical history: atrial fibrillation htn hypercholesterolemia social history: lives alone. works as a caterer, but took last week and this week off newly dx afib and generally not feeling well. no tob, occ etoh (had been taking shots to help w/ his cold), occ marijuana, no ivdu, no cocaine. has two brothers, one of whom is his legal next of ( #). family history: + cad. m has a pacermaker, f had a cabg around age 60. physical exam: vs: t 96.5, bp 115/69 (on dopa gtt), hr 70s, rr 14, sats 98% on 2l gen: wdwn, middle aged male, lying in bed, in nad. ruddy complexion. heent: sclera anicteric. perrl, eomi. op clear, no exudates or lesions. mm dry. neck: r ij line in, can not assess for jvd cv: rr, with some premature beats, normal s1, s2. no m/r/g. lungs: few scattered insp crackles, but otherwise ctab. abd: soft, ntnd. + bs. no masses. ext: warm, well perfused. 2+ dp, radial pulses bilaterally. no c/c/e. toes w/ onychomycosis. skin: warm, dry. back is pink, blanching, but pt denies that it's pruritic. does not extend to chest or abdomen. neuro: cn ii-xii grossly intact. pertinent results: labs on admission: wbc 10.9, hgb 17.0, hct 47.5, mcv 88, plt 360 (diff: neuts-74.2* lymphs-18.6 monos-5.2 eos-0.9 baso-1.1) pt 13.6*, ptt 25.0, inr(pt) 1.2* na 138, k 5.8, cl 102, hco3 28, bun 32, cr 1.5, glu 114 ca 9.9, ph 3.8, mg 1.9 alt 51, ast 34, alkphos 80, tbili 0.5 repeat: alt 58*, ast 31 tsh 1.7 . cardiac enzymes: 11:55am blood ck(cpk)-52 ctropnt-<0.01 05:45pm blood ck(cpk)-49 ck-mb-notdone ctropnt-<0.01 . urinalysis: 09:40pm urine color-straw appear-clear sp -1.006 blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg rbc-0-2 wbc- bacteri-few yeast-none epi-0-2 09:40pm urine hours-random creat-15 na-98 . labs on discharge: wbc 10.4, hgb 14.5, hct 39.4*, mcv 84, plt 244 pt 24.0*, inr(pt) 2.4* na 138, k 4.3, cl 103, hco3 25, bun 21, cr 1.2, glu 102, ca 9.2, mg 1.9, phos 4.3 . imaging: cxr - there are no prior studies available for comparison. there is a right internal jugular vein line, with its tip at the superior vena cava/right atrial junction. no pneumothorax is seen. the heart size is at the upper limits of normal for technique. the pulmonary vascularity is normal in appearance without redistribution. no pleural effusions are seen, though the extreme right costophrenic angle has been excluded from the study. there are no focal consolidations. . tee - 1. the left atrium is dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the right atrium is dilated. 2.the left ventricular cavity size is normal. the left ventricular function is hard to assess given that the ventricular rate is very rapid but there is probably moderate global left ventricular hypokinesis with an ef of 35-40%. 3. right ventricular chamber size is normal. right ventricular systolic function is borderline normal. 4.the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. trace aortic regurgitation is seen. 5.the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. 6.there is no pericardial effusion. . impression: no thrombus in the left or right atria. moderate global left ventricular hypokinesis. brief hospital course: 51yo m w/ hypotension and bradycardia, likely in setting of ccb and bb for his newly diagnosed afib. . # cv: * rhythm: mr. bradycardia was likely due to excessive nodal blockade from ccb and bb since he recovered his rate and bp off all nodal blocking agents. he then went back into rapid afib, with hr up to 160s despite the addition of bb. his bp remained stable so the decision was made to attempt cardioversion. tee showed no clot and dccv was attempted but he was only able to maintain nsr for ~30 sec. he continued to be in afib w/ rvr, with a rate as high as 160-170. diltiazem 30mg po qid was added, still with insufficient control of his rate. the diltiazem dose was then increased to 60mg tid on due to persistent tachycardia with good effect on his rate. ep was consulted to help guide the management of his arrhythmia and they recommended discontinuing his diltiazem and instead attempting to control his rhythm (and rate) with amiodarone. he was started on 400mg po tid x1 week, with the plan to decrease to dosing x1 week then qd dosing. once he had received an adequate amiodarone load, the plan was to attempt another dccv as an outpatient. mr. discussed this plan with dr. who also wanted him to wear of hearts monitor upon discharge. mr. was instructed in the use of of hearts monitor and was told to send in rhythm strips to dr. daily, so his rate and his intervals could be monitored daily. despite the initiation of amiodarone, mr. also needed a beta-blocker to keep his rate under control. his beta-blocker was slowly increased up to 75mg po qid and was then switched to toprol xl 300mg po qd prior to discharge. the toprol xl and amiodarone allowed mr. to achieve a resting heart rate of 90-100s. coumadin was started on with a goal inr of . he was kept on a heparin gtt until his inr was therapeutic. he was discharged on 3mg of coumadin daily, and his inr on discharge was 2.4. . * pump: although mr. had no evidence of heart failure by exam (lungs were ctab and his jvp was flat), his osh echo and tee here showed a depressed ef. after receiving ivf in the er, he had some swelling in his hands and feet which resolved on its own. he never required diuresis with lasix. . * ischemia: mr. has no evidence of ischemia. his ce enzymes were negative x2. ekg has no evidence of st or t wave changes. . # arf: mr. was in mild arf on admission, w/ cr of 1.5 and k of 5.8. it resolved after receiving several liters of ivf in the er. it was most likely prerenal +/- atn from hypotension. his cr was 1.2 on discharge (lowest value was 1.0 during his stay). . # fen: he follwed a regular heart-healthy diet. no ivf were needed. his electrolytes were checked daily and were repleted prn to keep k >4 and mg >2. . # access: he had a centrail line (r ij) placed in the er initially, but it was pulled after tee/dccv. he then had peripheral ivs for iv access. . # ppx: he was on heparin gtt as a bridge to coumadin until his inr was therapeutic. he had a bowel regimen. no ppi was indicated. . # code: full . # dispo: to home, with of hearts monitor. will follow up in dr. office for inr checks. . # communication: brother = ph# medications on admission: atenolol 50mg po qd diltiazem cd 240mg po qd warfarin 5mg po qhs discharge medications: 1. coumadin 1 mg tablet sig: three (3) tablet po at bedtime. disp:*90 tablet(s)* refills:*2* 2. amiodarone 200 mg tablet sig: two (2) tablet po tid (3 times a day): please take 400mg (2 tablets) three times a day for 4 more days. starting on , take 2 tablets (400mg) twice a day for one week. starting , please take 2 tablets (400mg) once a day. . disp:*100 tablet(s)* refills:*2* 3. metoprolol succinate 100 mg tablet sustained release 24hr sig: three (3) tablet sustained release 24hr po daily (daily). disp:*90 tablet sustained release 24hr(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: symptomatic bradycardia and hypotension secondary to high dose atenolol and diltiazem therapy acute renal failure . secondary diagnoses: atrial fibrillation hypertension hypercholesterolemia discharge condition: good. hr 100s, bp 123/98, rr 20, sats 97% on ra. discharge instructions: 1. please call your pcp or go to the nearest er if if you develop symptoms of dizziness, lightheadedness, weakness, malaise, chest pain/pressure, shortness of breath, leg heaviness, nausea, vomiting or any other concerning symptoms. 2. please take all your medications as prescribed. 3. please send in a transmission from your of hearts monitor every day. 4. please follow-up with your pcp weeks for follow-up from your hospitalization. followup instructions: 1. you will require blood work to be completed at dr. office in 2 to 3 days (no later than wednesday) to ensure your inr is therapeutic with your current coumadin (warfarin) dosing. 2. you should follow-up with dr. in weeks. please call her office on monday to make an appointment at your convenience. you should have hepatitis serologies drawn to insure that your elevated liver enzymes are not due to hepatitis infection. you should also have pfts scheduled since you are starting on amiodarone. 3. please contact dr. , phone (, to schedule a follow up appointment in 4 weeks for further management of your atrial fibrillation. 4. please send in a tracing to dr. every day from your of hearts monitor. procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart other electric countershock of heart diagnoses: other iatrogenic hypotension pure hypercholesterolemia unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation other specified cardiac dysrhythmias other and unspecified agents primarily affecting the cardiovascular system causing adverse effects in therapeutic use coronary vasodilators causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to