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: the patient is an 85 year old male who was admitted on for a syncopal episode while climbing up to the stairs at his home. at that time the patient lost consciousness. he was found by his daughter who then called the paramedics. upon admission the patient had a syncopal workup which included a head computerized tomography scan which was negative, as well as a carotid duplex which was negative. the patient had an electrocardiogram done which showed no st elevation and nonspecific changes. he was then sent for a stress test which had uninterpretable changes because of his current regimen which included digoxin. it was thought that at that time the patient may have increased vagal tone which may have lead to the syncopal episode so a biventricular pacer was then placed. the patient at that time was still in atrial fibrillation which he has been in for some time. following his pacer placement, the patient was doing well but the following morning he was found unresponsive and pulseless by the house staff. the patient was immediately given oxygen and recovered quickly without cardiopulmonary resuscitation or any other means. the patient was then transferred to the cardiac care unit. upon admission the patient was found to be afebrile with a temperature of 98 degrees. his heartrate ranged between 72 and 83 with atrial fibrillation. his respirations ranged from 17 to 26, blood pressure systolic ranged from 103 to 112/51 to 59. he was sating at 99% on 2 liters of oxygen, nasal cannula. his ins and outs at that time for a 20 hour period were 501 cc in, 1105 cc out for a negative total of 604 cc. physical examination: on examination the patient was calm, in no apparent distress but was found to have - respirations with notable hyperventilation followed by apneic periods. head and neck examination, the patient was nonicteric, mucosa were moist. no jugulovenous distension was noted. his chest was clear to auscultation, anteriorly and laterally. cardiac examination, he had an irregularly irregular rhythm with a ii/vi murmur, no rubs were noted. his abdomen had positive bowel sounds, nontender, nondistended. his extremities showed no cyanosis, clubbing or edema with intact 2+ pulses bilaterally. neurological examination, he was alert and oriented times three. pupils were equally round and reactive to light, extraocular movements intact. the patient had no nystagmus. mild increase in tone in all four limbs symmetrically with downgoing toes bilaterally. his strength and sensation were grossly intact and symmetrical bilaterally. laboratory data: laboratory studies on admission revealed the patient had a white count of 6.4, hemoglobin 9.5, hematocrit of 27.1. chem-7 with sodium 143, potassium 4.5, chloride 108, bicarbonate 23, bun 31, creatinine 1.7. his ast was 24, alt 20, lactate of 3.7. the patient had serial cardiac enzymes with a peak cpk of 487, calcium 9.0, phosphorus 3.2, magnesium 2.1. he had a urine culture from which was positive for enterococcus over 100,000 units. the previous head computerized tomography scan was negative. chest x-ray showed a possible small infiltrate. stress test, electrocardiogram was uninterpretable because of digoxin therapy. his echocardiogram done on showed a dilated left ventricle, decreased left ventricular systolic function with an ejection fraction of 25% with 1 to 2+ aortic regurgitation and 1 to 2+ mitral regurgitation, 2+ tricuspid regurgitation with some mild pulmonary hypertension, all findings which were similar to a previous echocardiogram, . carotid duplex showed no abnormalities. hospital course: during the patient's admission to cardiac care unit, serial cardiac enzymes were drawn at which time he ruled in for a myocardial infarction with no st segment elevation. the patient was started on a beta blocker, aspirin, heparin with an ace inhibitor which was held temporarily because of his increase in creatinine which was thought to be due to his hypotensive episode. the patient was then sent the following day for a cardiac catheterization which revealed no change in his coronary artery disease and no intervention was done at that time. the following day, , the patient was transferred to the floor and was found to have a creatinine that improved to 1.2. at that time an ace inhibitor was started. the following day, , the patient did well but had some confusion over night and was found to have a slight decrease in urine output with a slight rise in creatinine to 1.4. the patient had gentle intravenous hydration. the case manager was consulted at that time as well as physical therapy. the patient's foley catheter was discontinued. the following day , the patient did well over night with no confusion noted. the patient did urinate some dark red urine which was thought to be related to trauma from his foley catheter. it was also decided at that time that the patient should be cardioverted for his atrial fibrillation so that his biventricular pacer could function more efficiently. it was also decided at that time that the patient should continue on anticoagulation with coumadin after his discharge from the hospital because of the future risk of atrial fibrillation and history of stroke. the following day, the patient did well. he had somewhat decreased urine output which was red, thought to be secondary to his foley catheter which had since been removed. the patient had a chest x-ray which showed no signs of congestive heart failure so he continued with gentle intravenous hydration. his creatinine at that time was found to be 1.5. his blood pressure was stable with systolics to the 160s so the patient's lopressor was increased to 50 mg b.i.d. and his ace inhibitor was changed to lisinopril 5 mg q.d. because the patient's inr was 1.5 on his coumadin dose of 60 mg per day, the patient was placed on lovenox temporarily until his inr became therapeutic between 2 and 3. the patient was then discharged to a rehabilitation facility. at discharge, the patient's status was good. the patient was found to have good mental status, bibasilar crackles with some lower extremity edema 1+, but the rest of the examination was unremarkable. discharge diagnosis: 1. syncope with permanent pacer placement 2. acute myocardial infarction 3. atrial fibrillation status post cardioversion discharge medications: 1. aspirin 325 mg once a day 2. lipitor 10 mg once a day 3. amiodarone 400 mg twice a day 4. coumadin 6 mg once a day 5. metoprolol xl 50 mg twice a day 6. lisinopril 5 mg once a day 7. docusate 100 mg twice a day 8. lovenox 80 mg subcutaneously q. 12 until his inr is therapeutic follow up: the patient's follow up plans are to go to a rehabilitation facility where he will have his inr checked and continue coumadin. the patient will have frequent creatinine checks with close monitoring of his ins and outs with gentle intravenous hydration. the patient will also continue on his amiodarone where he will follow up with pulmonary function tests, liver function tests and thyroid function tests to monitor toxicities. the patient after rehabilitation will have follow up appointments with device clinic for his pacemaker, have a cardiology follow up appointment with dr. . he will follow up with his primary care physician, . for an appointment in approximately two to three weeks. the patient will also follow up with inr checks either at home or at clinic. disposition: the patient will be transferred to for rehabilitation. , m.d. dictated by: medquist36 procedure: left heart cardiac catheterization coronary arteriography using a single catheter other electric countershock of heart catheter based invasive electrophysiologic testing initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle angiocardiography of right heart structures diagnoses: subendocardial infarction, initial episode of care urinary tract infection, site not specified atrial fibrillation hematoma complicating a procedure mitral valve insufficiency and aortic valve insufficiency rheumatic heart failure (congestive) other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation diseases of tricuspid valve chronic combined systolic and diastolic heart failure 

Answer: The patient is high likely exposed to