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: calcium channel blocking agents-benzothiazepines / statins-hmg-coa reductase inhibitors / nexium / amiodarone attending: chief complaint: increasing palpitations major surgical or invasive procedure: pulmonary vein isolation history of present illness: 79-year-old female with a longstanding history of paroxysmal atrial fibrillation, htn, and hyperlipidemia who was admitted for afib ablation. has had atrial fibrillation x39 years but recently episodes have increased in frequency, requiring four hospitalizations since . she is symptomatic with these episodes, with rates in the 140s to 160s. she describes palpitations with her atrial fibrillation, as well as having severe chest pain and burning that makes her feel like she is having a heart attack, severe fatigue and lightheadedness. she states that these episodes are incapacitating. she was referred for pulmonary vein isolation and ablation of afib on day of admission. . atrial fibrillation history is as follows: she has had paroxysmal atrial fibrillation since the age of 40 and has been managed on beta-blockers, calcium channel blockers, digoxin, amiodarone and more recently sotalol, on escalating doses. currently on 160mg po bid and continues having breakthrough episodes on that dose. she was intolerant to amiodarone with extreme tremors and was unable to tolerate calcium channel blockers as well. she has had two prior dc cardioversions and multiple hospital admissions for chemical conversions. . patient had pulmonary vein isolated with all veins isolated. found to have atrial tachycardia, pt shocked out of at. sheath pulled in lab after protamine was given. case complicated by large pelvic hematoma (12x 5 cm) without retroperitoneal bleed, so patient transfused 2units prbcs, transferred to ccu for further observation. . on arrival to ccu, pt in sinus rhythm, stable hemodynamics. denied chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. pt arrived on neosynephrine drip, which was subsequently weaned due to stable sbps in the 130s--> 100s after weaned. finished her ordered 2 units of prbc, rechecked hct q6hrs. hct bumped appropriately from 29.4-->36.0. inr was therapeutic at 2.8, coumadin held overnight. controlled pain with tylenol #3. . cardiac review of systems significant for no lower extremity edema, orthopnea, syncope or presyncope. she has had no symptoms consistent with stroke and/or tia. past medical history: past medical history: 1.cardiac risk factors:(-)diabetes, (+)dyslipidemia, (+)hypertension 2. cardiac history: -atrial fibrillation x 39yrs -percutaneous coronary interventions: -cardiac catheterization in , complicated by femoral artery either perforation or dissection. -cabg: none -pacing/icd: none 3. other past medical history: -hyperlipidemia, not on statin due to intolerance/severe muscle cramps -hypertension -s/p 2 total right hip replacements and two additional right hip surgeries -gerd, -: emergent exploratory laparotomy after bowel perforation from swallowing part of a tooth pick -s/p resection of skin cancers -s/p appendectomy -s/p resection of ovarian cyst -s/p hemorrhoid surgery social history: she is married and lives with her husband in , . she has one 59 year old son. : she is a former smoker, quit 17 years ago -etoh: was a formal drinker but does not drink anymore due to her atrial fibrillation. -illicit drugs: denies family history: nc physical exam: vs: t=99.5 bp=131/64 hr=85 rr=12 o2 sat=99% on 2l nc general: wdwn f 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 <10 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. ii/vi systolic murmur throughout precordium, no rubs/gallops. 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 but tender to palpation over left lower abdomen to midline, 3-4cm below umbilicus. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. femoral sites oozing. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 1+ pt 1+ left: dp 1+ pt 1+ pertinent results: ecgs post-intervention ecg, : sinus rhythm, rate 74bpm, l axis, atrial bigeminy, old lbbb. ecg on arrival to ccu : sinus rhythm, rate 81bpm, left axis, old lbbb. : sinus rhythm at a rate of 57 beats per minute with a pr interval of 180 ms, a qrs interval of 142, and qtc of 477. she notably has a left bundle-branch block. cardiac cath: - pvi procedure - wet read per ep fellow note s/p pvi. all veins isolated. at (lower loop around ivc; ablated: then reentry around cs os (confirmed by pacing r and l side); burns around cs and within cs. cs sheath got pulled back during case: case terminated; pt shocked out of at. sheath pulled in lab after protamine was given. l hemipelvic hematoma ct abd/pelvis : there is a large complex fluid collection in the left hemipelvis, with several fluid levels, suggestive of acute bleeding. the collection displaces urinary bladder, which contains a foley catheter. the collection extends along the left iliac vessels and into the left inguinal region. the overall measurements are approximate due to complex shape. the largest dimensions are 12.5 x 5.5 cm in the axial plane. the rectum is unremarkable, and the sigmoid colon is displaced by a collection. ct abd/pelvis : - large extraperitoneal left pelvic hematoma has slightly increased in size, measuring overall 14.7 x 6.8 cm in largest axial dimensions, compared to 12.5 x 6.0 previously. there is slightly greater superior extent of the hematoma which now slightly expands the left psoas muscle. the hematoma continues to displace and compress the urinary bladder as well as the sigmoid colon. admission labs 09:01pm hct-36.0 02:29pm hct-29.4*# 02:03pm po2-72* pco2-37 ph-7.37 total co2-22 base xs--3 02:03pm hgb-11.2* calchct-34 o2 sat-94 08:53am wbc-9.0# rbc-4.61 hgb-13.4 hct-39.8 mcv-86 mch-29.1 mchc-33.7 rdw-13.0 08:53am plt count-284 06:45am glucose-112* urea n-17 creat-0.8 sodium-140 potassium-4.1 chloride-106 total co2-22 anion gap-16 06:45am pt-28.3* ptt-35.4* inr(pt)-2.8* discharge labs inr=2.9 hct=30.9 05:18am blood hct-30.9* 07:39am blood wbc-8.2 rbc-3.72* hgb-11.4* hct-32.4* mcv-87 mch-30.5 mchc-35.0 rdw-14.1 plt ct-210 05:18am blood pt-29.0* ptt-32.9 inr(pt)-2.9* 05:11am blood glucose-114* urean-16 creat-0.6 na-136 k-4.0 cl-101 hco3-26 angap-13 brief hospital course: 79-year-old female with a longstanding history of paroxysmal atrial fibrillation, htn, and hyperlipidemia with increasing symptomatic afib presented for pvi which led to successful conversion to normal sinus rhythm and was c/b large pelvic hematoma. recurrent afib s/p pvi: patient s/p pvi for atrial fibrillation on . all pulmonary veins were isolated, patient converted to nsr post procedure. patient asymptomatic post procedure. procedure complicated by large pelvic hematoma as below. patient continued on lower dose of sotalol 120 (home dose was 160mg po bid) and discharged on this lower dose. initial inr was 2.8, coumadin held in setting of bleed, and coumadin restarted slowing as bleeding resolved. on discharge, patient was in sinus rhythm, with inr of 2.9 on 5mg coumadin daily. she was discharged back on her home dose of coumadin which 5mg po daily except for 2.5mg tu, fri. she should have inr and hct rechecked on tuesday . she was scheduled with f/u with dr. as an outpatient. pelvic hematoma: had large pelvic hematoma as complication of pvi procedure. measured at 12x 6cm on initial ct, and repeat ct was slightly increased at 14.7 x 6.8cm. patient received total of 7 units of prbcs during her stay, coumadin was temporarily held in setting of acute bleed, and by discharge, her hct was stable at 30.9 with decreased abdominal distension. patient should have hct rechecked on and faxed to pcp for followup. she was discharged with instructions to limit activity to moderate activity. pump: pt has preserved ef>60%. in setting of large blood volume resuscitation, patient started having some symptoms of volume overload on am of , given 10mg iv lasix x 2 for diuresis. after that, patient had autodiuresis and equilibration. she did not need any ongoing lasix on discharge. euvolemic at discharge. coronaries: status of coronaries not documented, no known h/o cad; had cath in past, but results unknown, no mention of cad or pci. risk factors include htn and hyperlipidemia. transient hypotension: during pvi procedure had transient hypotension requiring intra procedural neosynephrine, which was weaned off within hours of arrival to ccu. no other issues with bp, patient restarted on home doses of metoprolol and valsartan and discharged on home bp medications. gerd: continued on ranitidine 150mg po bid. hyperlipidemia: stable; not currently treated with statins. comm: (husband): medications on admission: folic acid 1 mg tablet 1 tablet(s) by mouth qpm losartan 50 mg tablet 1 tablet(s) by mouth qpm metoprolol tartrate 25 mg tablet tablet(s) by mouth twice a day potassium chloride 10 meq tab sust.rel. particle/crystal 1 tab(s) by mouth qpm ranitidine hcl 150 mg tablet 1 tablet(s) by mouth twice a day sotalol 160 mg tablet 1 tablet(s) by mouth twice a day warfarin 5 mg tablet tablet(s) by mouth on tuesdays and fridays, one tablet all other days magnesium oxide 400 mg tablet 1 tablet(s) by mouth qpm multivitamin daily discharge medications: 1. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 2. folic acid 1 mg tablet sig: one (1) tablet po hs (at bedtime). 3. losartan 50 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 5. potassium chloride 10 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po at bedtime. 6. multivitamin tablet sig: one (1) tablet po daily (daily). 7. sotalol 80 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 8. outpatient lab work please have your inr and hematocrit checked on tuesday and fax to your primary care provider, . for adjustment of your coumadin at ( 9. percocet 5-325 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain for 10 days. disp:*10 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis recurrent atrial fibrillation secondary diagnosis pelvic hematoma hypertension hyperlipidemia gastroesophageal reflux discharge condition: stable, walking around, abdominal pain and distension improved discharge instructions: you were admitted to the hospital for a procedure for your recurrent abnormal heart rhythm called atrial fibrillation. you developed a bleed in your pelvic area that we watched carefully and gave you blood transfusions. while you were actively bleeding, we temporarily held off on giving you your blood thinner medication called coumadin but this was restarted and you should continue taking coumadin daily on discharge. please continue taking all your home medications except for the following additions and changes. - decrease your sotalol dosing from 160mg twice a day to 120mg twice a day - continue taking your 5mg coumadin pills - half tablet on tuesdays and fridays, one tablet all other days. you will need to check your inr at your appointment on with dr. please call your primary care physician or cardiologist if you experience any dizziness, lightheadedness, palpitations, shortness of breath, chest pain slurred speech, weakness, facial droop, increased abdominal pain or distension, or any new or worrisome symptoms. followup instructions: you have a follow up appointment with dr. on friday at 3:40pm. ( you have a follow up appointment with your primary care doctor, , p. on at 11:00am. ( procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach cardiac mapping transfusion of packed cells diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension atrial fibrillation hematoma complicating a procedure atrial flutter constipation, unspecified other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other left bundle branch block other postprocedural status accidents occurring in residential institution precipitous drop in hematocrit hip joint replacement nonspecific low blood pressure reading cyst of kidney, acquired 

Answer: The patient is high likely exposed to