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: percocet / inderal la / lopressor / sotalol / ultram / opioid analgesics attending: chief complaint: dyspnea major surgical or invasive procedure: ablation right atrial foci history of present illness: mr. is an 80 year-old male with a history of avr/mvr who is being transferred from an osh for vtach. . over the last few months, has had increasing dyspnea on exertion. prior to , he could walk for a few hundred yards without doe. now he has difficulty walking more than 20 yards or one flight of stairs. since his aaa in , he has also noticed significant lower extremity edema. . on the day of transfer, was admitted to an osh on with severe respiratory distress. he complained of two days of sob, but he did not initially want to go to the hospital. overnight (-->) he experienced extreme sob at 4am (after waking to use the bathroom) and called ems. upon arrival to the osh ed, was in extreme respiratory distress, responsive, but unable to talk. vitals showed bp 192/110 hr 108 rr 20 temp 96.7 o2 sat 96% on ra. an ekg showed ivc which was suspicious for slow vtach so an amiodarone drip was started. a cxr showed heart failure and a nitro drip was started and 80mg iv lasix was given with >1 liter of urine output resulting. cpap was also used. . prior to transfer, had another episode of vtach at 1:45pm. . currently, the patient is feeling significantly improved. his sob is resolved and he states that his breathing is almost at it's baseline. he denies any chest pains, palpatations. he did have some mild nausea on arrival, which he atributes to a bumpy ambulance ride. he remains on a nitro gtt. past medical history: s/p aaa repair at hypertension hyperlipidemia valvular heart disease s/p bioprosthetic avr s/p mitral valve repair in atrial fibrillation/flutter bph anxiety hypothyroidism obstructive sleep apnea social history: the patient lives in his own home. one of his sons has been staying with him recently as he is between jobs. he has two sons. has a girlfriend. the patient continues to work at as a clinical psychologist. he reports smoking for 20 years but quit ~40 years ago. rare etoh. . adls/iadls: the patient is independent with his adls/iadls. he continues to drive and does not report any near misses. . advanced directives: the patient's son is his hcp. family history: nc physical exam: blood pressure was 134/69 mm hg while sitting in bed. pulse was 86 beats/min and regular, respiratory rate was 19 breaths/min with an oxygen saturation of >95% on 2 liters. generally the patient was well developed, well nourished and well groomed. the patient was oriented to person, place and time. the patient's mood and affect were not inappropriate. . there was no xanthalesma and conjunctiva were pink with no pallor or cyanosis of the oral mucosa. the neck was supple with jvp 2-3cm above the neck at 45%. the carotid pulse was easily palpable. there was no thyromegaly. the chest wall showed pectus excavatum. the respirations were not labored and there were no use of accessory muscles. the lungs showed bibasilar crackles with good air movement. . palpation revealed no thrills, lifts or palpable s3 or s4. the heart sounds revealed a harsh midsystolic murmur at the aortic site. . there was no hepatosplenomegaly or tenderness. the abdomen was soft nontender and nondistended. the extremities had no pallor, cyanosis, clubbing. there was + bilateral edema. there were no abdominal, femoral or carotid bruits. inspection and/or palpation of skin and subcutaneous tissue showed no stasis dermatitis, ulcers, scars, or xanthomas. . pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ pertinent results: 05:23pm glucose-141* urea n-22* creat-1.3* sodium-137 potassium-4.0 chloride-101 total co2-29 anion gap-11 05:23pm estgfr-using this 05:23pm alt(sgpt)-42* ast(sgot)-35 ld(ldh)-312* ck(cpk)-82 alk phos-97 tot bili-0.7 05:23pm ck-mb-notdone ctropnt-0.02* 05:23pm calcium-8.3* phosphate-3.3 magnesium-2.4 05:23pm wbc-10.1# rbc-4.44*# hgb-11.8*# hct-35.6* mcv-80*# mch-26.6* mchc-33.2 rdw-17.5* 05:23pm plt count-208 05:23pm pt-35.0* ptt-32.9 inr(pt)-3.8* . ct head findings: comparison is made to and . . the tiny hyperdensity of the left centrum semiovale is again visualized which is not significantly changed. there is no surrounding vasogenic edema. this finding may represent a calcification. . no intracranial hemorrhages are identified. the /white matter differentiation is maintained. again seen are extensive periventricular hypodensities consistent with small vessel ischemic changes and small watershed infarcts of the right frontal and occipital lobes. the ventricles and extra-axial csf spaces are unchanged. . the visualized orbits are normal. the visualized paranasal sinuses and mastoid air cells are clear. no suspicious bony abnormalities are seen. . impression: no intracranial hemorrhages. no significant change in tiny hyperdensity of the left centrum semiovale which likely represents a calcification. . echo general comments: suboptimal image quality - poor echo windows. conclusions: the left atrium is markedly dilated. the right atrium is markedly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. a bioprosthetic aortic valve prosthesis is present. the transaortic gradient is at the upper limit of normal for this prosthesis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. a mitral valve annuloplasty ring is present. the mitral annular ring appears well seated and is not obstructing flow. no mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is an anterior space which most likely represents a fat pad. . impression: mild left ventricular hypertrophy with preserved regional/global biventricular systolic function. marked biatrial dilation. mild aortic regurgitation in the presence of a bioprosthetic avr. gradients across avr at at upper limits of normal. mitral valve annuloplasty ring appears well seated. gradients across ring also at upper limits of normal. mild pulmonary hypertension. mildly dilated thoracic aorta. brief hospital course: 80 year-old male with a history of cad, atrial fibrillation s/p avr/mvr who was transferred from from an osh for concern for ventricular tachycardia. on arrival his ekg's were as follows: ekg #1 (; osh): wide complex tachycardia with a rate of 110. ekg #2 (; ): nsr with a 1st degree av block. lad; possible . loss of r-waves in precordial leads (old). lvh electrophysiology consult was placed and it was felt that this was more likely a supraventricular tachycardia in the setting of a bundle branch block. plan was for evaluation and possible ablation in the electrophysiology lab however we had to wait several days as his inr was supratheraputic. once inr < 2 he went to ep lab and had ablation of atrial tachycardia focus. . 1. respiratory distress: the patient's examination and cxr were most consistent with pulmonary edema. he responded well to lasix and a nitro gtt. regarding possible causes for this, he was hypertensive on admission to the osh which may have been a precipitant, as well as his tachycardia. he has significant valvular disease and symptoms of both right and left heart failure. the patient diuresed appropriately on lasix and was weaned down to room air satting 96% for several days before discharge. he is discharged on lasix in addition to his usual medications. in addition, his ace dose was increased to 20 mg. an echo demonstrated preserved ejection fraction, mitral and aortic gradients at upper level of normal, and left ventricular hypertrophy, as noted above in the reports section. . 2. wide-complex tachycardia: the rhythm had a wide qrs with a rate in the 110-120 range, most likely ventricular tachycardia. the patient presented to the osh on amiodarone and was given a drip; by the time he arrived at , he was in nsr with a long pr-interval, and amiodarone was discontinued. enzymes were within normal limits. he did have a few episodes of this tachycardia on telemetry, during which he remained asymptomatic. his inr was elevated which delayed by a few days ep study. ep study demonstrated several right atrial foci, which were ablated on with no complications. his beta blocker was continued. . 3. hypertension: his ace inhibitor was uptitrated and he was continued on his beta blocker. 4. atrial fibrillation/flutter: the patient is s/p at least two attempts at ablation (', ') and a recent cardioversion. reports that he has been in sinus since the cardioversion. his initial inr was 3.8 so coumadin was held, and reintroduced just prior to discharge. given his amiodarone use, liver and thyroid tests were performed, which were essentially normal except for alt 42 and ldh 312. . 5. hyperlipidemia: - continued atorvastatin . 6. anxiety: - continued ativan . 7. hypothyroidism: - continued levothyroxine . 8. hematuria: the patient had his foley pulled out about one week prior to discharge, and he immediately passed bright red blood and then was unable to void for several hours. foley catheter was reinserted and he was started on continuous bladder irrigation as well as proscar to treat prostatic bleeding. the next day, flushes and irrigation were not easy to retrieve through the foley, and some clots were visible. the patient developed significant pain and chills. urology was consulted. blood and urine cultures grew pansensitive e coli, and the patient was put on ceftriaxone with rapid improvement in his symptoms. urology followed the patient and one day prior to discharge, his foley was pulled. the patient was able to void normally with no post void residual. his hematuria had resolved 2 days prior to discharge. he will need to follow up with urology as an outpatient. . 9. s/p fall - he was in the bathroom and tripped on edge of shower hitting his head on the hand rail. the fall was witnessed, no loss of conscious, however his inr was supratheraputic so he had a head ct which did not show any evidence of intracranial hemorrhage. he did well following this incident with no complications. . 10.contact- ***dr son - medications on admission: 1. aspirin 81 mg daily 2. carvedilol 12.5 mg 3. lisinopril 5 mg daily 4. amiodarone 300 mg daily --> increased to 400mg at osh. 5. atorvastatin 10 mg daily 6. warfarin 10 mg daily 7. levothyroxine 125 mcg daily 8. ativan 0.5 mg p.o. qhs p.r.n. daily. 9. ketaconazole cream topical . 10. testosterone injections every two weeks discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. carvedilol 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). 3. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 4. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 5. lorazepam 0.5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 6. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. warfarin 5 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: wide complex tachycardia bacteremia urinary tract infection hematuria discharge condition: stable. ambulatory on room air. sinus rhythm. normal urination discharge instructions: admitted for an abnormal rhythm in your heart. the places in the heart that were causing the abnormal rhythm were ablated by the electrophysiology service. please keep your follow up appointments and take all your medications. new medications have been added to your regimen. you developed also hematuria (blood in your urine)and an infection in your bladder and bloodstream, which was treated with antibiotics. you need to follow up with urology. call your doctor or go to the ed if you feel any symptoms that concern you, for example chest pain, shortness of breath, further bleeding, or others. see your primary care doctor as soon as possible to resume your usual health care and inr checks. followup instructions: call your primary care doctor within one week of discharge call your urologist within two weeks. call your cardiologist within two weeks. also see: provider: , m.d. phone: date/time: 11:00 procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach cardiac mapping diagnoses: obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation atrial flutter hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) paroxysmal ventricular tachycardia other and unspecified hyperlipidemia other specified cardiac dysrhythmias bacteremia heart valve replaced by transplant infection and inflammatory reaction due to indwelling urinary catheter 

Answer: The patient is high likely exposed to