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: no drug allergy information on file attending: chief complaint: vt major surgical or invasive procedure: ep endocardial mapping history of present illness: 73 yo m h/o non-ischemic cm (ef 20-25%), af s/p av node ablation s/p biv icd, h/o vt with shocks presented to hospital with sustained vt @ 150 bpm requiring icd shocks. patient had a pacer/icd upgrade in and was initiated on amiodarone therapy. since that time, he had not experienced any shocks until the day of admission to . he received three shocks in the morning, separated by 30-60 seconds apiece. he described concomitant chest tightness and some mild dizziness but denied acute sob or syncope. he was admitted to hospital and was loaded with amiodarone with 150 mg, then 1 mg/hr x 6 hrs, then amiodarone gtt @ 0.5 mg/hr. his blood pressure remained in the 80s-90s systolic, which is within his baseline. he was ruled out for mi. he was also felt to be in acute on chronic heart failure and received one dose of iv lasix, to which he responded well. he was transferred to for vt ablation. given that his inr was 2.7, he was given vitamin k in preparation for the procedure. . the patient reports feeling "down" for the last week, and notes increased dyspnea on exertion and pnd. he denied le swelling. he takes 3-4l of home o2 at night for his heart failure at baseline, and did not increase this. he also notes a cough productive of green sputum x 1 month, but states that he was diagnosed with sinusitis and started on antibiotics a week or two ago, after which his cough improved. he denies fevers, chills, n/v/d, abd pain. he denies chest pain at rest. past medical history: 1. systolic heart failure with lvef of 20-25%, thought to be viral cardiomyopathy ~20 years ago s/p biv/icd implantation 2. atrial fibrillation with av node ablation. 3. ventricular tachycardia with recent shocks. 4. right shoulder surgery. 5. mild hypotension. social history: the patient is married. he continues to work parttime as a carpenter. he has two grown children and two grandchildren. he smoked in the army and has not smoked for more than 20 years. occasional etoh, but none in the past year. no illicit drug use. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: 97.9 66 106/71 16 99% 2l nc gen: wdwn middle aged male 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 9 cm. cv: very distant heart sounds. regular rate and rhythm. no appreciable m/r/g. resp: cta with diminished bs at r base. abd: soft, ntnd. no hsm or tenderness. +bs. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: portable tte (complete) done at 10:00:00 am the left atrium is markedly dilated. the right atrium is markedly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. there is severe global left ventricular hypokinesis (lvef = 15-20%). only the anterior wall and lateral wall have any degree of systolic function. the estimated cardiac index is depressed (<2.0l/min/m2). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. compared with the prior study (images reviewed) of , lv dilatation and dysfunction and valvular regurgitation are all similar. the degree of dyssynchrony may have improved however formal dyssynchrony evaluation could not be performed as tissue synchronization imaging was not performed. cbc 05:40am blood wbc-8.1 rbc-4.47* hgb-13.8* hct-41.9 mcv-94 mch-30.8 mchc-32.9 rdw-15.5 plt ct-138* 11:51pm blood wbc-10.1 rbc-5.03 hgb-15.1 hct-46.3 mcv-92 mch-30.0 mchc-32.6 rdw-15.0 plt ct-143* 04:13am blood wbc-12.1* rbc-5.12 hgb-15.2 hct-47.3 mcv-92 mch-29.8 mchc-32.2 rdw-14.9 plt ct-183 05:41pm blood wbc-13.2* rbc-4.80 hgb-14.7 hct-44.4 mcv-93 mch-30.6 mchc-33.1 rdw-15.3 plt ct-168 09:50pm blood wbc-10.1 rbc-4.94 hgb-14.6 hct-45.6 mcv-92 mch-29.6 mchc-32.0 rdw-15.3 plt ct-178 coags 05:40am blood pt-14.4* ptt-32.2 inr(pt)-1.2* 11:51pm blood pt-14.7* ptt-38.4* inr(pt)-1.3* 04:13am blood pt-15.1* ptt-26.3 inr(pt)-1.3* 05:41pm blood pt-17.1* ptt-48.6* inr(pt)-1.5* 09:50pm blood pt-21.7* inr(pt)-2.0* chemistry 05:40am blood glucose-111* urean-40* creat-1.8* na-140 k-4.4 cl-102 hco3-30 angap-12 05:30am blood glucose-158* urean-41* creat-2.0* na-136 k-3.8 cl-99 hco3-27 angap-14 11:51pm blood glucose-129* urean-41* creat-1.9* na-136 k-4.2 cl-98 hco3-28 angap-14 04:13am blood glucose-117* urean-37* creat-1.8* na-138 k-4.5 cl-98 hco3-27 angap-18 05:41pm blood glucose-117* urean-32* creat-1.6* na-139 k-3.4 cl-100 hco3-25 angap-17 09:50pm blood glucose-158* urean-33* creat-1.9* na-136 k-3.6 cl-95* hco3-30 angap-15 05:40am blood calcium-8.9 phos-2.8 mg-2.2 05:30am blood calcium-8.7 phos-2.7 mg-2.2 11:51pm blood calcium-9.0 phos-2.5* mg-2.3 03:05pm blood albumin-3.2* calcium-6.8* phos-2.8 mg-1.8 04:13am blood calcium-9.0 phos-3.7 mg-2.1 05:41pm blood calcium-8.1* phos-4.5 mg-1.7 09:50pm blood calcium-8.9 phos-3.4 mg-2.0 brief hospital course: 73 yo m h/o chf (ef 15-20%) s/p biv/icd placement, af s/p av node ablation, h/o vt p/w sustained vt s/p icd firing x 3 and subsequent conversion, on amiodarone load admitted for vt ablation, now s/p endocardial mapping, which did not find any endocardial source for vt . # nonsustained vt - patient was evaluated by ep, underwent endocardial mapping without an endocardial source for vt identified. arrythmogenic focus thought to be epicardial, likely due to some scarring on exterior of heart. patient is planned for epicardial mapping on a separate admission. during his stay in the ccu, patient continued to have asymptomatic runs of vt, but not tachycardic enough to trigger his icd, which is set at a threshold of 150. patient was continued on amiodarone, uptitrated on metoprolol, and started on mexilitine. patient was also continued on warfarin for goal inr of . on discharge, patient's inr was 1.2 and so was discharged with lovenox bridge. patient was instructed to have his inr checked in 2 days for further management of warfarin dosing. he will continue to follow up with dr. as an outpatient. . # pump/chf - the symptoms the patient described on the week prior to admission are suggestive of acute heart failure. tte on this admission shows he has severe global left ventricular hypokinesis with lvef of 15-20%. patient appeared euvolemic and was continued on furosemide and metoprolol. lisinopril was held given hypotension and possible acute renal failure. patient will follow up with his cardiologist who will advise as to when to restart the ace inhibitor. . # hypotension - noted to be slightly hypotensive on admission, but for the rest of his admission, his blood pressure was at his baseline sbp in the 90's. . # elevated creatinine ?????? unknown baseline creatinine. attempts to contact the pcp to find out his baseline creatinine were unsuccessful as he was away. patient had stable creatinines in 1.6-2.0 range on this admission. ace inhibitors were held as it was unclear if this was acute or chronic renal failure. medications on admission: amiodarone 400 mg po bid lisinopril 2.5 mg po qd metoprolol 25 mg po tid lasix 40 mg po qd kcl 20 meq po qd mag ox 400 mg po qd coumadin 2.5 qwf, 5 mg qsmtuthsa discharge medications: 1. warfarin 2.5 mg tablet sig: one (1) tablet po 2x/week (we,fr). 2. warfarin 5 mg tablet sig: one (1) tablet po 5x/week (,mo,tu,th,sa). 3. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol succinate 25 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po daily (daily). disp:*90 tablet sustained release 24 hr(s)* refills:*2* 5. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 6. enoxaparin 80 mg/0.8 ml syringe sig: one (1) syringe subcutaneous q12 () for 7 days. disp:*14 syringe* refills:*0* 7. mexiletine 150 mg capsule sig: one (1) capsule po q12h (every 12 hours). disp:*60 capsule(s)* refills:*2* 8. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 9. magnesium oxide 400 mg tablet sig: one (1) tablet po once a day. 10. outpatient lab work please draw pt, ptt, and inr on and have the results faxed to dr. at . discharge disposition: home discharge diagnosis: primary diagnosis: - ventricular tachycardia secondayr diagnosis: - systolic heart failure with lvef of 15-20%, thought to be viral cardiomyopathy ~20 years ago s/p biv/icd implantation - atrial fibrillation with av node ablation. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital because of an abnormal fast ventricular heart rate that triggered your icd to fire. you were evaluated by the electrophysiology service while you were here. they were unable to find the source of the vt from endocardial mapping, and so you will need to have an epicardial mapping performed in the near future. the following changes were made to your medications: - new: mexiletine 150mg, twice a day - new: lovenox 80 mg, injected under your skin, every 12 hours for 1 week, or until your inr is therapeutic. - new: metoprolol succinate (long acting) 75 mg daily - please decrease your amiodarone dosing to 200 mg dailiy - please stop taking your old metoprolol tartrate (short acting) - please stop taking lisinopril for now. you will have to discuss with your cardiologist whether or not it should be restarted the rest of your medications have not changed. please continue to take them as originally prescribed. you will need to have your inr checked on tuesday, , for management of your warfarin dosing. on discharge your inr was 1.2. your goal inr range is . followup instructions: please keep your follow up appointment with dr. on . it is important that you see him within 1-2 weeks following discharge form the hospital. if you need to reschedule, his office number is please have your inr checked on tuesday, for further management of your warfarin dosing. please have the lab fax the results to your primary care physician, . , . if you do not hear from her about what to do with your warfarin dosing, please call her office at procedure: catheter based invasive electrophysiologic testing cardiac mapping diagnoses: other primary cardiomyopathies congestive heart failure, unspecified atrial fibrillation chronic kidney disease, unspecified paroxysmal ventricular tachycardia chronic systolic heart failure automatic implantable cardiac defibrillator in situ 

Answer: The patient is high likely exposed to