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 known allergies / adverse drug reactions attending: chief complaint: ventricular tachycardia major surgical or invasive procedure: placement of internal cardiac defibrillator: st. fortify history of present illness: 57 yo m w/ no sig pmh p/w sob x 1week, found to be in vt at . he appeared stable but bp was in the 80s so cardioverted him w/ one shock and has been in sinus since w/ bps in 110s to 120s and hr in the 110s. he was started on amio drip and heparin drip, got plavix loaded and asa. sinus ekg w/ twi inferiorly and anterior qs trop i was 0.59 and ck 139. pt. now asymptomatic. he says that he was feeling well until 10 days ago when he started noticing doe a/w palpitations, his dyspnea would resolve w/ rest and he also noted that his rapid heart rate would resolve w/ rest. he says that his doe was intermittent and did not reliably occur to the same degree every time. he did not have any chest pain at any time. today he had acute onset of sob at rest a/w cold sweat, he tried to drink some water but vomitted. these sx persisted for several hours w/o improvement and he presented to ed. . surgical hx. he has had chronic rle swelling and duskiness for several years, slowly progressive but noticed about 10 days ago that his lle also started swelling and turning purplish. . on review of systems, he denies any f/c/ns, cough. cardiac review of systems is notable for presence of one episode of syncope which occured about 1.5 yrs ago when he was doing work outside in the heat and felt dehydrated, he lost consciousness and his neighbors called 911, he did not revive until ems arrived and refused hospital transport at that time. . past medical history: none, denies surgeries. social history: -tobacco history: quit 25yrs ago, 14pack year hx -etoh: 4 gin and tonics/night (1-2shots each) -illicit drugs: remote, denies cocaine works as an organist and in horse maintainence lives with wife, daughter (26) and son in law family history: adopted physical exam: on admission: vs: t=97.7 bp= 115/80 hr= 118 rr= 28 o2 sat= 100% 4l nc general: nad. oriented x3. mood, affect appropriate. tachypneic heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. 18g piv in r ej neck: supple with jvp not visible habitus cardiac: regular tachycardic, distant heart sounds lungs: decreased breath sounds in the bases bilaterally abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: bilateral venous stasis in the lower extremities with tender woody edema w/ 3x2cm venous stasis ulcer on the r and 1+ pitting edema on the left . on discharge: gen: alert, oriented, conversant heent: supple, no jvd, mm moist cv:rrr, no m/r/g resp: ctab abd: soft, nt, pos bs extr: no further edema. right le with distinct varicocites. wound covered. neuro: alert, oriented extremeties: pulses: right: dp 1+ pt 1+ left: dp 1+ pt 1+ pertinent results: 05:06am glucose-140* lactate-3.8* na+-136 k+-6.4* cl--107 05:06am type-art po2-116* pco2-27* ph-7.35 total co2-16* base xs--8 intubated-not intuba comments-nasal 05:21am pt-22.3* ptt-42.8* inr(pt)-2.1* 05:21am plt count-139* 05:21am wbc-15.3* rbc-5.14 hgb-16.3 hct-49.0 mcv-95 mch-31.6 mchc-33.3 rdw-14.8 05:21am ck-mb-23* mb indx-5.4 ctropnt-0.35* 05:21am alt(sgpt)-3526* ast(sgot)-4044* ld(ldh)-4050* ck(cpk)-425* alk phos-80 tot bili-2.7* 05:21am estgfr-using this 05:21am glucose-143* urea n-30* creat-3.1* sodium-136 potassium-6.5* chloride-105 total co2-17* anion gap-21* ========studies====================== . echo the left atrium is markedly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. overall left ventricular systolic function is severely depressed (lvef= 15-20%). the right ventricular cavity is markedly dilated with severe global free wall hypokinesis. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is a very small pericardial effusion. the effusion appears circumferential. . impression: biventricular dilatation with severe hypokinesis. the lateral wall of the lv has relatively better function. no significant valvular abnormality seen. very small pericardial effusion. . chest xray findings: moderate cardiomegaly with slight tortuosity of the thoracic aorta. no pulmonary edema. no pneumonia, no pleural effusions. . bilateral lower extremity doppler impression: no evidence of dvt. . cardiac mr: findings: structure and function there was normal epicardial fat distribution. the pericardial thickness was normal. there was a small pericardial effusion. there were no pleural effusions. the indexed diameters of the ascending and descending thoracic aorta were normal. the main pulmonary artery diameter index was normal. the left atrial ap dimension was moderately increased. the right and left atrial lengths in the 4-chamber view were moderately increased. the coronary sinus diameter was normal. the left ventricular end-diastolic dimension index was normal. the end-diastolic volume index was moderately increased. the calculated left ventricular ejection fraction was severely decreased at 29% with global systolic dysfunction. the anteroseptal and inferolateral wall thicknesses were normal. the left ventricular mass index was mildly increased. the right ventricular end-diastolic volume index was normal. the calculated right ventricular ejection fraction was moderately decreased at 35%, with global hypokinesis. the aortic valve was poorly visualized but did not appear stenotic. impression: 1. moderately increased left ventricular cavity size with global left ventricular systolic dysfunction. the lvef was severely decreased at 29%. 2. normal right ventricular cavity size with global hypokinesis. the rvef was moderately decreased at 35%. 3. the indexed diameters of the ascending and descending thoracic aorta were normal. the main pulmonary artery diameter index was normal. 4. moderate biatrial enlargement. 5. small pericardial effusion. . labs on discharge: wbc rbc hgb hct mcv mch mchc rdw plt ct 10.0 4.99 15.7 46.8 94 31.5 33.5 12.9 240 glucose urean creat na k cl hco3 angap 106*1 38* 1.8* 139 4.6 102 30 12 brief hospital course: assessment and plan 57 yo m with no known prior cardiac history presented with monomorphic vt and likely underlying dilated cardiomyopathy. . # monomorphic vt/chf: likely that the patient had an ischemic event in the past week or so which lead to scarring and ventricular tachycardia as anterior qwaves apparent on ekg and troponin i only 0.59 and ck in the 130 130s. underlying dilated cardiomyopathy likely given significant alcohol use. he was transferred to the ccu due to stable ventricular tachycardia on telemetry on the floor. in the ccu he was given iv lasix and metolazone with significant urine output. he continued to autodiurese in the hospital with weight at discharge 125.7 kg. he was started on hydralazine and isosorbide dinitrate in the ccu, later changed to low dose lisinopril and his home metoprolol was titrated up. cardiac mr was completed showing severely depressed ef. decision was made place icd for secondary prevention prior to discharge. patient tolerated procedure well without any complications. he will follow up with dr. and the device clinic here at . . # renal failure: renal failure likely secondary to poor forward flow in the setting while hypotensive in vt. have been in vt for a prolonged. renal failure initially worsened with diuresis and improved off diuretics per recommendation of nephrology consult. his creatinine . # elevated transaminases: likely shock liver in the setting of hypotension. unclear if baseline elevated lfts. liver function enzymes improved throughout ccu stay. amiodarone held until liver function improved. . # hypoxia: likely secondary acute pump failure from vt. improved. . # venous stasis - he presented with bilateral lower extremity non-pitting edema, which he reported as chronic. he also had a large (4cm by 8cm) ulcer over medial aspect of the right ankle, which was there since . vascular surgery was consulted and decided against debridement and favored wound care and compression. . #metabolic acidosis: likely lactic acidosis from poor perfusion from what was likely in the setting of prolonged vt and hypotension. . medications on admission: none discharge medications: 1. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. metoprolol succinate 100 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po daily (daily). disp:*60 tablet sustained release 24 hr(s)* refills:*2* 4. collagenase clostridium hist. 250 unit/g ointment sig: one (1) appl topical daily (daily). disp:*1 tube* refills:*2* 5. outpatient lab work please check chem-7 and lft's on at dr. office. 6. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. cephalexin 500 mg capsule sig: one (1) capsule po three times a day for 2 days. disp:*6 capsule(s)* refills:*0* 8. vicodin 5-500 mg tablet sig: one (1) tablet po four times a day as needed for pain. disp:*10 tablet(s)* refills:*0* 9. aspirin 81 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: , discharge diagnosis: ventricular tachycardia acute systolic dysfunction: ef 29% acute kidney injury acute liver failure chronic vascular disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you had ventricular tachycardia that required a defibrillation. your heart was very weak and volume overloaded when you were admitted but you responded well to diuretics and other medicines to help your heart pump better and your heart function has improved. we are not sure why your heart was so weak but you should not drink any more alcohol and will need to see a cardiologist regularly. a cardiac mri was done which showed that your heart function is improved but still weak. you should watch your legs closely to monitor for any swelling. weigh yourself every morning, call dr. if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. you should eat a low sodium diet. while your heart was not working well, your kidneys and liver were also impacted and you developed liver and kidney failure. this has improved tremendously and should normalize in time. you should follow up with your new primary care doctor and cardiologist on a regular basis and also see dr. here at to evaluate and treat your right leg ulcer. . you should take the following medicines at home every day: 1. aspirin, a mild blood thinner, to prevent blood clots 2. thiamine, a b vitamin 3. folic acid, another b vitamin 4. metoprolol, a beta blocker to prevent irregular heart beats and help your heart pump better. 5. lisinopril, to lower your blood pressure and help your heart pump better. 6. collagenase: to help remove dead tissue from the wound. followup instructions: name: , md address: , , phone: appt: at 2:30pm department: cardiac services when: thursday at 11:40 am with: , md building: sc clinical ctr campus: east best parking: garage . please talk to dr. about getting a primary care physician. department: cardiac services when: thursday at 10:30 am with: device clinic building: sc clinical ctr campus: east best parking: garage procedure: implantation or replacement of automatic cardioverter/defibrillator, total system [aicd] diagnoses: acidosis hyperpotassemia coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified acute and subacute necrosis of liver personal history of tobacco use mononeuritis of lower limb, unspecified paroxysmal ventricular tachycardia acute systolic heart failure other specified hypotension other and unspecified alcohol dependence, continuous alcoholic cardiomyopathy venous (peripheral) insufficiency, unspecified nonspecific abnormal electrocardiogram [ecg] [ekg] ulcer of ankle 

Answer: The patient is high likely exposed to