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: patient recorded as having no known allergies to drugs attending: chief complaint: back pain major surgical or invasive procedure: picc placement history of present illness: 74 yo f with a history of hypertension, coronary artery disease, carotid stenosis, hypercholesterolemia, afib, lacunar stroke, who presented to the ed complaining of weakness. she was found to have severe bradycardia, hypotension and acute on chronic renal failure. she was initially treated with kayexalate and atropine intially. however, upon arrival to the micu goals of care were further discussed. after multiple family meetings, the decision was not to proceed with further workup and have the goals directed at comfort measures only. she was changed to morphine prn and zofran. additionally she was given ntg prn for back pain with relief. past medical history: hypertension coronary artery disease non-intervenable 3 vessel disease (severe disease of her left cx, mid and distal lad) medically managed hypercholesterolemia paroxysmal afib mini strokes right ica 80-99%, left ica 60-90% stenosis. renal insufficiency baseline cr 1.2-1.4 social history: a 35-40 pack year history, she quit in . no alcohol use. family history: her brother and mother have cad. physical exam: general: tired-appearing, nad, speaks in very short phrases (baseline) neck: jvp elevated cv: regular, nl s1s2, nl m/r/g pulm: crackles bilaterally, no wheezing abd: + bs, soft nt, nd, obese ext: no edema neuro: approprite; exam non-focal pertinent results: admission labs: 08:15pm blood wbc-11.6* rbc-4.04* hgb-12.5 hct-37.4 mcv-93# mch-30.9 mchc-33.4 rdw-14.7 plt ct-253 08:15pm blood pt-11.5 ptt-23.9 inr(pt)-1.0 08:15pm blood glucose-185* urean-35* creat-2.4*# na-134 k-7.4* cl-109* hco3-16* angap-16 03:42am blood calcium-8.7 phos-4.7* mg-2.1 03:42am blood hapto-202* brief hospital course: 74 yo with cad, afib, hypertension, bilateral carotid stenosis, hypercholesterolemia, lacunar stroke, who presented to the ed with hyperkalemia, acute on chronic renal failure and with bradycardia. bradycardia. found in the ed to be severely bradycardic and was given atropine. on review of the ecg it appears to be slow atrial fib or junctional escape rhythm. currently she is in normal sinus rhythm with a rate of 54 (only slightly bradycardic). it is difficult to tell if the bradycardia preceeded/caused renal failure. she was evaluated by pe and thought not to be a candidate for a pacer currently. if she again goes into atrial fib or has persistent bradycardia, may need to consider pacer at that time. acute on chronic renal failure: initally had rapidly worsening renal function. potassium continued to increase and patient refused dialysis. she was treated with kayexelate but continued to have poor renal function. was briefly cmo but had improvement in renal function. cause thought to be secondary to prerenal causes. renal function continued to improve without any clear cause. chf. ef 55% with 3+ mr tr. was volume overloaded and had oxygen requirement. held on diuresis until renal function improved and then was given 1 dose of 20 mg lasix to which she had large volume diuresis and at time of discharge did not have an oxygen requirement. cad. per history has non-intervenable 3 vessel disease that is managed medically. per previous records has refused catherization. will follow for now. need stress test per cardiology as outpatient. - continued on asa, plavix - held beta-blockers, lisinopril, imdur for now and will restart with symptoms and increased bp. hypothyroidism. continued synthroid. tsh normal. anemia. baseline hct low 30's and stable but without signs of iron deficiency (chronic disease). . paf. no nodal agents. no amiodarone. code: dnr/i medications on admission: amiodarone 200 mg p.o. daily, zetia 10 mg po daily, inderal la 160 mg p.o. daily, lisinopril 20 mg twice a day, plavix 75 mg p.o. daily, nitro prn levoxyl 75 mcg p.o. daily, norvasc 10 mg p.o. daily, aspirin 81 mg p.o. daily, triamterene/hctz 25 mg p.o. daily. imdur discharge medications: 1. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain. 2. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 3. simethicone 80 mg tablet, chewable sig: tablet, chewables po qid (4 times a day) as needed for indigestion. 4. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. 5. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q 24h (every 24 hours) as needed for back pain: 12 hours on, 12 hours off. 6. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 10. tramadol 50 mg tablet sig: one (1) tablet po q12h (every 12 hours) as needed. 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 13. calcitriol 0.25 mcg capsule sig: one (1) capsule po every other day (every other day). 14. cephalexin 500 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 3 days. 15. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: extended care facility: roscommon discharge diagnosis: renal failure bradycardia congestive heart failure secondary: hypertension, coronary artery disease, hypercholesterolemia, history of atrial fibrillation, history of strokes, carotid stenosis, renal insufficiency discharge condition: improved renal function discharge instructions: you were admitted with renal failure and low heart rate. you were treated with iv fluids and holding your heart rate medications please return to the ed or call your doctor if you have any shortness of breath, pain, passing out or any other concerning sytmptoms. patient recently had renal failure leading to hyperkalemia. will need close monitoring of her renal function and electrolytes. also patient with volume overload. will need monitoring of fluid status. responds well to lasix. she has been taken off all of her cardiac medicines including imdur, norvasc, lisinopril, zetia, inderal, and amiodarone due to bradycardia. she has a history of atrial fibrillation and hypertension. if patient becomes tachycardic or hypertensive will need to restart. followup instructions: please follow up with your pcp , in weeks please follow up with cardiology. procedure: venous catheterization, not elsewhere classified diagnoses: end stage renal disease anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism atrial fibrillation paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified cardiac dysrhythmias dehydration tricuspid valve disorders, specified as nonrheumatic 

Answer: The patient is high likely exposed to