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: shellfish attending: chief complaint: hypotension following a-flutter ablation major surgical or invasive procedure: a flutter ablation. ep testing. history of present illness: mr. is a 67m with pmh of cad s/p cabg in , numerous mi's most recent in , and complete heart block with pacer/icd implantation in , who presented to the hospital today for elective ablation of atrial flutter. the patient first began to notice symptoms such as fatigue, shortness of breath, lightheadedness, and dyspnea on exertion in . in the patient was seen in the device clinic for routine follow-up, and was noted to have atrial flutter with complete heart block. in early , he underwent tee and dc cardioversion at hospital, and since that time his symptoms have markedly improved. however, in susequent outpatient cardiology visits, it was decided that he should undergo atrial flutter ablation to prevent recurrent arryhthmia. since the patient has not undergone defibrillation threshold testing since device implantation in , he was scheduled for a combined icd testing and tee/atrial flutter ablation procedure in the ep lab for today, . his coumadin has been discontinued since saturday and he has been bridged with lovenox. . prior to presenting for his study, the patient states that he was in his usoh, with his only complaint being chronic hip pain. the patient felt generally well and denied any chest pain or dyspnea. he also denies palpitations, lightheadedness or syncope. he reports that he has never been shocked by his device. he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, cough, or hemoptysis. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . in the ep lab, tee showed no throbmus, and afl isthmus ablation was performed. subsequently he underwent an ep study (dft testing) x 2. after the second test he had prolonged hypotension to sbp in 50's for 10-15 minutes. also had hypoxia with poor airway security, desta to 80s. briefly given neo and dopa with resolution of hypotension, and an lma was placed for airway protection, which was d/c'ed on recovery. his l femoral arterial line was left in place, and he was admitted to the ccu for further monitoring. past medical history: cad, s/p cabg in , 5 mi's from - cardiomyopathy (?ischemic), with ef documented at 30% in complete heart block s/p pacer/icd in atrial flutter hypertension dyslipidemia moderate aortic stenosis diabetes type 2 with peripheral neuropathy bilateral carotid artery disease, s/p right cea rectal bleeding 2-3 years ago bph bilateral osteoarthritis appendectomy as a child social history: married, semi-retired masonry teacher at vocational tech. does not drink alcohol. remote history of very brief tobacco use. family history: family history is significant for extensive coronary artery disease, with multiple male relatives having in their 50-60s. mother died of mi in her 70's. physical exam: vs: t 96.2, bp 105/60, hr 80, rr 21, o2 97% on 5l nc gen: obese middle aged male in nad, resp or otherwise. oriented x3. mood, affect appropriate. pleasant. heent: nc/at. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: r lateral cervical surgical scar. supple with jvp of 10 cm. cv: quiet precordium. pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no s4, no s3. no m/r/g. chest: well healed midline sternotomy scar. no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. no crackles, wheeze, rhonchi. abd: obese and protuberant, soft, nt/nd, no hsm or tenderness. no abdominial bruits. ext: l groin with arterial line still in place, no hematoma or bruit. r groin puncture site also with no hematoma or bruit. extermities with bileteral 2+ pitting edema to below the knee, skin: chronic venous stasis changes and hyperemia bilaterally le pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp medical decision making pertinent results: creatinine 2.3, baseline 2.2 inr 1.6 . echo the left atrium is dilated. mild spontaneous echo contrast is seen in the body of the left atrium. mild spontaneous echo contrast is present in the left atrial appendage. no thrombus is seen in the left atrial appendage. the right atrium is dilated. no atrial septal defect is seen by 2d or color doppler. lv systolic function appears depressed. right ventricular systolic function appears depressed. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets are severely thickened/deformed. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. impression: no atrial thrombus seen. borderline low left atrial appendage velocities and mild spontaneous echo contrast in the left atrium/laa. brief hospital course: 67m with cad, chb s/p pacer/icd , and recent development of atrial flutter, admitted for defibrillation threshold testing and a-flutter ablation c/b brief hypotension and airway compromise, admitted to the icu for closer monitoring post procedure. . 1. hypotension: patient became hypotensive after procedure, and was briefly on dopamine and neosynephrine. was weaned off prior to being transferred to ccu for overnight monitoring. hypotension likey related to propofol administered during anesthesia for dft testing, or a transient effect of induced arrhythmia. patient with stable blood pressure in the ccu. his sbp fell temporarily to high 60's after morning administration of antihypertensives. he is been told to stagger daily bp meds by taking cozaar at night. other than that change, he is to continue his home regimen. . 2. cad/angina: continued medical management with isosorbide mn 120mg daily, lipitor 40mg daily, valsartan 50mg daily, carvedilol 12.5mg . also started on asa 81 mg daily. will continue this at home. . 3. chf - no documented ef, but likely chronic systolic chf. continued bb and as above, and bumetanide 4 mg am, and 2mg pm) . 4. rhythm - s/p flutter ablation, currently in ventricularly paced rhythm. underlying rhythm is chb. patient is to follow up with dr. in 3 weeks, and the device clinic as per scheduled appt. he will continue amiodarone 200 mg daily. he is to restart coumadin tonight, and get inr checked on monday. the result will be sent to his pcp's office. he was also given lovenox day of discharge, and was given a prescription for 1 dose day after discharge. . 5. hyperlipidemia: continued statin . 6. dm: continue glypizide held in the hospital, fsg qid, riss. will restart glypizide upon discharge. medications on admission: coumadin, last dose lovenox 60mg sq and naproxen 250mg tid lipitor 40mg daily cozaar 50mg daily isosorbide mn120mg daily bumetanide 2mg tid klor con 10meq daily glipizide xl 10mg amiodarone 200mg daily coreg 12.5mg discharge medications: 1. naproxen 250 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed. 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. losartan 50 mg tablet sig: one (1) tablet po daily (daily): take in evening. 4. isosorbide mononitrate 60 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po daily (daily). 5. bumetanide 2 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 6. bumetanide 2 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 7. potassium chloride 10 meq capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 8. glipizide 10 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po bid (2 times a day). 9. carvedilol 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 11. isosorbide mononitrate 120 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 12. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 13. lovenox 60 mg/0.6 ml syringe sig: one (1) subcutaneous once a day for 1 days. disp:*1 1* refills:*0* 14. outpatient lab work inr check for . please fax results to dr. office. fax: 15. warfarin 2 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: atrial flutter hypotension . secondary: cad htn dmii obesity hyperlipidemia discharge condition: stable. discharge instructions: you came to the hospital for ablation of an abnormal heart rhythm and testing of your heart. during the procedure, your blood pressure was low, and you were admitted to the ccu, and have been stable since. . some medication changes: 1. we recommend that you take your cozaar at night, to stagger it from your other antihypertensive medications. 2. you should also take an aspirin 81 mg everyday. prescription is included with your discharge work. 3. restart your coumadin tonight. 4. take one dose of lovenox at home tomorrow (). a prescription is included. . please call your doctor or return to the hospital if you have chest pain, worsening shortness of breath, lightheadedness, or any other concerning symptoms. procedure: diagnostic ultrasound of heart excision or destruction of other lesion or tissue of heart, endovascular approach automatic implantable cardioverter/defibrillator (aicd) check diagnoses: other primary cardiomyopathies other iatrogenic hypotension congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortic valve disorders diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes atrial flutter chronic kidney disease, unspecified systolic heart failure, unspecified other and unspecified hyperlipidemia other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation automatic implantable cardiac defibrillator in situ obesity, unspecified dehydration accidents occurring in residential institution 

Answer: The patient is high likely exposed to