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: biaxin / erythromycin base attending: chief complaint: mechanical fall v-fib arrest major surgical or invasive procedure: pacemaker generator change history of present illness: 59 yo f with h/o severe nicm ef 15-20%, severe mr, c cad s/p iatrogenic mi ' from lad dissection, cabg ' svg to lad, mild 2v-d in ', biv/icd in , paroxysmal a-fib. multiple previous admissions for chf. recently, admitted for sob , for heart failure, recieved lasix, dobutamine, dig, once more stable with improved volume status and hemodynamics, the pt was transferred to rehab still on dobutamine. she was able to return home 10 days ago. at home, the pt requires a lot of help with adls. she has significant lower extremitity deconditioning. on , the pt presented to osh after mechanical fall at home. the pt describes that shw was walking with her walker and tried to walk backwards, which led her to lose her balance and trip and fall and hit her head. no loc. the pt notes some increased le weakness over the past 2 days. the pt was taken to osh and dig level was found to be 6. she got 4 vials of digibind at osh. cpr was required. in the ed at , the pt noted icd firing. the cardiology note mentions episodes of firing. the pt denies that she has felt any shocks at home over the past 10 days since she left the rehab facility. past medical history: 1. advanced chf with a lvef of 15 to 20% secondary to ischemic cardiomyopathy, on home dobutamine. uncertain if she wants cardiac transplantation. 2. severe 4+ mr on 3. mild to moderate + tr by on 4. -v/icd in , generator change , 5. cad s/p mi in and cabg in 6. pfts from with a mild restrictive ventilatory defect 7. hypothyroidism secondary to amiodarone toxicity 8. history of paroxysmal atrial fibrillation- pt is anticoagulated on coumadin and her inr from was 3.8. 9. s/p cholecystectomy . s/p tia x3 with slurred speech- this was transient and is currently resolved. . social history: 18 pack year history but quit in , currently, not smoking. no alcohol use. the patient lives alone and has vna. she is retired dental assistant,is divorced and has one son. she is the youngest of 3 childern. family history: mother - non-alcoholic liver cirrhosis, cad, lung ca, alzheimer's disease father - dm. deceased mi at age 50. sister with sle. physical exam: physical exam: t afeb hr 80 bp 110/70 r 18 sat 98% gen: nad, slightly drowsy cv: rrr, loud holosystolic murmur apex. +heave. lungs: clear abd: s/nt/nd +bs ext: no edema neuro: maew pertinent results: ct pelvis impression: no fracture or dislocation. . ct t-spine impression: 1. compression fracture t5. see above. 2. prominent supraclavicular lymph nodes. 3. moderate-sized right-sided pleural effusion. 4. patchy lung opacities in the visualized lung fields. . ct l-spine impression: no evidence of fracture. deganerative disease with disc abnormalities at l3-s1 as described. brief hospital course: 59 yo f with h/o severe nicm ef 15-20%, severe mr, cad s/p mi, mild 2v-d in ', biv/icd in 7/. pt now presents with dig toxicity and icd shocks. . 1. rhythym: the pt was admitted to the cardiac intensive care unit, given the history of v-fib arrest with loss of pulse and unresponsiveness in the ambulance to the hospital. the electrophysiology team was called to evaluate the pacemaker/icd and found that the device was functioning according to its programmed parameters, sensing fast vfib/vtach. however, the icd was unable to detect slow vt, which the pt was experiencing in the setting of digoxin toxicity. the device was reprogrammed to sense lower rates of vt. on , the pt was taken to the ep lab for generator change since the battery was low. this operation proceeded without complications. the unstable rhythm occured in the setting of digoxin toxicity in acute renal failure. digoxin was stopped, with the plan to not restart given the history of prior episodes of dig toxicity. the pt was noted to have a hematoma around the device, on the day prior to discharge. this was evaluated by the ep team, found to be stable. should be followed up at rehab. . 2. chf: primarily secondary to valvular dz with 4+ mr, cad s/p mi and cabg (svg--> lad), pt was euvolemic most of the hospital stay. after the ep lab operation, the pt was found to be volume overloaded and diuresed with lasix over the following several days, returned to . pt did not appear to tolerate ace or well with creatinine , plan is to continue imdur/hydral. pt will be continued on aldactone, imdur/hydral, lasix 120 po bid. . 3. cad: no active ischemia during the hospitalization. pt has chronic cp symtoms, likely not anginal. pt had lad dissection 20 y ago, cabg svg to lad, last cath shows occ svg, but otherwise mild 2v disease. pt will be continued on asa, statin . 3. chronic back pain: the pt's pcp, . recommended high doses of pain medicines, given the patient's poor overal prognosis with severe chf. the plan was to help provide as much comfort for the patient as possible. the patient agreed with this plan. pt was started on a regimen of fentanyl patch, morphine ir, and valium. . 4. weakness/deconditioning: pt will get further conditioning at rehab. . 5. arf: resolved. cr bumped to 1.6 from baseline cr. 0.7 secondary to pre-renal state. . 5. paroxysm a-fib: pt was in paced rhythm during hospitalization. the a-fib was not an acute issue. continue amio, was loaded with 200 for 2 weeks, then started 200 daily. continue coumadin 3 mg hs, being discharged on lovenox bridge. . 6. hypothyroid: on levoxyl . 7. diarrhea: resolved medications on admission: amio 200 mg aspirin e.c. 81 mg--one tablet by mouth every day aldactone 25mg po qd digoxin 125 mcg po qod lasix 100 mg nitroglycerin 0.4mg/dose spray prn warfarin 2 mg--take 2 mg every day except sunday tues and thurs 3 mg levothyroxine sodium 137mcg--take one tablet by mouth every day ativan 1mg--take one tablet by mouth three times a day pepcid 40mg--take one tablet by mouth every day percocet 5-325mg--take 1-2 tabs by mouth every 4-6 hours as needed zoloft 100 mg discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 4. levothyroxine sodium 137 mcg tablet sig: one (1) tablet po daily (daily). 5. sertraline 100 mg tablet sig: one (1) tablet po daily (daily). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 8. promethazine 25 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 11. fentanyl 75 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours). 12. warfarin 1 mg tablet sig: three (3) tablet po hs (at bedtime). 13. morphine 15 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 14. diazepam 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for back pain. 15. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours). 16. hydralazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours). 17. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). 18. amiodarone 200 mg tablet sig: one (1) tablet po once a day. 19. enoxaparin 60 mg/0.6ml syringe sig: one (1) subcutaneous q12h (every 12 hours). 20. lasix 80 mg tablet sig: 1.5 tablets po twice a day. discharge disposition: extended care facility: bear nursing center - discharge diagnosis: chf v-fib arrest digoxin toxicity discharge condition: stable discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: followup instructions: please follow up in heart failure clinic. , : cardiac services phone: date/time: 9:00 procedure: transfusion of packed cells replacement of automatic cardioverter/defibrillator pulse generator only diagnoses: other primary cardiomyopathies mitral valve disorders acute kidney failure, unspecified hyposmolality and/or hyponatremia unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status hematoma complicating a procedure old myocardial infarction diarrhea backache, unspecified cardiotonic glycosides and drugs of similar action causing adverse effects in therapeutic use acute on chronic combined systolic and diastolic heart failure fitting and adjustment of automatic implantable cardiac defibrillator other heart block 

Answer: The patient is high likely exposed to