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: penicillins / ditropan xl / norvasc attending: chief complaint: palpitations major surgical or invasive procedure: none. history of present illness: 83 yo female with history of htn, hld, cad, stage iv ckd, copd, dchf (ef >55%) with multiple recent admissions for chf last discharged who developed palpitations while being dialyzed and was found to be in rapid afib. patient does not have a prior history of afib. at dialysis, ekg revealed afib to 140. she was given cardizem bolus then gtt and her pressure "tanked" to sbp 80-100. she had an episode of hypotension followed by nausea and vomiting, but denied cp, sob, f or c. she reported posterior neck pain but noted this was chronic and related to positioning. a left femoral central line was placed in the field and she was started on neo. two peripherals, 24 and 20 were placed in her feet. . in the ed, vitals upon admission were 97.9 120 121/72 22 100% 2l. she arrived from osh off neo in rapid afib to 140 with systolic bp over 100. cardiology consult was obtained and recommended ccu admission with cardioversion. v/s prior to transfer: 100/61 148 97% on 3l. past medical history: 1. cardiac risk factors: -diabetes, +dyslipidemia, +hypertension 2. cardiac history: - cabg: - percutaneous coronary interventions: - pacing/icd: 3. other past medical history: hypertension hyperlipidemia cad- per pt. no records of this at dchf stage 4-5 ckd c/b anemia and secondary hyperparathyroidism r carotid stenosis depression asthma osteoporosis osteoarthritis r hip fx s/p orif thyroid disease- h/o both hypo and hyperthyroidism vitamin d deficiency - 25 oh 19 benign adnexal cyst followed and planned again for imaging chronic aspiration- based on video swallow eval chronic labyrinthitis h/o l pneumothorax social history: social history: widowed, no smoking, etoh, illicits. has been living at home with her son and his fiance with assistance and private home care services. . family history: son with heart surgery for unknown reason on fall . - no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission pe: general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. dilated l pupil (for years per pt), eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. 2/6 systolic murmur best heard at the rusb. no thrills, lifts. no s3 or s4. lungs: bibasilar crackles, no wheezing abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: 2+ edema b/l. discharge pe: vitals - tm/tc:98.0/97.5 hr: 60-69 bp:103-115/50 rr:16-20 02 sat:100% ra . general: 83 yo f in no acute distress, lying in bed heent: mucous membs dry, no lymphadenopathy, jvp non elevated chest: crackles left base, no wheezes, no rhonchi cv: s1 s2 normal in quality and intensity rrr, 2/6 systolic murmur best heard at the rusb. abd: soft, non-tender, non-distended, bs normoactive. no rebound/guarding. ext: wwp, no edema. dps, pts 1+. neuro: a/o x3, hoh. mae. skin: stage 2 pressure sore on coccyx. pt developed this at home. no drainage, redness. pertinent results: admission labs: 06:40am blood wbc-6.3 rbc-2.65* hgb-8.9* hct-25.6* mcv-97 mch-33.6* mchc-34.7 rdw-14.5 plt ct-210 07:05pm blood wbc-8.2 rbc-2.54* hgb-8.5* hct-24.5* mcv-97 mch-33.5* mchc-34.8 rdw-15.6* plt ct-202 06:40am blood plt ct-210 07:05pm blood pt-12.2 ptt-27.3 inr(pt)-1.0 06:40am blood glucose-88 urean-20 creat-3.2*# na-136 k-4.9 cl-101 hco3-28 angap-12 07:05pm blood glucose-115* urean-11 creat-2.0*# na-143 k-3.5 cl-101 hco3-32 angap-14 07:05pm blood ck(cpk)-47 07:05pm blood ck-mb-8 probnp-* 02:51am blood calcium-8.4 phos-2.9 mg-1.9 discharge labs: 06:55am blood wbc-6.9 rbc-3.20* hgb-10.5* hct-30.5* mcv-95 mch-32.7* mchc-34.2 rdw-19.0* plt ct-284 06:55am blood pt-24.2* inr(pt)-2.3* 06:55am blood glucose-93 urean-36* creat-4.6*# na-139 k-4.6 cl-99 hco3-31 angap-14 06:55am blood calcium-9.4 phos-2.1* mg-2.3 12:42pm blood vitb12-1498* folate-greater th 12:42pm blood tsh-2.0 vitamin d pending. brief hospital course: 83 yo female with history of htn, hld, cad, stage iv ckd, copd, dchf (ef >55%) with multiple recent admissions for chf last discharged who developed palpitations while being dialyzed and was found to be in rapid afib. . # afib w/rvr. had hypotension (sbps 80-100) after diltiazem given in field. unclear etiology of new onset afib. most likely cause is worsening chf with atrial distension. spontaneously converted to nsr and started on admiodarone with approx 5 gram load (400 mg for 1 week). metoprolol was also increased to 100 mg daily. will need to follow hr and decrease metoprolol as needed as amiodarone load cont. chads score 3 so started on warfarin at 5mg x 2 doses, to 4mg on and will discharge on 3mg and thereafter. please follow inr closely as amiodarone will cause higher inr on lower dose. holding albuterol to prevent tachycardia but may restart if pt becomes wheezy now that she is rate controlled. . #hypotension: related to rate especially in setting of dchf. continued to be an issue during dialysis but treatment today was tolerated well. diltiazem caused briefly depressed bps. transiently required pressor support. now with sbp 93-115 on metoprolol. home dose of lisinopril 5mg was not continued low blood pressure but should be considered in the setting of chf. . # acute on chronic diastolic congestive heart failure: recent admission (dc ) for dchf in setting of elevated bp and flash pulm edema. dc at 53 kg though dry weight was 51kg she had hypotension during dialysis so her dry weight was not achieved. she is 49.0 kg at discharge and this should be considered her new dry weight. fluid management per dialysis. she is on long acting beta blocker but no ace inhibitor as noted above, this should be considered. . #esrd: on hd. sevelamer d/c'ed as phosphorus low. cont on nephrocaps and calcitriol. receives epogen in hd. noted vitamin d deficiency in pmh but did not have supplement on her home medicaton list. vitamin d 25 hydroxy is pending at discharge but would suggest vitamin d as per nephrology. . #hyperlipidemia: cont atorvastatin . #depression: cont venlafaxine .. transitional issues: #1 pt will be discharged with of hearts event monitor and will need to send transmissions to the holter lab as directed #2 consider vitamin d supplementation as per nephrology #3 follow heart rate and decrease metoprolol for low hr or bp #4 check inr with labs on and adjust warfarin dose, continue frequent monitoring as amiodarone interaction can occur late #5 please make primary care appt at discharge from rehabilitation medications on admission: 1. acetaminophen 325 mg tablet po q6h as needed for pain. 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization inhalation q6h as needed for wheezing/sob. 3. b complex-vitamin c-folic acid 1 mg capsule po daily 4. calcitriol 0.25 mcg po daily 5. docusate sodium 100 mg capsule po bid 6. ipratropium bromide 0.02 % solution inhalation q6h 7. polyethylene glycol 3350 17 gram/dose po daily 8. senna 8.6 mg tablet po bid as needed for constipation. 9. sevelamer carbonate 800 mg tablet po tid w/meals 10. venlafaxine 150 mg capsule, ext release 24 hr po qhs 11. bisacodyl 5 mg tablet, delayed release two po daily as needed for constipation. 12. metoprolol tartrate 37.5 mg tablet po bid 13. atorvastatin 80 mg tablet po daily discharge medications: 1. colace 100 mg capsule sig: two (2) capsule po twice a day. 2. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day). 3. ipratropium bromide 0.02 % solution sig: one (1) vial inhalation q6h (every 6 hours) as needed for wheezing/shortness of breath. 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 5. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). 6. polyethylene glycol 3350 17 gram/dose powder sig: one (1) packet po daily (daily). 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 8. venlafaxine 75 mg capsule, ext release 24 hr sig: two (2) capsule, ext release 24 hr po daily (daily). 9. bisacodyl 5 mg tablet sig: one (1) tablet po once a day as needed for constipation. 10. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 11. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 3 days: last day , then decrease to 200 mg daily therafter. 12. amiodarone 200 mg tablet sig: one (1) tablet po once a day: start on . 13. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 14. outpatient lab work please check cbc, chem 7 and inr on thursday . 15. warfarin 3 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: hospital for continuing medical care discharge diagnosis: new onset atrial fibrillation with rapid ventricular response end stage renal disease chronic diastolic congestive heart failure anemia of chronic disease hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear ms. , it was a pleasure taking care of you while you were hospitalized at . you were admitted to the hospital because you had heart palpitations, and we found that your heart was beating fast and it was in an irregular rhythm called atrial fibrillation. you were started on a medicine called amiodarone and your heart rhythm converted back to a normal rhythm. atrial fibrillation makes you much more likely to have a stroke so you were started on a medicine called warfarin, a blood thinner, to prevent a stroke. you will need to get your blood level of warfarin checked regularly to make sure your warfarin level is not too high or too low. the goal warfarin level is 2.0-3.0. you also received a unit of blood because your blood count was low, it is still low but much closer to what it normally is now. . we made the following changes to your medicines: 1. start taking amiodarone to lower your heart rate and keep you in a normal rhythm 2. start taking warfarin (coumadin) to prevent a stroke with the atrial fibrillation 3. increase tylenol to three times a day to prevent any pain and help you with physical therapy 4. increase colace to prevent constipation 5. decrease atorvastatin to 40 mg daily to lower your cholesterol 6. stop taking albuterol as this could cause a fast heart rate. followup instructions: department: cardiac services when: wednesday at 11:00 am with: , md building: sc clinical ctr , campus: east best parking: garage procedure: hemodialysis diagnoses: anemia in chronic kidney disease end stage renal disease renal dialysis status congestive heart failure, unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status depressive disorder, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia hypotension, unspecified osteoporosis, unspecified pressure ulcer, lower back chronic obstructive asthma, unspecified chronic diastolic heart failure osteoarthrosis, unspecified whether generalized or localized, lower leg pressure ulcer, stage ii 

Answer: The patient is high likely exposed to