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: syncope major surgical or invasive procedure: none history of present illness: pt is a 77 yo male with h/o systolic heart failure with ef 20%, htn, and asymptomatic fib s/p recent cardioversion now admitted after syncopal episode, found to be bradycardic. he was anticoagulated for 4 weeks and cardioverted at yesterday for a fib with rvr and started newly on amiodarone. this morning he was feeling weak and took lasix 120mg and was walking up the stairs on his way to use the bathroom when he had a near syncopal event. he was caught by his family member, sustained no head trauma, though he was + for loc. . ems arrived and he had a junctional rhythm at 50. he was externally paced in the field and he received a total of 1 amp of atropine for a bradycardia in the 30s and his sbp was in the 70s. he was brought to and found to have a hr in the 50s. he was started on a dopamine drip at 6mg. he desated to 90% on 4l and he needed to be started on a non rebreather with sats at 98%. he was given lasix 20mg iv x1. the pt voided a total of 100cc at -wellesey. in transport the pt voided an additional 240cc. pt refuses foley catheter and demands to stand to urinate. a ct scan was done at osh to look for a bleed. . + 2 pillow orthopnea winded after climbing one flight of stairs . on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, ankle edema, or palpitations. past medical history: chf with ef 20% (acute systolic and diastolic heart failure decompensation in setting of new a fib with rvr) htn afib/flutter with rapid ventricular response- dx sometime after s/p radiation for prostate ca in --dr. at s/p tonsillectomy allergies: nkda outpatient cardiologist: dr. pcp: . social history: social history is significant for the absence of current tobacco use. there is no history of alcohol abuse. family history: his father died of an mi at 57. physical exam: vs: t 96.2, bp 119/80 , hr 86 , rr 22 , 96% on non rebreather gen: wdwn middle aged male in nad, resp or otherwise. oriented, mood, argumentative heent: perrl, eomi, mmm, no lad neck: supple with elevated jvd. cv: regular rate and rhythm normal s1, s2. no s4, no s3. chest: + diffuse crackles throughout lung, + accessory muscle use, no chest wall deformities, scoliosis or kyphosis. abd: distended, mild tense, + tympany in rlq, no shifting dullness ext: pitting edema +1 to knees r>l, +2 dp pulses in both extremities. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: radial +2 bilaterally, dp +2 bilaterally left: radial +2 bilaterally, dp +2 bilaterally pertinent results: laboratory data on admission: creatinine 3.9 mg 2.9 ph 6 inr 2.3 wbc 13.4 . ekg demonstrated nsr with left anterior hemiblock; ekg showed conduction of p waves. t wave inversion in i and avl and question of q waves in iii and avf and v1-v4 which have been stable since prior ekg. 12-leads from nw show junctional escape rhythm at rate ~40. ekg : atrial flutter with variable block. left axis deviation. left anterior fascicular block. intraventricular conduction delay. late r wave progression. . telemetry demonstrated: nsr in 70s. . 2d-echocardiogram performed on demonstrated: -ef of 20% with severe global hypokinesis -left atrium is markedly dilated, right atrium is moderately dilated. -right ventricular cavity is mildly dilated with severe global free wall hypokinesis -trace aortic regurgitation -moderate (2+) mitral regurgitation -moderate pulmonary artery systolic hypertension . portable cxr : cardiac silhouette is enlarged but unchanged. there is again noted prominence of the interstitial markings consistent with pulmonary edema. this is slightly increased since the previous study. no pleural effusions are seen. . renal u/s : findings: the right kidney measures 11.2 cm, and the left kidney measures 11.9 cm. there is mild right and moderate left hydronephrosis. multiple bilateral cysts are seen, the largest measuring 4.8 cm in the superior pole of the right kidney. the cortical thickness is preserved. urinary bladder is distended, measuring 15.5 x 11.6 x 16.5 cm. the prostate is enlarged, measuring 7 x 6.5 x 6.3 cm. impression: mild bilateral hydronephrosis most likely due to prostate hypertrophy, chronicity indeterminate. brief hospital course: a/p: 77 yo male with h/o htn, chf and ef of 20%, and recent cardioversion for a fib who is s/p syncopal event with ekg showing junctional bradycardia. now hemodynamically stable in sinus rhythm. . # syncope/bradycardia: pt had junctional bradycardia with underlying sinus node dysfunction leading to hemodynamic instability initially requiring dopamine gtt. he had normal av node conduction. of note he was on amiodarone, digoxin, and carvedilol, the levels of which may have been increased in the setting of arf. he meets criteria for pacemaker/icd placement but patient emphatically refused despite being told that he could have recurrence of his syncope without intervention. he was monitored on telemetry during his admission. he was discontinued on digoxin and amiodarone. he was discharged on lower dose of carvedilol. he has a follow up appointment with dr. . . # pump: he had acute on chronic diastolic and systolic hf. the patient has a history of diastolic and systolic chf with an ef of 20%. prior to admission his home dose of lasix was 80qam and 40qpm although the morning prior to admission to the osh he took lasix 120mg and received 20mg iv at the osh. on presentation to the ccu he desaturated and required a non rebreather mask in order to maintain an oxygen saturation of 94%. on arrival to the ccu he was volume overloaded on exam with diffuse crackles and 1+ pitting edema to the knee r>l. he was continued on low dose coreg but his lasix and ace i were held given his acute renal failure. he was discharged on lasix 120mg daily. . # rhythm: the pt was in a fib until being cardioverted the day prior to his admission. on admission he had conducting p waves and a long pr interval. he was originally on a heparin drip in case the decision was made to put in a pacer. . # acute renal failure on chronic renal insufficiency: he patient has a baseline creatinine of 1.6 to 2.2. on admission his creatinine was 3.9 and it improved to 2.4 by the time of discharge. his renal failure was likely secondary to obstruction from enlarged prostate which was seen on ultrasound. his urinary retention was likely exacerbated by the atropine dose received on day of admission. the patient adamantly refused a foley despite our recommendation. his ace, lasix, and digoxin were held given his acute renal failure. he was discharged on lasix 120mg daily. . # abdominal distention: the patient had significant abdominal distention during his admission. he was having normal bowel movements and no abdominal pain. his lfts were normal with the exception of an isolated conjugated hyperbilirubinemia. he should follow up this abnormal lab value as an outpatient with his pcp. . # elevated wbc: the patient had an increased white cell count to 13. 4 on admission but was afebrile and asymptomatic. his ua/ucx, blood cx, and cxr were all negative. he developed no other signs of infection during his hospitalizations. his white count was 11.5 on the day of discharge. . # cad: he was continued on asa, statin, and a low-dose beta blocker. his ace inhibitor was held given his acute renal failure. . # htn: he originally required a dopamine gtt which was successfully weaned. he was then restarted on a lower dose of carvedilol. he was discharged on lasix 120mg daily. his quinapril was held in the setting of his acute renal failure and was not restarted prior to discharge. . # fen: he was on a cardiac/low salt diet and his lytes were maintained k>4 and mg>2. medications on admission: carvedilol 12.5 mg digoxin 0.125 mg daily lasix 40 mg 2 tabs in the am and 1 tab in the pm (he states he took another ?????? tab last night) quinapril 80mg daily coumadin 5 mg 1 tab daily simvastatin 20 mg 1 tab daily asa 81 mg 1 tab daily calcium supplement 1 tsp daily mvi 1 tab daily discharge medications: 1. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. calcium oral 4. multivitamin oral 5. outpatient lab work please draw bun, creatinine, potassium, alt, ast, alk phos, t. bili, d. bili and forward results to dr. fax: 6. lasix 40 mg tablet sig: three (3) tablet po once a day. tablet(s) 7. carvedilol 3.125 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*0* 8. standard walker discharge disposition: home discharge diagnosis: primary 1. syncope 2. junctional bradycardia sinus node dysfunction 3. atrial fibrillation with rvr 4. acute systolic heart failure . secondary cardiomyopathy with ef of 20% htn s/p radiation for prostate ca () s/p tonsillectomy discharge condition: stable discharge instructions: you were admitted for syncope due to an abnormal, slow heart rhythm which resulted from your heart's impaired intrinsic pacing. you were treated medically for your symptoms since you did not want a pacemaker placed. you were also treated for acute congestive heart failure. . we have made the following changes to your medications. you should not be taking: coumadin quinapril digoxin amiodarone . we have decreased the carvedilol to 3.125mg twice daily. we have increased to a full dose aspirin 325mg daily. we have changed the lasix to 120mg daily. . you had some abnormalities in your liver function tests and your kidney function, these appear to be improving. you will need to get follow up labs drawn on friday, and these will be forward to dr. office in where you will be seeing him next week. . you will need to discuss with dr. regarding the best time to restart the quinapril and he may want to increase the dose of carvedilol at your next appointment. . if you develop any new chest pain, shortness of breath, weakness or any other general worsening of condition please call your pcp or come directly to the ed. . weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet. followup instructions: cardiology: dr. wednesday at 2:30pm. office phone: . procedure: other electric countershock of heart diagnoses: other primary cardiomyopathies mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified malignant neoplasm of prostate long-term (current) use of anticoagulants sinoatrial node dysfunction hydronephrosis jaundice, unspecified, not of newborn acute on chronic combined systolic and diastolic heart failure 

Answer: The patient is high likely exposed to