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 attending: chief complaint: icd firing major surgical or invasive procedure: none history of present illness: mr. is an 85 yo m with a history of type 2 dm, paroxysmal afib, chronic systolic chf, severe lv dysfuntion (ef 20-25%), s/p biv icd placment in , and vt s/p amiodarone and dofetilide who was transferred from an osh on to the cardiology service to recurrent vt on mexilitine, transferred to ccu for further monitoring after vt x 2 terminated by icd firing. recently, he was admitted to an osh ( through ) and his icd was reprogrammed to treat vt/vf with atp x 1 followed by 1 shock. on this admission he was started on mexelitine and sent home. the patient returned to the osh with slow vt (rate of 120s - 130s) on the mexilitine with pre-syncopal symptoms. the dizziness lasted several minutes while lying in bed. he denied chest pain, palpitations, shortness of breath. he was referred to for further ep evaluation and possible vt ablation. past medical history: 1. cardiac risk factors: hyperlipidemia 2. cardiac history: -cabg: none -percutaneous coronary interventions:none -pacing/icd: biv icd placed in . this was a concerto. 3. other past medical history: chronic systolic congestive heart failure (ef 20%). ventricular tachycardia treated with dofetilide. s/p biv icd atrial fibrillation chronic back pain mild dementia with short-term memory deficits bladder ca, s/p tumor excision dyslipdiemia chronic venous insufficiency social history: -tobacco history: patient smoked 1.5ppd x 50 years. quit 20 years ago. -etoh: no alcohol. -illicit drugs: none. family history: nc physical exam: vs: 96.8, 76 bpm, 93/82, 19, 100% on 2 l nc general: wdwn male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp at clavicle. cardiac: pmi located in 5th intercostal space, midclavicular line. distant heart sounds. rr, normal s1, s2. no m/r/g. lungs: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. patient has an umbilical hernia. easily reducible. extremities: chronic venous stasis bilaterally. minimal ankle edema bilaterally. 2+ pt pulses bilaterally. pulses: right:dp 2+ pt 2+ left: dp 2+ pt 2+ pertinent results: c. cath no coronary artery disease pcw mean 26 ra 14 . ekg the tracing is marred by baseline artifact. the rhythm appears to be atrial sensed and ventricular paced with occasional ventricular ectopy as recorded on without diagostic interim change. there is occasional intrinsic a-v conduction. intervals axes rate pr qrs qt/qtc p qrs t 81 136 24 62 -98 . 2d-echocardiogram: 5/`14/09 the left atrial volume is markedly increased (>32ml/m2). left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is severe global left ventricular hypokinesis (lvef = 20-25 %). the estimated cardiac index is depressed (<2.0l/min/m2). there is no left ventricular outflow obstruction at rest or with valsalva. the right ventricular cavity is dilated with depressed free wall contractility. the aortic root is moderately dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: dilated, lv with severe global hypokinesis. the lateral wall has relatively better function.the rv is not well seen but is probably mildly dilated/depressed. mild mitral and aortic regurgitation. compared with the report of the prior study (images unavailable for review) of , the findings are similar. the degree of mitral regurgitation and ventricular dilatation are slightly less on the current study. 07:30pm blood wbc-5.7 rbc-4.36* hgb-12.8* hct-38.1* mcv-87 mch-29.2 mchc-33.5 rdw-15.1 plt ct-187 06:18am blood wbc-5.0 rbc-3.89* hgb-11.3* hct-34.0* mcv-87 mch-29.0 mchc-33.3 rdw-15.0 plt ct-144* 06:50am blood wbc-4.6 rbc-4.22* hgb-12.7* hct-36.8* mcv-87 mch-30.0 mchc-34.4 rdw-15.9* plt ct-141* 06:50am blood plt ct-141* 06:50am blood pt-14.1* ptt-74.5* inr(pt)-1.2* 07:30pm blood pt-21.7* ptt-29.1 inr(pt)-2.1* 07:30pm blood glucose-151* urean-37* creat-1.7* na-136 k-3.8 cl-96 hco3-28 angap-16 06:18am blood glucose-151* urean-41* creat-1.9* na-132* k-4.0 cl-95* hco3-27 angap-14 06:50am blood glucose-134* urean-48* creat-2.0* na-133 k-4.2 cl-95* hco3-27 angap-15 04:58pm urine hours-random urean-392 creat-86 na-42 04:58pm urine osmolal-351 cxr findings: in comparison with the study of _____, there is continued enlargement of the cardiac silhouette in a patient with a dual-channel pacemaker defibrillator device. the pulmonary vascularity is difficult to evaluate, but is essentially within normal limits. mild elevation of the left hemidiaphragmatic contour with atelectatic changes at the bases and blunting of the costophrenic angle. the upper lungs are essentially clear. c. cath comments: 1. selective coronary angiography of this right dominant system revealed no obstructive coronary artery disease. the lmca was normal. the lad had minor luminal irregularities. the lcx had minor luminal irregularities. the rca was a large dominant vessel, without angiographically apparent stenosis. 2. resting hemodyanamics demonstrated elevated left and right sided filling pressures, with a lvedp and rvedp or 26mm hg and 17m hg, respectively, with a mean pcwp of 26 mm hg. there was mild to moderate pulmonary arterial hypertension with a pressure of 48/24 mm hg, likely secondary to the elevated pcwp. there was no evidence of restrictive or constrictive physiology. there was no evidence of an intracardiac shunt by oximetry. there was no significant gradient across the aortic valve on carefull pullback of the catheter from the left ventricle to the aorta. systemic arterial pressures were in the normal range. final diagnosis: 1. no obstructive coronary arteries disease. 2. elevated left and right sided filling pressures consistent with congestive heart failure. brief hospital course: at , he had cardiac cath evaluation on that revealed clean coronaries and elevated left and right sided filling pressures. on the floor he underwent agressive diuresis. on the night of he had an episode of vt/vf which was terminated w/ atp followed by shock (icd). on mexilitine and dofetilide were stopped with plan to start amiodarone after wash out and plan of vt ablation on . patient was to be continued on heparin gtt and agressive diuresis. on patient had a run of vt/vf w/ resultant icd firing. ep was called and pt. was given 150mg iv bolus of amiodarone. following amiodarone bolus, pt. transiently became hypotensive to the 70's, but returned to baseline w/o intervention. again 45 minutes later, pt. had a run of vt w/ resultant shock. he was transferred to the ccu for observation and for further management. . in the ccu, patient was continued on amiodarone and lidocaine gtt. on he was started on amiodarone 400mg po bid. he was diuresed wtih iv lasix, with goal i/os even. on the patient was started on mexelitine 150mg po tid. lidocaine gtt and amiodarone gtt stopped. on discharge patient was maintained on mexelitine and amiodarone po. ep recommeded tapering amiodorone to 300 mg daily. # h/o atrial fibrillation: coumadin was stopped. patient was placed on heparin gtt temporarily in anticipation of potential ep ablation, which was not required in the end. patient restarted on coumadin prior to discharge. . # pump: chronic systolic heart failure with ef 20%, s/p biv icd placement. repeat tte on this admission shows unchagned ef 20-25% dilated, lv with severe global hypokinesis. mild signs of fluid overload on exam, including ankle edema and elevated jvd. cath revealed elevated markedly elevated right (ra = 14 mm hg) and left heart (pcwp = 26mmhg) filling pressures consistent with chf. patient was diuresed with lasix 80mg po daily with goal i/os even to negative 500cc. continued on carvedilol 6.25mg po daily, spironolactone 12.5mg po daily. . # renal failure: cr up to 2.3. apparent baseline 1.5 to 1.7. likely due to dm and htn. also rising in the setting of diuresis. urine lytes were consistant with pre-renal failure. patient was discharged with plan to hold lasix for 2 days and then resume at a lower dose. he should continue to have regular renal labs checked. medications on admission: coumadin 5 mg daily metolazone 2.5 mg twice a week lasix 80 mg daily lidoderm 700 mg 5% patch daily imdur 7.5 mg daily spironolactone 25 mg daily allopurinol 100 mg daily dofetilide 0.25 mg daily zocor 40 mg daily carvedilol 12.5 mg b.i.d. tramadol 50 mg t.i.d. prn back pain glyburide lantus 12 units daily albuterol nebulizer p.r.n. cough discharge medications: 1. warfarin 1 mg tablet sig: three (3) tablet po once daily at 4 pm. disp:*30 tablet(s)* refills:*2* 2. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 3. spironolactone 25 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* 4. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 5. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 6. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for back pain. 8. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q6h (every 6 hours) as needed for wheezing. 9. insulin glargine 300 unit/3 ml insulin pen sig: twelve (12) units subcutaneous once a day. 10. glyburide 2.5 mg tablet sig: one (1) tablet po once a day: please take the dose that you were taking prior to admission. 11. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 12. outpatient lab work please have inr, bun/cr checked in 3 days. please fax results to pcp. 13. amiodarone 100 mg tablet sig: 3-6 tablets po once a day: 600 mg per day for 7 days, then 300 mg daily. disp:*180 tablet(s)* refills:*2* 14. lasix 40 mg tablet sig: one (1) tablet po once a day: start on . disp:*30 tablet(s)* refills:*2* discharge disposition: extended care facility: nursing home discharge diagnosis: primary diagnosis: ventricular tachycardia discharge condition: stable. normal sinus rhythm. discharge instructions: you were admitted with ventricular tachycardia, and your icd firing as a result. your medications were changed, and currently you are on amiodarone and mexiletene. you were briefly in the ccu because of your fast heart rate and low blood pressure. this was controlled with the above medications. if you have worsening chest pain, shortness of breath, palpitations, lightheadedness or any other symptoms please call your primary care doctor or go to the emergency department. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet followup instructions: you have the following appointments provider: clinic phone: date/time: 11:00 provider: , m.d. phone: date/time: 12:00 provider: , m.d. phone: date/time: 2:40 procedure: coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization diagnoses: congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified atrial fibrillation paroxysmal ventricular tachycardia other and unspecified hyperlipidemia chronic systolic heart failure ventricular fibrillation automatic implantable cardiac defibrillator in situ 

Answer: The patient is high likely exposed to