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: no known allergies / adverse drug reactions attending: chief complaint: shortness of breath major surgical or invasive procedure: pacemaker placement () history of present illness: 68m with h/o diastolic chf, bradycardia p/w sob since this evening, which awoke him from sleep tonight. his symptoms feel like his previous chf, and he was last admitted ~1.5mos ago for same and noted to be bradycardic at which time his bb was stopped. currently, he denies cp, fevers, light headedness or leg swelling. . he was admitted for chf exacerbation and . lasix was increased on this last admission. he was also brady that admission so they stopped his metoprolol. saw cardiologist two weeks ago who increased lasix from 40mg to 60mg. tuesday feeling more sob than normal (even with rest). last night breathing heavier and brought in at 2am. he thought this was similar to prior chf exacerbations and therefore presented to the er. . in the ed, initial vs: 95.8 42 101/35 22 98%. a cxr revealed mild pulmonary edema. he was noted to be in . he received atropine x 1. he was given 1 amp of calcium for concern for prolonged qt secondary to hypocalcemia. his bradycardia persisted to the 40s, it was thought to be junctional vs afib per cardiology and he developed hypotension to the 80s, which was asymptomatic. he was then given 1l of fluid with improvement to the high 90s. he refused a rectal guiac. cr noted to be 2.7 from a baseline of 1.4-1.6. his bnp was 1594 (it was 1362 on and was 324 in ). blood cultures were drawn. cxr showed mild congestion. ekg showed slow junctional rhythm. ekg on was nsr and showed lad. echo in showed ef > 60% and lvh. on transfer to the floors, hr 60's, bp 121/39, pox 95ra. . on the floor, he denies dizziness. he denies dietary noncompliance and is not sure what his weight has been doing. . ros: denies fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria. past medical history: 1. cardiac risk factors: diabetes, dyslipidemia, hypertension 2. cardiac history: two stents placed in past. patient seen by dr. and reportedly had a "normal" stress (as per the patient) about 6 months ago. prescribed nitroglycerin but only uses it twice/year. -cabg: n/a -percutaneous coronary interventions: in , ramus was stented with a 2.5 x 12 mm drug-eluting taxus stent. in , mid lad was stented with a 3.5 x gfx stent. -pacing/icd: none. 3. other past medical history: --prostate cancer --glaucoma social history: used to work for / in the claims department. is married and likes to travel with his wife. one son who lives in . smoked 2 ppd for 54 years - recently quit. has an occasional shot of etoh on the weekends. denies illicits. family history: mother and grandmother with dm. mother died of aneurysm and father died of "old age." physical exam: on admission: vs: t afebrile bp 102/31, hr 46, rr 18, pox 98ra general: well-appearing man in nad, comfortable, appropriate. heent: nc/at, perrla, eomi, sclerae anicteric, mmm, op clear. neck: supple, jvd slightly elevated. heart: rrr, no mrg, nl s1-s2. lungs: bibasilar rales, good air movement, resp unlabored. abdomen: soft/nt/nd, no masses or hsm, no rebound/guarding. extremities: wwp, no c/c/e, 2+ peripheral pulses. skin: no rashes or lesions. neuro: awake, a&ox3, muscle grossly intact . on discharge: vs: t 98.5 bp (116-158)/49-74, hr 73-91, rr 20, pox 92-98%ra general: well-appearing man in nad, comfortable, appropriate. heent: nc/at, perrla, eomi, sclerae anicteric, mmm, op clear. neck: supple, jvd slightly elevated. heart: rrr, no mrg, nl s1-s2. lungs: bibasilar rales, good air movement, resp unlabored. abdomen: soft/nt/nd, no masses or hsm, no rebound/guarding. extremities: wwp, no c/c/e, 2+ peripheral pulses. skin: no rashes or lesions. neuro: awake, a&ox3, muscle grossly intact pertinent results: on admission: . 03:10am blood wbc-6.8 rbc-3.79* hgb-11.6* hct-36.1* mcv-95 mch-30.6 mchc-32.2 rdw-16.1* plt ct-239 03:10am blood neuts-51 bands-0 lymphs-42 monos-7 eos-0 baso-0 atyps-0 metas-0 myelos-0 03:10am blood pt-13.2 ptt-22.9 inr(pt)-1.1 03:10am blood glucose-154* urean-82* creat-2.7*# na-138 k-4.9 cl-101 hco3-22 angap-20 03:10am blood ctropnt-0.02* 03:10am blood probnp-1594* 03:10am blood calcium-9.9 phos-5.3*# mg-2.4 . cxr: mild pulmonary congestion . ekg: probable junctional rhythm with atrial premature beat. delayed r wave progression with late precordial qrs transition is non-diagnostic. since the previous tracing of probable junctional rhythm has replaced sinus rhythm. . pacemaker: ppm interrogation aai-ddd r - 7.3mv, 584 ohms, 1v @ 0.5 ms p - 5.5 mv, 496 ohms, 0.5v@0.5ms . on discharge: 07:45am blood wbc-6.4 rbc-3.97* hgb-12.3* hct-38.4* mcv-97 mch-30.9 mchc-32.0 rdw-16.0* plt ct-212 07:45am blood glucose-117* urean-32* creat-1.4* na-139 k-4.8 cl-106 hco3-22 angap-16 . blood cultures: ngtd brief hospital course: 68m with h/o diastolic chf, cad s/p rca and lad stents, longstanding dm, and bradycardia p/w sob since this evening who now has diastolic congestive heart failure, acute kidney injury, and bradycardia. . #) bradycardia: noted on last 2 hospital admissions but had been attributed to beta-blocker, which was stopped in . on presentation to the ed, hr in 30s-40s showing junctional rhythm with occasional sinus beats. he was given 1 mg atropine in the ed. the patient did complain of intermittent lightheadedness at home. ep was consulted and elected to place a dual chamber pacemaker on . he is to follow-up in device clinic in 1 week. he was started on toprol 25 mg per day. . #) diastolic chf: two recent admissions for decompensated chf in and . lasix had recently been increased by his outpatient cardiologist to 60 mg per day. on admission, bnp was elevated to 1594, cxr showed mild congestion, and was present. he was given iv lasix 20 mg on hd#1. his discharge lasix dose was 60 mg per day. . #) cad: last stent in , currently on asa 325 and plavix. these were continued. once pacemaker was place, he was started on metoprolol succinate at 25 mg qday. . #) : creatinine elevated to 2.7 from baseline 1.4-1.6. likely secondary to poor forward flow in the setting of bradycardia. creatinine returned to baseline of 1.6 by hd#1 with gentle diuresis. cr was 1.4 on discharge. . #) glaucoma: continued eye drops . #) dm: continued novolog and ssi . #) hl: continued atorvastatin . dvt prophylaxis was with subq heparin. he remained full code. medications on admission: 1. novolog mix 70-30 100 unit/ml (70-30) solution , 44units 2. actos 45 mg daily 3. lipitor 40 mg daily 4. clopidogrel 75 mg daily 5. aspirin 325 mg tablet daily 6. prednisolone sodium phosphate ophthalmic 7. azopt ophthalmic 8. travatan z ophthalmic 9. lasix 60 mg tablet sig: one (1) tablet po once a day. discharge medications: 1. novolog mix 70-30 100 unit/ml (70-30) solution sig: forty four (44) units subcutaneous twice a day. 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. travoprost 0.004 % drops sig: one (1) ophthalmic qd (). 7. brinzolamide 1 % drops, suspension sig: one (1) ophthalmic (2 times a day). 8. prednisolone sodium phosphate 1 % drops sig: one (1) ophthalmic twice a day. 9. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 1 days. disp:*4 capsule(s)* refills:*0* 10. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). disp:*30 tablet extended release 24 hr(s)* refills:*1* 11. furosemide 40 mg tablet sig: 1.5 tablets po once a day. disp:*45 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis 1. sinus node dysfunction 2. acute on chronic diastolic heart failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted because you short of breath thought to be due to slow heart rate. you were noted to have abnormal heart rhythm which was thought to be from age associated fibrosis. a pacemaker was implanted to help with your slow heart rate without any complications. . following medication changes were made to your medical regimen start metoprolol succunate 25 mg daily decrease aspirin to 81 mg by mouth once a day continue lasix 60 mg by mouth once a day . should you experience any symtpoms that concern you after leaving the hospital, please call your cardiologist. weigh yourself every morning, md if weight goes up more than 3 lbs. . followup instructions: please call your outpatient cardiologist's office on monday in order to schedule an appointment within 1 week. . please call device clinic at ( on monday in order to schedule a follow-up appointment in 1 week for wound check. please make an appointment with your primary care physician within a week. procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle diagnoses: acidosis coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified acute on chronic diastolic heart failure personal history of tobacco use unspecified glaucoma percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia sinoatrial node dysfunction 

Answer: The patient is high likely exposed to