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: shortness of breath major surgical or invasive procedure: cardiac catheterization with ethanol septal ablation. history of present illness: 80 year old male with hypertrophic cardiomyopathy, mild aortic stenosis, moderate mitral regurg, htn, hyperlipidemia, and history of cad status post stents to proximal lad and proximal rca in the past who presented acutely to the lakes hospital after being found unresponsive at home by friends. although scheduled for an elective ethanol septal ablation on friday , the patient was acutely transferred to on for urgent septal ablation after he had been ruled out for mi. head ct showed no hemorrhage; however, moderate cerebral atrophy and chronic microvascular infarcts were noted. . the patient had been falling a lot at home, possibly undergoing syncopal episodes perhaps due to transient hypotension secondary to dynamic lv outflow obstruction. falling was also exacerbated by alcoholism. he rinks at least 3 alcoholic beverages daily. his serum alcohol level was 250 at the osh. due to the falls, he had several pelvic bruises and ecchymotic swollen left elbow hematoma. per report, the left arm was without fracture on xray. . the patient reported feeling well before ablation. he denied dizziness and presyncope. no chest pain or shortness of breath. telemetry displayed sinus rhythm with first degree heart block with a pr interval of 0.28. he had bp 112/69, afebrile, 95% o2 on ra. cardiac catheterization performed revealed patent stents, hocm, and right dominant system. past medical history: hypertrophic obstructive cardiomyopathy cad s/p stents to lad and rca in hypertension syncope ethanol abuse anemia peptic ulcer disease left rotator cuff repair social history: lives at home with wife, drinks a few drinks a day, denies tobacco family history: father died of mi in his 60s. physical exam: pe: af vs 129/70 hr 65 rr 18 sats 98% ra gen: pleasant, elderly male, appears younger than stated age, no evidence of respiratory distress heent: ncat, perrl, eomi, no jvd, op clear cvs: rrr, iii/vi end-systolic murmur, loudest at rusb resp: cta bilaterally, no wheeze, no crackles abd: soft +bs, ntnd, no masses ext: no lower ext edema, wwp, dp/pt pulses 2+ and symmetric lue, 2-3cm hematoma over lateral aspect of elbow +ecchymosis, nontender, normal rom (x-rays at osh reportedly neg per patient) neuro: cn ii-xii intact, no focal motor or sensory deficits pertinent results: echo done : significant hypertrophic cardiomyopathy with a resting gradient of 31mmhg and with valsalva a 188mmhg gradient. severe mitral insufficiency, mild to moderate ai. ef 60%. aortic valve area 1.6. . labs at osh: ruled out for an mi. bun 14/creat 1.2 k 4.0 na 134 wbc 10.5, hct 37.3, plt 34.9 inr not done-will be done prior to transfer wt 206.3 ekg:sinus 1st degree av block, borderline lvh, no st/tw changes, no change from . admission labs : wbc-9.1 rbc-3.61* hgb-11.8* hct-33.9* mcv-94 mch-32.8* mchc-34.9 rdw-13.6 plt ct-243 calcium-9.1 phos-3.9 mg-1.9 glucose-100 urean-17 creat-1.0 na-131* k-3.8 cl-101 hco3-23 angap-11 ck(cpk)-713* ck-mb-155* mb indx-21.7* ctropnt-1.96* . ck(cpk)-610* ck-mb-137* mb indx-22.5* ck(cpk)-214* ck-mb-29* mb indx-13.6* ctropnt-1.92* . discharge labs : wbc-9.8 rbc-3.81* hgb-12.6* hct-36.0* mcv-95 mch-33.0* mchc-34.9 rdw-13.3 plt ct-284 calcium-9.3 phos-3.2 mg-2.1 glucose-88 urean-15 creat-1.0 na-130* k-4.0 cl-99 hco3-24 angap-11 . echo (at ) mild symmetric lv hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. no left ventricular outflow obstruction at rest but a mild gradient (peak 36mmhg) was induced with valsalva. rv chamber size and free wall motion are normal. aortic root and ascending aorta are mildly dilated. aortic valve leaflets (3) are moderately thickened. mild aortic stenosis with mild (1+) aortic regurgitation. mitral valve leaflets are mildly thickened. no systolic anterior motion of the mitral valve leaflets. trivial mitral regurgitation. estimated pulmonary artery systolic pressure is normal. impression: symmetric left ventricular hypertrophy with mild inducible (valsalva) lvot gradient. mild aortic stenosis. mild aortic regurgitation. dilated ascending aorta. . cardiac cath 1. no angiographically apparent flow limiting coronary artery disease. 2. moderate aortic stenosis. 3. severe left ventricular outflow tract gradient with the majority of the gradient related to hypertrophic obstructive cardiomyopathy. 4. successful ethanol ablation of the basal septum. . echo study date of there is mild symmetric left ventricular hypertrophy. overall left ventricular systolic function is normal (lvef>55%). there is no left ventricular outflow obstruction at rest or with valsalva. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. compared with the prior study (tape reviewed) of , no significant lvot gradient was not inducible with valsalva. . ecg study date of 7:56:52 am sinus rhythm with slowing of the rate compared to the previous tracing of . right bundle-branch block and left anterior fascicular block. prior inferior wall myocardial infarction. the st-t wave abnormalities have improved. the rate has slowed. otherwise, no diagnostic interim change. brief hospital course: 80 year old man with hypertrophic obstructive cardiomyopathy treated with ethanol septal ablation. . cardiovascular: a) the patient has known cad with 2 stents placed in to the proximal lad and rca. in , cardiac catheterizatin reveales patent stents and non flow limiting disease. the patient was placed on an optimal medical regimen including metoprolol 100mg , simvastatin 40mg qhs, and asa 325mg. * b) pump: on catheterization, severe left ventricular outflow tract gradient with the majority of the gradient related to hypertrophic obstructive cardiomyopathy. the dynamic outflow tract gradient caused by hypertrophic obstructive cardiomyopathy was reduced after treatment with ethanol septal ablation therapy. the gradient was not inducible with valsalva after the ablation. * c) valves: per echocardiogram, the patient had mild as/ar, trivial mr, and a normal tricuspid valve. * d) rhythm: normal sinus rhythm was observed on tele monitoring without sign of heart block. post ablation, he retained a temporary pacer wire with excellent threshold of 0.2 who's firing was not required during the hospital visit. the cardiac electrophysiology service was consulted for ecg showing new rbbb, l axis deviation, and known av prolongation. no permanent pacer placement or further intervention was deemed necessary at this moment, and he continued to perform well on subsequent monitoring. follow up with outpatient cardiology was recommended for continued evaluation of his new rhythm and possible need for pacemaker placement. . renal: the patient had mild chronic renal insufficiency with baseline creatinine of 1.2, thus creatinine was followed. . alcohol abuse: no medication was needed according to ciwa scale. also, he lacked signs of withdrawal. outpotient counselling was recommended. . pulmonary: the patient had moments of apnena on telemetry monitor and had sleep study in past. however he does not use c-pap at home due to discomfort. we will have pt follow up with outpatient pcp : sleep apnea. medications on admission: home: metoprolol, zocor, prilosec, folate, norvasc transfer: folate, thiamin, b12, b6, mvi, fe, lopressor 100bid prilosec 40 zocor 40 norvasc 10 asa 325 received pneumovax discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 4. multivitamin capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 5. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 6. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. folic acid 1 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: hypertrophic obstructive cardiomyopathy secondary: coronary artery disease, hypertension, syncope, anemia, pud discharge condition: good. discharge instructions: please follow up with your doctors. please take all of your medications as indicated. the only medication change is a discontinuation of your norvasc. your blood pressure and heart rate has been adequately controlled without the norvasc. please consult your outpatient cardiologist regarding the changes in your medications. followup instructions: please follow up with your cardiologist within one week of discharge. you can call to schedule an appointment. at the time, please have an ecg performed and your medication list reviewed. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters excision or destruction of other lesion or tissue of heart, endovascular approach insertion of temporary transvenous pacemaker system diagnoses: pure hypercholesterolemia unspecified essential hypertension aortic valve disorders unspecified fall hypotension, unspecified home accidents other and unspecified alcohol dependence, continuous first degree atrioventricular block contusion of elbow 

Answer: The patient is high likely exposed to