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: history of present illness: this is a 49 year old with a history of hypertrophic obstructive cardiomyopathy complicated by paroxysmal atrial fibrillation and class iii congestive heart failure who was admitted for cardioversion and alcohol septal ablation. she was initially diagnosed with hypertrophic obstructive cardiomyopathy at age 21 after she had a pre-syncopal episode. she has been controlled on anti-arrhythmic drugs since then. her disease has been complicated by runs of ventricular tachycardia and episodes of paroxysmal atrial fibrillation. she has also noted a seven to eight month of progressive onset of lethargy and increasing dyspnea on exertion. she becomes short of breath after 12 steps. she occasionally feels as if she is about to pass out and also occasionally has intermittent chest pressure independent of exertion. she notes two-pillow orthopnea and paroxysmal nocturnal dyspnea as well as lower extremity edema that is controlled with lasix. she self-treats her chest pain with lopressor p.r.n. given her increased fatigue and decreased exercise tolerance, she had been scheduled to undergo alcohol septal ablation in order to alleviate her symptoms. two days prior to her scheduled admission, she noted the onset of chest pain and palpitations. she presented to where she was noted to be in rapid atrial fibrillation with her rate in the 130s. she was hemodynamically stable. she was treated with intravenous and p.o. lopressor and aspirin and started on a heparin drip. she was transferred to where she underwent a transesophageal echocardiogram that showed no clot and she was cardioverted times one at 360 joules with a return of normal sinus rhythm. the following morning, she underwent alcohol septal ablation which decreased her left ventricular outflow tract gradient from 15 mm of mercury to 13 to 15 mm of mercury. at catheterization, she was noted to have left ventricular end diastolic pressure of 38 to 40. a temperature right ij pacer was placed during this procedure. she was then transferred to the cardiac care unit for further monitoring. on arrival, she noted four to five out of ten substernal chest pain with radiation to the left arm. she had no shortness of breath, nausea or vomiting. she was slightly diaphoretic. she had some st depression on ekg. her pain was partially relieved with 1 mg of morphine. review of systems: review of systems was otherwise negative. past medical history: 1. hypertrophic obstructive cardiomyopathy diagnosed at age 21 after she had palpitations and shortness of breath as well as pre-syncope. a murmur was noted by her primary care physician who sent her for catheterization which documented the disease. this has been complicated by ventricular tachycardia with two documented runs of . she was initially placed on norpace which was then changed to amiodarone which she did not tolerated which was then changed to sotalol. this has also been complicated by paroxysmal atrial fibrillation since , currently controlled on sotalol. this has also been complicated by progressively increasing congestive heart failure, now at class iii with shortness of breath, edema, orthopnea and paroxysmal nocturnal dyspnea. 2. hypercholesterolemia. 3. hypothyroidism. 4. status post dilatation and curettage in for abnormal uterine bleeding. 5. status post tonsillectomy. medications: 1. sotalol 160 mg twice a day. 2. verapamil 80 mg three times a day. 3. lasix 40 mg twice a day. 4. 20 meq q. day. 5. synthroid 100 mg q. day. 6. zoloft 100 mg q. day. 7. aspirin 325 mg q. day. 8. lipitor 10 mg q. day. 9. toprol xl 25 mg q. h.s 10. she also received 40 mg of prednisone and 150 of zantac prior to the procedure due to her dye allergy. allergies: penicillin causes anaphylaxis; valium causes nausea; benadryl causes agitation; and amiodarone causes fevers and nightmares. she is also allergic to shellfish and iodinated contrast. social history: she works as a psychiatric social worker at . she lives alone in . she quit smoking eleven years ago after 1.5 pack per day for 15 years. she occasionally drinks alcohol and notes no intravenous drug use. family history: significant for a father who died of a sudden cardiac death at age 37. she has a paternal cousin with hypertrophic obstructive cardiomyopathy whose daughter died a sudden cardiac death at age 21. physical examination: this is a pleasant woman in no acute distress who is 5'6" and 250 pounds. she is afebrile with a blood pressure of 119/40; pulse of 56; respiratory rate of 14 and oxygen saturation of 93% on room air. her heent examination is unremarkable. her neck is supple with no jugular venous distention. her lungs are clear to auscultation with no wheezes or rales. her heart is regular in rate and rhythm with a iii/vi systolic ejection murmur loudest at the right upper sternal border that increases with a valsalva. she has a positive s4. her abdomen is obese with good bowel sounds. her groins are clean, dry and intact without bruits. her extremities are with trace pretibial edema and one plus distal pulses bilaterally. laboratory: labs reveal a white count of 9.1, hematocrit of 40, platelet count of 139. her coagulations are within normal limits. her chem-7 shows a sodium of 138, potassium 4.6, chloride 107, bicarbonate 23, bun is 16, creatinine is 0.7. her glucose is 123. her ck went from 62 to 790 to 1055 to 1037. echocardiogram in , showed an ejection fraction of greater than 65% with moderate left atrial dilatation and severe symmetric left ventricular hypertrophy with relative sparing of the inferior wall and one plus mitral regurgitation as well as a sign aortic valve gradient. transesophageal echocardiogram on the showed an ejection fraction of 75 to 80% as well as a hyperdynamic heart. she had no left atrial mass or thrombus but had moderate to severe spontaneous echocardiogram contrast in the left atrial appendage with good left atrial appendage velocity. she had severe symmetric left ventricular hypertrophy without intracavitary change gradient. she had a normal right ventricle and one plus mitral regurgitation. cardiac catheterization this admission revealed normal coronary arteries and a baseline aortic gradient of 50 that decreased to 13 to 15 after receiving 3 cc of alcohol into a single proximal septal perforator off of her left anterior descending. she had a severe increase in her left ventricular end diastolic pressure of 38 to 40 that did not change with the alcohol ablation. angina that she felt during the procedure was relieved with fentanyl. a temporary pacer was screwed into her right ventricle near her right internal jugular. she did not have any episodes of complete heart block. she had a three-beat run of supraventricular tachycardia during the catheterization. her groin was closed with angio-seal. echocardiograms performed during the ablation reveal intense opacity and echogenicity at the basal one-third of the interventricular septum with minimal contractility that progressed to septal akinesis. her other left ventricular segments were within normal limits with regard to wall motion. she had minimal mitral regurgitation. hospital course: miss had chest pain on arrival to the cardiac care unit that was relieved with morphine. it resolved with time. her cks peaked at 1055 and then trended down. she had occasional runs of non-sustained ventricular tachycardia on telemetry throughout her stay. she had no episodes of complete heart block or other conduction problems. it was decided to place an icd in her given her runs of non-sustained ventricular tachycardia as well as her positive family history for sudden cardiac death. this will likely happen in two to four weeks after her infarction has had time to heal. also, given the left atrial appendage echogenicity seen on transesophageal echocardiogram, she was placed on a heparin drip and was started on coumadin as an outpatient to decrease her risk of embolic phenomenon. she was started on aspirin and lopressor for post myocardial infarction medications. she was continued on her sotalol, lasix and verapamil. it is hoped that over the next three to six months that her congestive heart failure symptoms will improve. the temporary pacer was in place for three days and then removed. discharge medications: she was discharged home on her home medications with the addition of: coumadin 5 mg q. h.s. discharge instructions: 1. to follow-up with dr. , her primary care physician in , for follow-up on her anti-coagulation and inr check, her first being tuesday after discharge. 2. she will also follow-up with dr. with regards to her cardiac medications. her inr on discharge was 1.0. 3. an echocardiogram was also done after her procedure which showed an ejection fraction of 60% and a peak resting left ventricular outflow tract gradient of 35. condition at discharge: improved. discharge status: to home. discharge diagnoses: 1. hypertrophic obstructive cardiomyopathy complicated runs of non-sustained ventricular tachycardia, paroxysmal atrial fibrillation, and class iii congestive heart failure status post alcohol septal ablation. 2. hypothyroidism. 3. hypercholesterolemia. , m.d. dictated by: medquist36 procedure: other and unspecified coronary arteriography excision or destruction of other lesion or tissue of heart, endovascular approach insertion of temporary transvenous pacemaker system injection or infusion of other therapeutic or prophylactic substance atrial cardioversion diagnoses: other primary cardiomyopathies atrial fibrillation 

Answer: The patient is high likely exposed to