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: vt ablation major surgical or invasive procedure: percutaneous ablation of vt focus history of present illness: 65 yo m w/ pmh of cad s/p anterior and inferior mi, ischemic cardiomyopathy with ef of 30% (), atrial fibrillation (on dofetilide and coumadin), ventricular tachycardia (s/p icd placement with multiple icd shocks), dm ii who was admitted to the cath lab today for vt ablation. patient has a prolonged history of vt starting in with monomorphic vt and s/p icd placement then. since placement he has been shocked multiple times, once for atrial tachycardia and most recently in for sustain monomorphic vt in the setting of grocery shopping and it was nonresponsive to antitachycardia pacing at 188. he has since developed post-traumatic stress disorder due to the multiple shocks. he has been previously treated for his afib with amiodarone however developed transaminitis and therefore was switched to dofetilide. he was evaluated by dr. as an outpatient who recommended a trial of vt ablation in the cath lab. today the patient underwent vt ablation with ablation around the inferior scar where he had 2 inducible pathways. his course was complicated by poor lv function in the cath lab and required placement of an impella. on arrival to the floor the patient had already had the impella device removed. he was alert and interactive, slightly confused. he denied chest pain or difficulty breathing and reported that he would like to talk with his wife. on review of systems, 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, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: #cad s/p ami and imi (remote) #ischemic systolic heart failure with ef of 25% () #moderate mr #atrial fibrillation- has been trialed on amiodarone however failed transaminitis, currently on dofetilide #ventricular tachycardia- diagnosed in with monomorphic vt with r axis at cycle length of 340msec. ed visit for monomorphic vt at a rate of 188 beats per minute that failed to terminate with two atp therapies and required an icd shock #s/p dual chamber icd placed () in and generator replaced in #ptsd from icd shocks #diabetes mellitus #htn #hlp #gout #gave- with gi bleed in s/p cauterization social history: spanish speaking. originally from . jehovah's witness and does not accept tranfusions. separated from his wife & lives alone. wife will accompany to procedure via the ride. family history: + h/o heart disease physical exam: admission physical exam vs: t 96.0, bp 120s/60s, hr 79-83, rr 13, o2 sat 100% 4l nc general: nad. oriented x1 person only. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: unable to sit up due to groin sites, jvd not seen lying flat cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no murmurs, + s3. no thrills, lifts. lungs: no chest wall deformities, scoliosis or kyphosis. 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. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: aaox1, cnii-xii intact, 5/5 strength biceps, triceps, knee/hip flexors/extensors . discharge physical exam: afebrile, bp 100-130s/80s, hr 80s, saturations 100% ra exam unchanged pertinent results: admission labs: 07:42am blood wbc-7.3 rbc-4.01* hgb-11.5* hct-33.4* mcv-83 mch-28.6 mchc-34.4 rdw-18.6* plt ct-194 07:42am blood pt-17.1* inr(pt)-1.6* 07:42am blood glucose-179* urean-17 creat-1.1 na-123* k-5.6* cl-90* hco3-25 angap-14 pertinent reports: cardiovascular c.cath technical anesthesia: local and general specimens: none estimated blood loss: <50 cc interventional details: the primary operator was dr. with dr. as the secondary operator proctoring the case. obtained access in the left common femoral artery. inserted a 6 french sheath and using a "preclose technique" two perclose at devices were deployed without complication after an initial perclose needles did not capture. antiiotics were preadministered. the sheath was exchanged for the 13 french impella sheath. an -1 catheter was used to cross into the lv using a straight wire. the catheter was then used to exchange for the 0.18" abiomed impella delivery wire with an appropriate curve to avoid trauma to the lv apex. the impella device was inserted without incident and with a flow of 2.0 l on p8. the vt ablation was completed (see separate report). the impella device was removed. the sheath was then removed and the perclose sutures cinched down acheiving complete hemostasis. the patient tolerated the procedures including impella removal, without complication. cta abdomen and pelvis preliminary read: no retroperitoneal hematoma discharge labs: 05:50am blood wbc-8.3 rbc-2.94* hgb-8.6* hct-25.1* mcv-85 mch-29.3 mchc-34.5 rdw-18.3* plt ct-132* 05:50am blood pt-40.2* ptt-32.6 inr(pt)-3.9* 02:31pm blood ret aut-1.5 05:50am blood glucose-122* urean-16 creat-1.1 na-129* k-4.1 cl-97 hco3-28 angap-8 02:31pm blood ld(ldh)-272* totbili-0.3 05:50am blood calcium-8.3* phos-2.5* mg-1.8 02:31pm blood hapto-43 brief hospital course: principle reason for admission mr. is a 65 year old male with history of ischemic systolic heart failure (lvef 30%) and recurrent monomorphic vt s/p icd who presents to the ccu s/p vt track ablation in the ep lab. he transiently had an impella device placed during the vt ablation of his inferior wall scar. he tolerated the procedure well and was transferred to the ccu for close monitoring. active problems # ventricular tachycardia (vt) s/p icd: his vt has been monomorphic and he had inducible vt in 2 places around his inferior wall scar. he underwent icd implantation in and he has been shocked multiple times over the years with post-traumatic stress syndrome as a result. he underwent ablation of these tracts in the ep lab on with transient use of impella device. he tolerated the procedure well and was transferred to the ccu for further monitoring. dofetilide was restarted on transfer at home dose 500 mg and patient was noted to be comfortable and appropriately atrially paced throughout his stay. # hyponatremia: na low at 123 on admission. improved to 130 later in the day and was 133 morning after procedure without intervention. drifted back down. appeared euvolemic so likely related to heart failure. chronic problems # cad: patient with history of ami and imi with resultant heart failure and icd placement. he denied chest pain and ekg was without evidence of ischemia. we continued valsartan 80 mg , carvedilol 25 mg , and atorvastatin 40mg daily. he is not on antiplatelet therapy due to history of gib. # chronic systolic heart failure: due to cad as above, last lvef 30% in , and he is s/p icd placement in . he had no evidence of decompensation. we continued his valsartan 80mg , carvedilol 25mg , lasix 40mg daily and spironolactone 25mg daily. # afib: continued patient's dofetilide and carvedilol. he was noted to be atrially paced during his stay. warfarin was held prior to ablation, and was restarted following procedure. # htn: well controlled during stay, continued home antihypertensive regimen. # hld: continued atorvastatin 40 mg daily. # diabetes: on metformin at home, a1c consistently in the 7s. metformin was held during stay and insulin sliding scale was used. he was restarted on metformin on discharge. transitional issues: - f/u with cardiology about icd device checks medications on admission: ammonium lactate - 12 % cream - apply to feet twice a day atorvastatin - 40 mg tablet - 1 tablet(s) by mouth once a day for cholesterol benzonatate - 200 mg capsule - 1 capsule(s) by mouth four times a day as needed for cough carvedilol - 25 mg tablet - 1 (one) tablet(s) by mouth twice a day clonazepam - 1 mg tablet - 1 tablet(s) by mouth one in am, and 2 qhs as needed for anxiety dofetilide - (not taking as prescribed: put on hold as of ) - 500 mcg capsule - 1 capsule(s) by mouth q 12 h econazole - 1 % cream - apply to rash on back and chest x 6 weeks disp at least 60gram tube fluticasone - 50 mcg spray, suspension - 1 puff each nostril once a day for allergies/running nose furosemide - 40 mg tablet - 1 tablet(s) by mouth once a day for swelling and blood pressure metformin - 500 mg tablet - 1 tablet(s) by mouth twice a day for diabetes (also called glucophage) pantoprazole - 40 mg tablet, delayed release (e.c.) - 1 (one) tablet(s) by mouth once a day generic fine spironolactone - 25 mg tablet - 1 tablet(s) by mouth q o d triamcinolone acetonide - 0.1 % ointment - apply twice daily to affected areas for up to 2 weeks/month max twice a day as needed for avoid face and folds valsartan - 80 mg tablet - 1 tablet(s) by mouth twice a day warfarin - (prescribed by other provider) - 2 mg tablet - 1 tablet(s) by mouth as directed last dose pre procedure thurs inr 3.5 friday medications - otc blood sugar diagnostic - strip - test twice a day multivitamin - tablet - 1 tablet(s) by mouth once a day peg 400-propylene glycol - (not taking as prescribed: ran out) - 0.3 %-0.4 % drops - 1 drop(s) each eye three times a day sennosides-docusate sodium - 8.6 mg-50 mg tablet - 1 or 2 tablet(s) by mouth at bedtime as needed for constipation discharge medications: 1. atorvastatin 40 mg po daily 2. carvedilol 25 mg po bid please hold for sbp < 90, hr < 50 3. dofetilide 500 mcg po q12h chronic dose. does not need ecg 2 hours after each dose 4. furosemide 40 mg po daily please hold for sbp < 90 5. spironolactone 25 mg po daily please hold for sbp < 90 6. valsartan 80 mg po bid please hold for sbp < 90 7. metformin (glucophage) 500 mg po bid 8. clonazepam 1-2 mg po bid:prn anxiety or insomnia take 1 tab in the morning or 2 tabs at night as needed for anxiety or insomnia 9. pantoprazole 40 mg po q24h 10. fluticasone propionate nasal 1 spry nu daily 11. multivitamins 1 tab po daily 12. senna 1 tab po daily:prn constipation 13. warfarin 2 mg po daily16 start: in am discharge disposition: home discharge diagnosis: primary diagnosis: ventricular tachycardia secondary diagnosis: coronary artery disease heart failure hypertension dyslipidemia diabetes anxiety discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you were admitted to the hospital for a procedure to help prevent dangerous heart rhythms. you tolerated the procedure well and were monitored closely in the icu and on the cardiology floor afterwards. you are now ready to go home. we made one change to your medications: hold your coumadin for today and tomorrow. resume your usual dose of coumadin on saturday and otherwise continue all your other medications as previously prescribed. it is important to follow up with your regular doctors as we have scheduled below. it has been a pleasure taking care of you! for your heart failure diagnosis: weigh yourself every morning, md if weight goes up more than 3 lbs in 3 days or 5 lbs in 2 days, follow a low salt diet. followup instructions: department: cardiac services when: wednesday at 10:00 am with: device clinic building: sc clinical ctr campus: east best parking: garage department: cardiac services when: wednesday at 10:30 am with: , np building: sc clinical ctr campus: east best parking: garage department: internal medicine when: thursday at 9:45 am with: , md building: (, ma) campus: off campus best parking: free parking on site :20 dr. () md procedure: other electric countershock of heart catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach cardiac mapping insertion of percutaneous external heart assist device diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia atrial fibrillation paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia old myocardial infarction chronic systolic heart failure automatic implantable cardiac defibrillator in situ posttraumatic stress disorder 

Answer: The patient is high likely exposed to