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: the patient is a 55-year-old female with a past medical history significant for atrial fibrillation of unknown duration and atrial septal defect who was admitted for a heart block following cardioversion. the patient has a history of atrial fibrillation noted by her primary care physician in - previous duration is unknown. she was referred to dr. for further evaluation. he started the patient on a beta blocker, and ace inhibitor, and also anticoagulated her on coumadin with plans for cardioversion. the patient was admitted on for a transesophageal echocardiogram and direct current cardioversion. the patient successfully underwent to direct current cardioversion; however, following this, she had a 15-second pause in her heart beat and a subsequent junction rhythm at 38 beats per minute to 40 beats per minute. she was given atropine, dopamine, and isoproterenol with an increase in her junctional rhythm to the 60s. she was continued on an isoproterenol drip with her heart rate remaining stable in the 60s; still junctional. the patient denied any dizziness, or shortness of breath, or chest pain with this. she was transiently hypotensive with a systolic blood pressure in the 70s immediately following her bradycardia; however, this quickly resolved. she was then transferred to the coronary care unit for further monitoring. past medical history: 1. atrial fibrillation of unknown duration. 2. atrial septal defect. medications on admission: (home medications included) 1. coumadin 3.5 mg by mouth once per day. 2. prilosec. 3. remeron 4. atenolol 25 mg by mouth once per day. 5. lisinopril 2.5 mg by mouth once per day. allergies: amoxicillin and sulfa. social history: no tobacco use. alcohol use revealed one glass of wine per month. physical examination on presentation: physical examination revealed the patient's temperature was 98.8 degrees fahrenheit, her blood pressure was 120/57, her heart rate was 64, her respiratory rate was 18, and her oxygen saturation was 93% to 100% on room air. in general, a pleasant and well-developed female in no acute distress. head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light. the extraocular movements were intact. the oropharynx was clear. cardiovascular examination revealed bradycardia with a regular rhythm. there were no murmurs, rubs, or gallops. the lungs were clear to auscultation bilaterally. the abdominal examination revealed positive bowel sounds. the abdomen was soft, nontender, and nondistended. extremity examination revealed no edema or cyanosis. neurologic examination revealed no focal deficits. pertinent laboratory values on presentation: laboratories revealed the patient's white blood cell count was 6.9, her hematocrit was 36.3, and her platelets were 247. her prothrombin time was 19.1, her partial thromboplastin time was 29.1, and her inr was 2.4. pertinent radiology/imaging: electrocardiogram revealed a junctional rhythm at a rate of 54 with retrograde p waves. left axis. no st changes. concise summary of hospital course by issue/system: 1. cardiovascular issues: (a) coronary artery disease: the patient with no known history of coronary artery disease. she had no chest pain or ischemic symptoms during her hospitalization. (b) pump: the patient with impaired systolic function. a recent echocardiogram revealed global left ventricular dysfunction with an ejection fraction of 40% to 50%. on a beta blocker and ace inhibitor as an outpatient; however, these were held following her admission, in the setting of her dysrhythmia and her pause following direct current cardioversion. following pacemaker placement, she was placed back on a beta blocker which was titrated up. this was tolerated well. (c) rhythm: the patient with a history of atrial fibrillation of unknown duration who was admitted for a transesophageal echocardiogram and direct current cardioversion. her transesophageal echocardiogram showed no thrombi, and she was successfully cardioverted. however, following this, she went into sinus asystole with a pause of approximately 15 seconds and then recovered with a junctional rhythm in the 40s. this was thought to be due to severe sinus node dysfunction given her long-term atrial fibrillation. the patient was initially started on isoproterenol and monitored to see if her sinus function recovered. she was observed in the unit for close monitoring. the patient's sinus function did not recover, and she continued to be in a junctional rhythm. following several days without any recovery of function, the decision was made to place a pacemaker. the pacemaker was placed on . she then underwent repeat direct current cardioversion. following this, the patient was a-paced with a rate in the 70s. she was started on sotalol which was titrated up to a dose of 80 mg by mouth twice per day. she was also started on coumadin and had followup scheduled in the device clinic. the patient was admitted on coumadin per her home regimen for her atrial fibrillation. her inr was supratherapeutic on admission, and her heparin was initially held. following her pacemaker placement, the patient was restarted on coumadin with a plan to follow up in the clinic for monitoring of her inr. 2. gastroesophageal reflux disease issues: the patient was admitted with a history of gastroesophageal reflux disease and was maintained on a proton pump inhibitor per her home regimen. 3. psychiatric issues: the patient with a diagnosis of depression. the patient was continued on remeron per her outpatient regimen. 4. fluids/electrolytes/nutrition issues: the patient was maintained on a cardiac diet which she tolerated well. her electrolytes were followed throughout her hospitalization. condition at discharge: condition on discharge was stable. discharge status: discharge status was to home. medications on discharge: 1. sotalol 80 mg by mouth twice per day. 2. pantoprazole 40 mg by mouth q.24h. 3. remeron 15 mg by mouth at hour of sleep. 4. clindamycin 600 mg by mouth q.8h. (times one week). 5. coumadin 4 mg by mouth once per day. the patient was instructed to discontinue aspirin when her inr is therapeutic at 2. discharge instructions/followup: 1. the patient was instructed to follow up in the device clinic on . 2. the patient was instructed to follow up as scheduled with dr. and her primary care physician. , m.d. dictated by: medquist36 procedure: diagnostic ultrasound of heart initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle atrial cardioversion atrial cardioversion artificial pacemaker rate check diagnoses: other iatrogenic hypotension coronary atherosclerosis of native coronary artery esophageal reflux cardiac complications, not elsewhere classified atrial fibrillation dysthymic disorder other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure sinoatrial node dysfunction heart disease, unspecified 

Answer: The patient is high likely exposed to