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: penicillins / tetracycline / sulfa (sulfonamides) / meperidine attending: chief complaint: icd firing major surgical or invasive procedure: vt ablation history of present illness: the patient is an 82 year old with known nonischemic cardiomyopathy (lvef 10-15%), s/p biv icd, caf s/p avn ablation, vt s/p ablation who presents with recurrent vt and icd firings. in , the patient had a biv icd placed, with an ef of 15%, prolonged, qrs, and nyha class 3. the patient represented on with vt storm and icd firing about 8 times. the patient was loaded with amioderone. he then underwent eps and vt ablation. on study, the patient was found to have three vts with rbbb morphology with varying late precordial transition and at least three vts with lbbb morphology were seen. an unstable induced vt with lbbb morphology with superior axis and dominant precordial r waves were induced, which required defibrillation. after the last set of ablation lesions, no inducible vt was seen with single extrastimulus testing. endocardial mapping demonstrated basal posterolateral and apical scar. the patient was discharged on amioderone from that hospitalization. . the patient was intially maintained on amioderone 200mg daily. without reoccurance, that dose was intially decreased to 100mg. a subsequent icd interrogation during the summer of showed two recurrent episodes of vt requiring icd shocks, and the amioderone dose was returned to 200mg. he has remained symptom free, without further icd firings, palpitations, chest pain, or pre-syncope. . over the last 3 weeks, the patient has noted increasing symtpoms of heart failure, with dysnpnea at rest and lower extremity swelling. his lasix dose was uptitrated from 40mg to 80mg , with notable improvement of symptoms, and loss of 5-6lbs of water weight. 6 days prior to presentation, the patient's icd fired. he was instructed by his cardiologist to go the ed if it reoccurred more than 1x per day. the patients icd fired again on thursday and friday, and on follow up with his cardiologist, his amioderone was increased to 200mg . his device fired again on saturday morning. . on the day of presentation, the patient awoke from sleep at 5am and felt light headed. he reports trying to feel his radial artery, but couldn't feel a strong pulse. he felt a shock, and went back to bed. he awoke again at 630 am, with a similar dizzyness, and his device fired for a second time. this happened again at 7am. the patient went to , where he was bolused with amioderone, and started on a gtt. he again went into stable vt, and again his device fired. he was transfered to for further care. . in the ed, the patient remained comfortable and chest pain free. he had another reoccurance of vt, with hr of 150. his blood pressure dropped to 78 systolic. his icd did not fire. he was given atomadate and dccv. he was bolused with lidocaine, and started on a lidocaine gtt. his blood pressures improved to 105/70, and v-paced rhythm 85. the patient is being admitted to the ccu for further care. 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. he had bloody stools three months prior, with a negative gi work up. 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, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors:: dyslipidemia, hypertension 2. cardiac history: with normal coronary arteries -pacing/icd: biv/icd in 3. other past medical history: . cardiomyopathy with ef 15% s/p icd glaucoma macular degeneration, chronic kidney disease ( cr~1.5) atrial fibrillation gastric polyps cataracts macular degeneration l hip osteoarthritis social history: reports no etoh, no tobacco, no drugs. pediatrician family history: no fhx of mi, otherwise non-contributory physical exam: vs: t=96.4 bp=136/64 hr= 85 o2 sat= 99% on 2l general: affable male in nad. oriented x3. mood, affect appropriate. flush in the face. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of cm. cardiac: pmi laterally displaced. rr with occasional pvcs, normal s1, with paradoxially split s2. no m/r. no thrills, lifts. ? + s3 in lldp 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. no abdominial bruits. extremities: 1+ posterior ankle edema, trace pre-tibeal edema. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: laboratory values: . 12:55pm blood wbc-6.4 rbc-4.00* hgb-13.0*# hct-38.2*# mcv-96 mch-32.5* mchc-34.0 rdw-17.1* plt ct-188 12:55pm blood pt-22.7* ptt-25.9 inr(pt)-2.2* . 12:55pm blood glucose-107* urean-70* creat-2.6*# na-143 k-3.6 cl-102 hco3-30 angap-15 04:15pm blood glucose-80 urean-60* creat-2.3* na-145 k-3.7 cl-108 hco3-23 angap-18 . 05:30am blood wbc-5.2 rbc-3.32* hgb-10.7* hct-31.5* mcv-95 mch-32.3* mchc-34.0 rdw-16.5* plt ct-160 05:30am blood pt-23.7* inr(pt)-2.3* 05:30am blood glucose-92 urean-82* creat-2.7* na-141 k-4.0 cl-105 hco3-25 angap-15 05:30am blood calcium-8.7 phos-4.0 mg-2.3 . 12:55pm blood ctropnt-0.08* 12:55pm blood ck(cpk)-61 12:55pm blood calcium-9.6 phos-3.5 mg-2.3 12:55pm blood tsh-10* 06:44am blood t3-68* free t4-0.95 . 12:55pm blood digoxin-2.9* . 04:43am urine color-yellow appear-clear sp -1.010 04:43am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 04:43am urine hours-random urean-605 creat-54 na-39 04:43am urine osmolal-396 . imaging/studies: cxr - no overt pulmonary edema or change in position of the dual pacemaker leads. . echo : the left atrium is elongated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. no masses or thrombi are seen in the left ventricle. overall left ventricular systolic function is severely depressed (lvef= 15-20 %) with global hypokinesis and akinesis to dyskinesis of th inferior and infero-lateral walls. tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). there is no ventricular septal defect. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. the left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . ekg : ventricular paced rhythm. compared to the previous tracing of ventricular premature depolarizations are no longer evident. brief hospital course: 82 y/o male w/ a hx of non-ischemic cm (ef 15%) s/p crt/d, caf s/p av ablation, vt s/p ablation, p/w vt w/ multiple icd firings. # coronaries: the patient has no history of cad with clean coronaries on cath . . # pump: the patient with known non-ischemic cardiomyopathy with an ef of 15%, and reported recent heart failure exacerbation, with described improvement of symptoms from increased diuresis. creatinine inceased from 1.5 baseline to 2.6, which may be the product of over diuresis. diuresis was initially held, however when pt underwent procedure for attempted vt ablation he received ivfs and was felt afterwards to be volume overloaded. he was diuresed over the next two days as blood pressure allowed with moderate responsive in uop to lasix 60mg iv. his home was held in the setting of acute renal failure. b-blocker was continued, but digoxin level was held as his level was supratherapeutic. compression stockings were applied. on , the patient was started on a milrinone drip to improve cardiac output and in particular blood flow to the kidneys. he was maintained on po torsemide 40mg po bid. his milrinone was discontinued on . his spironolactone was also discontinued in the setting of marginally low blood pressure. his valsartan was also discontinued, in the setting of low blood pressure and acute renal failure. his carvedilol was switched to metoprolol because metoprolol was thought to be better at reducing ectopy. your digoxin was discontinued. . # rhythm: patient with history of vt, s/p ablation. patient had been treated with increasing diuresis for hf exacerbation. has been on amiodarone. over last week, has had increasing frequency of icd firings with vt storm over last 24 hrs, with unstable vt in the ed requiring dccv with exernal pads. in af with v-paced rhythm on arrival to the icu and maintained on an amiodarone + lidocaine drip initially. he was brought to the ep for vt ablation at basal, posterolateral lv. vt was temporarily terminated, but patient did have some subsequent vpbs. he was started on po amiodarone and mexiletine with good effect. he then underwent generator change for his pacemaker on without complications. his coumadin was held for several days due to a supratherapeutic inr and was restarted on . he completed a 7 day course of levofloxacin for prophylaxis given penicillin and sulfa allergy. he was scheduled to follow-up with his cardiologist, dr. for device check and follow-up. the patient was discharged on mexilitine, amiodarone, and metoprolol. you should have your inr checked every other day, and coumadin dosed accordingly, with goal inr between . . # arf: on admission, the patient's creatinine up from presumed baseline 1.5 (last ) to 2.6 in the setting of diuresis for hf. all medications were renally dosed, and was held. diuresis was initially held, but resumed in the setting of volume overload. he had moderate response to diuresis with both lasix and torsemide throughout. once started on milrinone, his uop increased and creatinine remained stable at 2.6. his lasix was discontinued and he was continued on torsemide.his valsartan was not continued at discharge. you should have your labs drawn on , prior to your appointment with dr. . . # hypertriglyceridemia: continued fibrate. . # glaucoma: continued latanoprost and brimonidine gtts medications on admission: 1. gemfibrozil 600 mg tablet po bid 2. furosemide 80 mg po bid 3. metoprolol succinate 50 mg po daily 4. valsartan 40 mg po daily 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 8. digoxin 125 mcg po daily 9. warfarin 2.5 mg daily qod without dose on qtues discharge medications: 1. mexiletine 150 mg capsule sig: one (1) capsule po q8h (every 8 hours) as needed for vt. disp:*90 capsule(s)* refills:*2* 2. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 3. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 4. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 5. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed). 6. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. torsemide 20 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. warfarin 2.5 mg tablet sig: one (1) tablet po days (mo,tu,we,th,fr,sa). 10. outpatient work na, k, cl, co2, bun, creatinine, mg, po4, ca, ast, alt, alkaline phosphatase, ptt, pt inr. please draw . please send results to dr. office fax# 11. outpatient work ptt, pt, inr measure qod. goal inr is between . titrate coumadin accordingly. discharge disposition: extended care facility: rehab & nursing center - discharge diagnosis: primary: ventricular tachycardia, acute kidney failure, chronic systolic congestive heart failure secondary: dyslipidemia, hypertension, cardiomyopathy, chronic kidney disease, atrial fibrillation discharge condition: hemodynamically stable, afebrile. discharge instructions: you were admitted to with multiple activations of your icd (cardioversion device) and low blood pressures. you underwent a procedure called vt ablation to help remove a focus of your arrhythmia. however, you continued to have arrhytmia (vt, ventricular fibrillation) in the laboratory. because of this, you were continued on amiodarone and started on mexiletine. you also underwent a generator change for your icd. you hospital stay was complicated by acute renal failure, which stabilized at time of discharge. your valsartan and spironolactone were discontinued secondary to low blood pressure and acute on chronic kidney disease. please discuss with your cardiologist whether you should restart your valsartan and spironolactone. you carvedilol was discontinued and replaced with metoprolol because metoprolol is more effective in minimizing ventricular ectopy. please continue taking metoprolol. your lasix was discontinued and replaced with torsemide for more effective diuresis. please continue taking torsemide. you were discharged home in good condition. should you experience any palpitations, heart flutter, chest pain, dizziness, faintness, recurrent shocks, shortness of breath, or any other symptom concerning to you, please call your cardiologist, dr. or go to the nearest emergency room. followup instructions: you have a follow up with dr. on at 12:45pm . you have a previously scheduled appointment with dr. on at 3pm (). procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach implantation or replacement of cardiac resynchronization defibrillator pulse generator only [crt-d] diagnoses: other primary cardiomyopathies acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation unspecified glaucoma chronic kidney disease, unspecified pure hyperglyceridemia paroxysmal ventricular tachycardia other and unspecified hyperlipidemia atrioventricular block, complete macular degeneration (senile), unspecified long-term (current) use of anticoagulants acute on chronic systolic heart failure osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh personal history of colonic polyps other cataract 

Answer: The patient is high likely exposed to