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: palpitations major surgical or invasive procedure: none history of present illness: 66 yof with h/o alcohol use, afib on coumadin, systolic chf with ef 30%, htn, presented with palpatation x3 days, worsening dyspnea with exertion, increased peripheral edema with abdminal ascites over past week. reports difficulty sleeping due to dyspnea and palpatations, sleeping recumbant on 1 pillow. speaks full sentences in ed in no obvious respiratory distress. recently decreased her verapamil to 120 daily, questionable if pcp is . has not had a drink since late . . in the ed, patient's hr in 130s in afib with good bps. given 10mg iv dilt x2. admitted to for diuresis and rate control. . on floor, patient was found resting in bed. became tearful with discussing regarding her medical condition. . on review of systems, she 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 paroxysmal nocturnal dyspnea, orthopnea, syncope or presyncope. . past medical history: cardiac risk factors: diabetes, + dyslipidemia, + hypertension . cardiac history: cabg: none percutaneous coronary intervention: none pacemaker/icd: none social history: she is divorced, lives with her son. she works with historical manuscripts. she does smoke two packs of cigarettes a day. was drinking 10 glasses of wine per day but quit four month ago. no recreational drugs, does not do any regular exercise, or follow a particular diet. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: vs - 97.7 112/83 84 18 99% 3l nc gen: wdwn middle aged female in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 10 cm. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. murmur no r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. poor air movement, decreased breath sound b/l, wet crackles on right base, no wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: 03:05pm blood wbc-5.8 rbc-4.15* hgb-12.9 hct-39.0 mcv-94 mch-31.1 mchc-33.1 rdw-13.8 plt ct-202 05:40am blood wbc-6.4 rbc-4.06* hgb-12.7 hct-38.6 mcv-95 mch-31.4 mchc-33.0 rdw-14.7 plt ct-195 03:05pm blood pt-42.1* ptt-39.6* inr(pt)-4.5* 05:40am blood pt-18.4* ptt-42.8* inr(pt)-1.7* 03:05pm blood glucose-105* urean-16 creat-0.9 na-134 k-3.1* cl-98 hco3-23 angap-16 05:40am blood glucose-95 urean-18 creat-1.0 na-138 k-3.7 cl-97 hco3-29 angap-16 03:05pm blood alt-10 ast-25 alkphos-59 totbili-1.5 03:30am blood alt-11 ast-19 ld(ldh)-174 alkphos-47 totbili-1.3 03:05pm blood ctropnt-0.02* probnp-* 12:06am blood ck-mb-4 ctropnt-0.02* 08:15am blood ck-mb-3 ctropnt-0.01 12:06am blood calcium-9.2 phos-4.3 mg-2.2 05:40am blood calcium-9.3 phos-3.9 mg-1.5* 03:30am blood tsh-2.0 03:05pm blood greenhd-hold 12:19pm urine hours-random urean-502 creat-202 na-25 k-74 cl-47 12:19pm urine rbc-0-2 wbc-0-2 bacteri-rare yeast-none epi- 12:19pm urine blood-neg nitrite-neg protein-25 glucose-neg ketone-tr bilirub-neg urobiln-4* ph-5.0 leuks-neg 12:19pm urine color-amber appear-clear sp -1.018 2d-echocardiogram performed on demonstrated: l atrium dilation. moderate global left ventricular hypokinesis (lvef = 30-35%). rv moderately dilated with moderate global free wall hypokinesis. no as or ar. moderate to severe (3+) mr, moderate to severe tr. the estimated pulmonary artery systolic pressure is normal. small pericardial effusion with no signs of tamponade. cardiology echo no mass/thrombus is seen in the left atrium or left atrial appendage. mild spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). no spontaneous echo contrast or thrombus is seen in the body of the right atrium or the right atrial appendage. no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is moderately depressed (lvef= 30 %). right ventricular chamber size is normal. with moderate global free wall hypokinesis. there are simple atheroma in the descending thoracic aorta and aortic arch. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is a small pericardial effusion, most prominent near the inferior wall. there are no echocardiographic signs of tamponade. impression: mild left atrial appendage spontaneous echo contrast with depressed ejection velocities. no left atrial/appendage thrombus seen. hypokinetic lv with moderate mitral regurgitation. brief hospital course: 66 yof with afib on coumadin, systolic chf with ef 30%, htn, who presented with palpatations and found to be in afib with rvr, and heart failure, treated in the ccu with dopamine drip for hypotension/bradycardia likely associated to iv diltiazem + other nodal agents. tee and dccv planned for . . mrs had episode of hypotension secondary to low cardiac output in the setting of bradycardia as the result of multiple nodal agents for rvr control (received 40 iv dilt + 20 po dilt + home metoprolol + 240 verapamil cr). she had a repeat echo showed small pericardial effusion, ef stable (ef 30-35%) with 3+ mr, 3+ tr. she was transiently maintained on dopamine, amiodarone, atropine, calcium gluconate. antihypertensives were held. she was continued on amiodarone and started on metoprolol for her atrial fibrillation. she was diuresised aggressively and was placed on standing lasix for her heart failure. she underwent dccv after tee, after which she was in sinus rhythm. after the cardioversion, she was discharged in stable condition with significant modification in her medications. she will follow up with her pcp and cardiologist. . # code status: presumed full medications on admission: hydrochlorothiazide 12.5 mg a day cozaar 50 mg a day metoprolol succinate 50 mg a day verapamil 240 mg a day warfarin discharge medications: 1. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. disp:*20 tablet(s)* refills:*0* 2. amiodarone 200 mg tablet sig: one (1) tablet po once a day: please start after you have completed the 10 day course of twice a day dosing. disp:*30 tablet(s)* refills:*2* 3. warfarin 2 mg tablet sig: one (1) tablet po once daily at 4 pm. disp:*30 tablet(s)* refills:*2* 4. furosemide 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*2* 6. outpatient lab work chem10 (na/k/co2/cl/bun/cr/ca/mg/phos/glucose), coagulation (pt/inr) and send to pcp , fax: discharge disposition: home with service facility: discharge diagnosis: congestive heart failure atrial fibrillation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you came with heart failure and were in atrial fibrillation. you were treated with diuresis and given medication to control your heart rate. we were able to help you get rid of fluids to make you feel much better. you were discharged in stable condition. please follow up with the following doctors. please note we have made the following changes to your medications. stopped: hydrochlorothiazide 12.5 mg a day cozaar 50 mg a day metoprolol succinate 50 mg a day verapamil 240 mg a day warfarin 5mg a day started: 1. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. 2. amiodarone 200 mg tablet sig: one (1) tablet po once a day: please start after you have completed the 10 day course of twice a day dosing. 3. warfarin 2 mg tablet sig: one (1) tablet po once daily at 4 pm. 4. furosemide 40 mg tablet sig: one (1) tablet po once a day. 5. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. it was a pleasure taking care of you. we wish you a speedy recovery. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: provider: . phone: date/time:friday 2:30pm. provider: , md phone: date/time: 10:15; . pcp : , . , 4w, , . date/time: 3:30pm. new pcp if you prefer: provider: , md phone: date/time: 2:35 md procedure: diagnostic ultrasound of heart diagnoses: other primary cardiomyopathies other iatrogenic hypotension mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation alcohol abuse, unspecified other and unspecified hyperlipidemia other specified cardiac dysrhythmias long-term (current) use of anticoagulants acute on chronic systolic heart failure unspecified vitamin d deficiency tricuspid valve disorders, specified as nonrheumatic coronary vasodilators causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to