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: amoxicillin attending: chief complaint: atrial fibrillation, dyspnea, and hypotension major surgical or invasive procedure: pulmonary vein isolation history of present illness: a 66 year old male with pmh dm, hyperlipidemia, and atrial fibrillation is admitted to the ccu with bradycardia and hypotension after pulmonary vein isolation. . he was first diagnosed with atrial fibrillation in and has since undergone two pulmonary vein isolation procedures ( and ) by report, he maintained sinus rhythm from until 11/. at that time, he was treated with electrocardioversion and amiodarone and remained in sinus rhythm until and was treated again with dc cardioversion and again entered atrial fibrillation. while in atrial fibrillation, patient is symptomatic with dyspena and decreased exercise tolerance. after discussion with his primary cardiologist, dr. , the patient decided to undergo repeat pulmonary vein isolation, amiodarone was discontinued and his metoprolol dose was increased. . the patient was taken to the ep lab for pulmonary vein isolation. radiofrequency ablation was performed, targeting the right artium and the right inferior, superior pulonary vein, and carotid sinus and atrial fibrillation persisted. he was treated with dc electrocardioversion. he became bradycardic to 40 and hypotensive to sbp 79, a temporary pacer wire was placed and he was started on pheynlephrine and dopamine and admitted to the ccu. . he was received in the ccu off phenylephrine and dopamine, vitals were t:97.9 bp:135/61 p:67 sao2 96% on simple face mask. he complained of mild pain at the right cath site and nausea which had improved after receiving zofran in the procedure. . on review of systems, he denied headache, cough, dyspnea, fever/chills. denied abdominal pain, diarrhea. cardiac review of systems is notable for absence of chest pain, dyspnea, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, or presyncope. . past medical history: 1. cardiac risk factors: (+)diabetes, (+)dyslipidemia, (-)hypertension 2. cardiac history: possible silent imi early 's atrial fibrillation since - cabg: none - percutaneous coronary interventions: pulmonary vein isolation and - multiple cardioversions for atrial fibrillation - pacing/icd: 3. other past medical history: sleep apnea -recently started using cpap anemia basal cell cancer s/p excision remote kidney stones bilateral sacroiliitis vitamin b12 deficiency mrsa . surgical history back surgery right shoulder surgery cholecystectomy right wrist surgery after a fracture (plate) gastric bypass surgery . social history: lives with wife - history: quit 30 years ago - etoh: drinks/week - illicit drugs: denies family history: father mi age 40's paternal uncle mi grandmother dm physical exam: admission physical exam: t:97.9 bp:135/61 p:67 sao2 96% on simple face mask. general: middle aged male laying supine and in nad heent: mucous membs dry, jvp difficult to appreciate given body habitus cardiac: s1, s2, soft systolic murmur at the lusb with radiation to the rusb. lungs: equal air entry bl, no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: overweight, soft, ntnd. bs normoactive extremities: left venous sheath in place, c/d/i pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ discharge physical exam: tc 98.2, bp: 90-120s/40-60s, hr: 60-140s, rr: 18, 95% and at least 200ml urine out jvp: flat cardiac: irregularly irregular rate and rhythm. sytolic murmur lungs: ctab abdomen: obese, non-tender, + bowel sounds extremities: 1+ pitting edema bilaterally pertinent results: admission: 11:25am blood wbc-4.8 rbc-3.94* hgb-12.7* hct-36.9* mcv-94 mch-32.2* mchc-34.3 rdw-15.2 plt ct-183 11:25am blood glucose-88 urean-24* creat-1.2 na-143 k-4.2 cl-107 hco3-28 angap-12 05:30am blood calcium-8.7 phos-4.0 mg-2.1 discharge: microbiology: urine culture pending tte (): the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the aortic arch is mildly dilated. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are moderately thickened. there is mild aortic stenosis. there is no aortic egurgitation. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with borderline normal systolic function. severe pulmonary hypertension. mild right ventricular dilation with low normal function. moderate tricuspid and mild-to-moderate mitral regurgitation. mild aortic stenosis. compared with the prior study (images reviewed) of , regional left ventricular systolic dysfunction is less apparent but image quality is poorer. the severity of pulmonary hypertension has increased. ct angio chest (): final report pending at the time of discharge 1. there is no ct evidence of pulmonary emboli in the main and segmental branches; however, due to suboptimal contrast opacification in the subsegmental vessels, the assessment of pulmonary emboli in these vessels is limited. 2. non-specific subpleural reticulation in the bilateral lung bases. these findings are stable since and can occasionally be seen in older individuals with normal pulmonary function. if the patient is experiencing dyspnea or dry cough, consider correlative pft's. 3. smooth septal lines in the bilateral lung bases suggesting hydrostatic edema. 4. a tiny calcified granuloma in right upper lobe. 5. sever calcification of aortic valve. coronary artery calcifications. . discharge labs: 06:05am blood wbc-6.4 rbc-3.17* hgb-10.2* hct-29.4* mcv-93 mch-32.1* mchc-34.6 rdw-14.9 plt ct-104* 06:05am blood pt-22.6* ptt-28.1 inr(pt)-2.1* 06:05am blood glucose-194* urean-27* creat-1.0 na-140 k-3.7 cl-104 hco3-26 angap-14 brief hospital course: primary reason for admission: a 66 year old male with pmh dm, hyperlipidemia, and atrial fibrillation is admitted to the ccu with bradycardia and hypotension after pulmonary vein isolation (pvi). . active diagnoses: . # atrial fibrillation: patient with history of multiple pvis and has been treated previously with amiodarone, qunidine and atrial fibrillation continued. pt was initially in sinus s/p most recent pvi, but went back into a-fib prior to discharge. it is expected that atrialfibrillatio may return <30 days after pvi, continued monitoring will be needed to determine efficacy of pvi. patient was therapeutic on coumadin throughout his hospital course. he will follow up with dr. . . # hypotension: following the pvi proceedure, patient was hypotensive which was likely related to myocardial stunning vs systemic inflammatory response to pvi. he was treated with intervenous dopamine which was weaned after one day. . # pulmonary hypertension: post proceedure tte demonstrated new severe pulmonary hypertension and 2+ tr (60mmhg gradient) which was not present on tee 1 day prior. cta was performed to r/o pe, and the preliminary read was negative for pe. pt has been therapeutic on warfarin since admission, making pe highly unlikely. final read of cta was pending at the time of discharge, but was added to the results section of this summary after discharge. . # uti: at the time of discahrge, pt was complaining of dysuria. it was unclear if this was due to recent removal of his foley or uti, so ua and cultures were done prior to discahrge. the day after discharge his urine grew >100,000 proteus mirabilis sensitive to . the patient was notified and told to take antibiotics that were called into his pharmacy. a 7 day course of 500mg po bid was odered. . chronic diagnoses: . # sleep apnea: recently started on cpap at home, and was continued on cpap while in house. . # dyslipidemia: cholesterol from : tc 161, tg 109, hdl 46, ldl 104. pt was continued on his home statin throughout this hospitalization. . # dm: hga1c on was 6.7. pt's home lantus was continued and he was covered on ssi during this hospitalization. . # acne: pt's home doxycycline was continued. . transitional issues: pt was discahrged home with cardiology, hematology and heme-onc follow up. his is independent in his adls. he should follow up the final read of his cta with his pcp. was called into his pharmacy and the patient was notified of the need to take all antibiotics as prescribed. medications on admission: clonazepam prn muscle cramps cyanocobalamin (vitamin b-12) - 500 mcg 1 spray(s) nasal q month doxycycline monohydrate - 100 mg furosemide - 20 mg qam insulin glargine 22 units at bedtime insulin glulisine 15-20 units with meals per sliding scale metoprolol succinate - 100 mg qhs naproxen - 250 mg qam pramlintide - 2,700 mcg/2.7 ml pen injector - 120mcg with each meal pravastatin - 10 mg daily spironolactone - 25 mg tablet daily warfarin - 6mg daily ascorbic acid 1,000 mg aspirin - 81 mg tablet, daily cholecalciferol (vitamin d3) - 1,000 unit coenzyme q10 - 300 mg capsule ferrous sulfate - 325 mg (65 mg iron) glucosamine-chondroitin - dosage uncertain multivitamin - 1 tab daily omega-3 fatty acids-vitamin e - 1,000 mg discharge medications: 1. clonazepam 1 mg tablet sig: one (1) tablet po prn as needed for anxiety. 2. cyanocobalamin (vitamin b-12) 500 mcg spray, non-aerosol sig: one (1) spray nasal once a month. 3. doxycycline monohydrate 100 mg tablet sig: one (1) tablet po twice a day. 4. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 5. insulin glargine 100 unit/ml solution sig: twenty two (22) untis subcutaneous at bedtime. 6. insulin glulisine 100 unit/ml solution sig: 15-20 units subcutaneous tid with meals. 7. naproxen 250 mg tablet sig: one (1) tablet po daily (daily). 8. symlinpen 120 2,700 mcg/2.7 ml pen injector sig: one hundred twenty (120) mcg subcutaneous tid with meals (). 9. pravastatin 10 mg tablet sig: one (1) tablet po daily (daily). 10. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 11. warfarin 6 mg tablet sig: 0.5-1 tablet po once a day: per . 12. ascorbic acid 1,000 mg tablet sig: one (1) tablet po bid (2 times a day). 13. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 14. cholecalciferol (vitamin d3) 1,000 unit capsule sig: one (1) capsule po once a day. 15. coenzyme q10 300 mg capsule sig: one (1) capsule po once a day. 16. ferrous sulfate 325 mg (65 mg iron) capsule, extended release sig: one (1) capsule, extended release po bid (2 times a day). 17. glucosamine-chondroitin 750-600 mg tablet sig: two (2) tablet po twice a day. 18. multivitamin tablet sig: one (1) tablet po once a day. 19. fish oil 1,000 mg capsule sig: one (1) capsule po bid (2 times a day). 20. metoprolol succinate 50 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: - atrial fibrillation status post pulmonary vein isolation secondary: - type ii diabetes on insulin - anemia - dyslipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you came to our hospital for a pulonary vein isolation procedure to treat your atrial fibrillation. your atrial fibrillation was coverted to normal sinus rhythm by electrocardioversion. however, your heart rate and blood pressure dropped significantly. we temporarily placed a pacing device to maintain your heart rate and sent you to our cardiac care unit for intensive monitoring and treatment of your low blood pressure. you recovered very well, and we are able to gradually withdrawal supportive treatment eventually. we have made the following changes to your medication: - decrease dose of metoprolol succinate to 50 mg by mouth daily we have made a follow up appointment for you with dr. and dr. . please read below for specific instructions. it has been a great pleasure to take care of you here at . we wish you a speedy recovery. followup instructions: 1. cardiology department: cardiac services when: monday at 9:20 am with: , m.d. building: sc clinical ctr campus: east best parking: garage 2. cardiology - electrophysiology provider: . date/time: , 3:20 pm building: sc clinical ctr campus: east best parking: garage 3. primary care name: , a. f. location: healthcare - address: one pearl st, , , phone: when: thursday, :30am 4. hematology department: hematology/oncology when: monday at 9:30 am with: , md building: campus: east best parking: garage department: hematology/oncology when: monday at 9:30 am with: , np building: sc clinical ctr campus: east best parking: garage procedure: excision or destruction of other lesion or tissue of heart, endovascular approach diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial flutter other and unspecified hyperlipidemia other specified cardiac dysrhythmias hypotension, unspecified long-term (current) use of insulin 

Answer: The patient is high likely exposed to