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: lightheadedness major surgical or invasive procedure: permanent pacemaker placement history of present illness: 71yo man with h/o cad s/p cabg, a fib s/p mult cardioversions and recent pulm vein isolation, htn, hyperchol, dm2, tobacco, who p/w c/o lightheadedness this am. the pt awoke in his usoh, ate breakfast and minutes later developed lightheadedness and the feeling that he was going to faint. he was seated at the time and not doing anything particularly strenuous. the pt took his pulse and noted it to be about 40bpm. he denies any feeling of vertigo, any n/v, sob, cp, palps, jaw pain, diaphoresis. the pt called the ems, was biba to ed where hr 38 and sbp 131/50. he was given ivf and began to feel relief at that time. on questioning, the pt reports that he has felt similar feelings of lh in the past few months, lasting sometimes for minutes and rarely for hours. his most recent prior episode was 3d pta while performing non-strenuous yard work. he has not been able to correlate the feelings with any activity that he has been performing. he did not seek medical attention in the past because he felt that it was "self-correcting." he does not recall an association with eating, exertion, defacation, or micturition. no recent medication changes except extra lasix due to weight gain 4 days pta. no wt gain, wt loss, anorexia, fevers or chills. feels otherwise well. no sick contacts. the patient also reports that, though he exercises about a half hour each day, he has noticed that he is "laboring more" since his pulm vein isolation in . he says he is not sob,just "working harder" with exercise. ros: above as well as reports lgib/brbpr 3 weeks ago from "hemorrhoids" stopped with ice packs. no melena, dysuria, or hematuria. past medical history: coronaries: cad s/p mis, cabg (svbg at out of state hospital) in ' pump: chf ef 45-50% severe inferior hk, htn echo, lae; ; no asd; lv wall thicknesses and cavity size are normal; lvef 50%; rv chamber size and free wall motion are normal; simple atheroma in the aortic root, ascending aorta, aortic arch, and descending thoracic aorta; aortic valve leaflets (3) are mildly thickened; trace ar; mv structurally normal with trivial mr; no pericardial effusion. rhythm: a fib x 20yrs, multiple cardioversions, a flutter, a fib ablations, pulm vein ablation , on dofetilide and coumadin (taken off amio for lung dz) hyperlipidemia ldl >100; cva b/l lacunar ' with residual left paresthesias and gait dysfunction; dm2 >10yrs; osa on cpap; colon polyps, diverticulosis,ugib/lgib, hemorrhoids; etoh: loves many martinis, fatty liver, hsm; cri with baseline creat 2.3 ?htn/dm/gn; left ear deafness; h/o scarlet fever; 45 pk-y smoking hx quit in '; oa; gout social history: retired medical products salesman, lives with wife, drinks wine and a few martinis daily, smoked previosly as stated above, no illicits family history: dm2 physical exam: vitals in ed: 98 108/44 54 16 97% on 2l on 5mcg/kg/min dopamine gen: alert, pleasant, obese man, with flushed skin skin: spider angiomatas, rosacea on face heent: anicteric, mmm, op clear, supple neck, jvd without jvp elevation, no carotid bruits cv: rrr, nl s1s2, ii/vi systolic m, no r/g, radial and dp pulses 2+, cap refill <2 sec lungs: good air movement, fine crackles at bases b/l abdomen: s/nt/nd/nabs/palpable liver 14cm in mcl, ?palpable left kidney, +splenomegaly, no caput extrem: warm, no c/c, trace edema neuro: grossly intact, gait not assessed ekg: sinus high grade block 5:2, wenckebach 5:4, persistent rbbb, lafb, av delay pertinent results: 01:15pm blood wbc-7.0 rbc-4.01* hgb-13.6* hct-38.6* mcv-96 mch-33.8* mchc-35.2* rdw-14.7 plt ct-166 01:36am blood wbc-10.0# rbc-3.35* hgb-10.9* hct-32.2* mcv-96 mch-32.5* mchc-33.7 rdw-14.6 plt ct-163 01:00pm blood wbc-7.7 rbc-3.34* hgb-11.2* hct-32.5* mcv-97 mch-33.4* mchc-34.4 rdw-14.4 plt ct-168 01:15pm blood neuts-73.8* bands-0 lymphs-15.5* monos-5.7 eos-4.2* baso-0.7 01:15pm blood hypochr-normal anisocy-normal poiklo-normal macrocy-normal microcy-normal polychr-normal 01:15pm blood pt-17.5* ptt-31.0 inr(pt)-1.9 01:00pm blood pt-16.0* ptt-28.8 inr(pt)-1.6 01:00pm blood plt ct-168 01:15pm blood glucose-144* urean-68* creat-2.3* na-137 k-6.9* cl-106 hco3-20* angap-18 01:00pm blood glucose-148* urean-43* creat-2.0* na-138 k-5.0 cl-105 hco3-24 angap-14 06:30pm blood ck(cpk)-141 05:59am blood ck(cpk)-81 01:15pm blood ggt-64* 01:15pm blood ck-mb-4 06:30pm blood ck-mb-4 05:59am blood ck-mb-notdone ctropnt-<0.01 01:15pm blood calcium-8.9 phos-3.6 mg-2.6 iron-105 01:00pm blood calcium-8.8 phos-3.0 mg-2.0 01:15pm blood caltibc-320 vitb12-866 folate-greater th ferritn-108 trf-246 12:56pm blood %hba1c-5.8 01:15pm blood tsh-2.9 06:30pm blood cortsol-13.9 02:35pm blood k-5.9* 06:49pm blood lactate-1.1 k-4.9 brief hospital course: impression: 71 yo man with cad, prior afib, mult cardiac rf, now p/w symptomatic bradycardia x 3 months worse on doa. 1. cardiac a. rhythm: patient with known av delay, rbbb, lafb, now presented with bradycardia, chronotropic insufficiency, ddx included (1)increased vagal tone, (2)primary sinus node dysfunction -- sa node fibrosis or arrest (3)medication affect due to beta blockers or dofetilide especially given poor renal function although there is no evidence of recent change (4)hypothyroidism (5) myocarditis; (1) no evid of increased vagal tone or inciting events (2) most likely etiology; worsening conduction disease (3) pt has been stable on these meds for some time (4) tsh wnl (5) no recent infection though difficult to r/o. held pt's dofetilide, metoprolol given low hr and bp; started on dopa drip at 5 for stimulation of sa node and for pressure support; ep decided to place permanent pacer; dopa weaned off over 1d; held coumadin for ppm placement pt had ppm placed (ddd), no complications though difficult anatomy and as part of a research study has a special set of timing parameters to be readjusted at his follow up appointment in the device clinic in two weeks. b. cad s/p cabg: continue asa, lipitor increased from 10mg po qd to 40mg po qd as recent lipids profile still elevated; held bb and ace-i initially while hypotensive, rrestarted prior to discharge with some dizziness and sbp 92 after restarting the acei. pt to measure his bp with home monitor prior to taking his medications, with beta blocker and acei written to be held if sbp < 100mmhg. c. pump: ef 45-50%, bp has run in 100-120mmhg range while in hospital, holding agents as above. 2. pulmonary: mild hypoxia on admit, likely due to pulmonary edema, weaned to off 3. renal: crcl 25-27ml/min, mild hyperkalemia and hyperphosphatemia on admit likely due to worsened renal function but bun/cr not changed from previous. pt's k decreased and he did not require kayexylate. 4. endo/dm2: continue novolog 12 u, and lantus 40 units hs was decreased to 35 while here, started humalog insulin ss prn, dm/renal/cardiac diet; tsh wnl. 5. gi:fatty liver, hsm/?varices, likely due to etoh, with gib hx, monitored hct, no acute issues, last c-scope 6. heme: anemia (borderline macrocytic), b12 and folate wnl, recommend outpt f/u; possibly from chronic etoh use in line with concommittent low platelets 7. neuro: h/o cva, a fib; monitored off coumadin for ppm placement, will restart 2d after ppm placement 8. psych: etoh use/high-risk, put on ciwa scale to monitor for withdrawl, ciwa normal medications on admission: home meds: dofetilide 250mcg , metoprolol 25mg , allopurinol 100mg qd, dipyramidole 50mg qd, furosemide 20mg qd, spironolactone 25mg qd, moexipril 15mg qd, lipitor 10mg qd, warfarin 5 ttss, 7.5 mwf, novolog 12 units pre-dinner, lantus 45 units hs discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 weeks: hold for loose stools. disp:*14 capsule(s)* refills:*0* 3. lasix 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 4. atorvastatin calcium 40 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 5. keflex 500 mg capsule sig: one (1) capsule po once a day for 7 days. disp:*7 capsule(s)* refills:*0* 6. dofetilide 125 mcg capsule sig: two (2) capsule po bid (2 times a day). disp:*120 capsule(s)* refills:*2* 7. allopurinol 100 mg tablet sig: one (1) tablet po qod (every other day). disp:*15 tablet(s)* refills:*2* 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for af: please don't take if your systolic blood pressure is less than 100mmhg or if you feel lightheaded. disp:*60 tablet(s)* refills:*2* 9. moexipril hcl 15 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* please don't take if your systolic blood pressure is less than 100mmhg or if you feel lightheaded. discharge disposition: home discharge diagnosis: symptomatic bradycardia discharge condition: stable discharge instructions: please take all medications as prescribed and avoid strenuous activity for the next week to help your incision heal properly. keep the wound site clean and dry to avoid infection. also, please keep your appointments to ensure proper follow up after your recent procedure. you should also come in to have your inr checked early next week after starting back on coumadin this thursday (provided there is no bleeding or increased bruising in the wound site). you should avoid alcoholic beverages while taking coumadin as this can adversely effect the metabolism of the drug. you should also avoid grapefruit juice as this can increase the half-life of some of your antiarrythmic medications. lastly, you should call your regular cardiologist dr. to see if he would like to see you prior to your scheduled appointment on . should you have difficulties while in and need to see a cardiologist, dr. is an excellent choice at the hospital. followup instructions: please keep the following appointments: provider: , m.d. where: cardiac services phone: date/time: 4:00 provider: , m.d. where: cardiac services phone: date/time: 2:00 procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle non-invasive mechanical ventilation transfusion of packed cells diagnoses: hyperpotassemia coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute posthemorrhagic anemia candidiasis of other urogenital sites atrial fibrillation disorders of phosphorus metabolism old myocardial infarction sinoatrial node dysfunction 

Answer: The patient is high likely exposed to