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: lisinopril attending: chief complaint: dyspnea on exertion major surgical or invasive procedure: left ventricular lead placement via left thoracotomy history of present illness: this is an 83yo male with chronic systolic congestive heart failure, chronic slow atrial fibrillation and a left bundle branch block who recently underwent an upgrade to his st. icd in . unfortunately dr. was unable to place the lv lead at that time. he was therefore referred for surgical placement of epicardial lv leads. currently his symptoms include dyspnea on exertion. he denies orthopnea, pnd, le edema, lightheadedness, chest pain. past medical history: - chronic systolic chf - coronary artery disease s/p stemi in . underwent taxus stent to lad at . - atrial fibrillation - history of nsvt - hypertension - dyslipidemia - chronic renal insufficiency, baseline cr 1.4 to 1.7 - osteoarthritis - spinal stenosis, chronic low back pain - retinopathy - bph - complete occlusion of the left mid subclavian vein with reconstituion medially via collateral vessels. - history of colon cancer - history of basal cell carcinoma - psoriasis - iron deficiency anemia - history of h. pylori - gout - history of gi bleed while on lovenox s/p st. icd s/p single chamber aicd s/p mohs surgery (multiple) for basal cell s/p total colectomy s/p turp social history: lives with: alone in occupation: retired tobacco: quit 15 years ago after 50 pack year history etoh: high balls weekly family history: son with coronary artery disease physical exam: preop exam: pulse: 50 af resp: 18 o2 sat: 98% b/p right: 121/65 left: 120/65 height: 67" weight: 173lb general: wdwn elderly male in nad skin: warm, dry and intact. multiple nevi and keratosis heent: ncat, perrla, eomi, sclera anicteric, op benign neck: supple full rom no jvd chest: lungs clear bilaterally heart: irregular rate and rhythm abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused trace edema varicosities: mild neuro: grossly intact pulses: femoral right:2 left:2 dp right:1 left:1 pt :1 left:1 radial right:2 left:2 carotid bruit right: none left: none pertinent results: transthoracic echo: the right atrium is markedly dilated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is severely depressed (lvef= 25 %) with global hypokinesis and regional septal and apical akinesis. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. there is abnormal septal motion/position consistent with right ventricular pressure/volume overload. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. renal ultrasound: 1. normal kidneys, without hydronephrosis, nephrolithiasis, or mass lesion. 2. large ascites. abdominal ultrasound: 1. contracted gallbladder with gallstone identified within it. 2. moderate amount of intra-abdominal ascites. 3. bidirectional flow with reflux noted in the hepatic veins with associated pulsatile flow in the portal vein - findings are consistent with sequelae of right heart failure. 04:35am blood wbc-5.5 rbc-2.60* hgb-9.2* hct-27.7* mcv-107* mch-35.2* mchc-33.0 rdw-17.7* plt ct-145* 04:30am blood wbc-5.6 rbc-2.56* hgb-9.1* hct-27.7* mcv-108* mch-35.4* mchc-32.8 rdw-17.8* plt ct-128* 04:35am blood pt-17.1* inr(pt)-1.5* 04:30am blood pt-18.0* inr(pt)-1.6* 04:35am blood glucose-97 urean-40* creat-2.6* na-138 k-4.1 cl-99 hco3-31 angap-12 04:30am blood glucose-106* urean-25* creat-1.9* na-140 k-4.4 cl-100 hco3-29 angap-15 04:05am blood glucose-103* urean-41* creat-2.4* na-138 k-4.2 cl-102 hco3-24 angap-16 brief hospital course: mr. was admitted and underwent epicardial lead placement via left mini-thoracotomy by dr. . for surgical details, please see operative note. following the operation, he was brought to the cvicu in stable condition. within 24 hours, he awoke neurologically intact and was extubated without incident. device check on postoperative day one showed a normal functioning biventricular icd. he otherwise maintained stable hemodynamics and transferred to the sdu on postoperative day one. on postoperative day two, he became oliguric and hypotensive with little response to fluid resuscitation. creatinine was rising, and patient became hyperkalemic. renal ultrasound showed normal appearing kidneys while echocardiogram revealed no evidence of tamponade. renal ultrasound was however notable for large amount of ascites. he returned to the cvicu for invasive monitoring. he was started on inotropes and cvvh was initiated. given findings of ascites, warfarin was held for the possibility of paracentesis. renal service was consulted and continued to manage cvvh. it appeared much of his acute on chronic renal failure was attributed to contrast nephropathy dating back to during failed attempt for percutaneous left ventricular lead placement. over several days, urine output improved as did his creatinine. he gradually weaned from inotropic support. he was transitioned from cvvh to intermittent hemodialysis via tunnelled right internal jugular catheter. he did have a 80 mg iv lasix trial and made minimal urine in response. his foley was removed and he is to be straight cathed q 24 hrs - last hemodialysis run was . he is on a mon wed friday schedule for hd. he continued to make good progress and was cleared for discharge to at in on pod # 13 in stable condition target inr 2.0- 2.5 for chronic a fib. all follow up appointments were advised. medications on admission: -allopurinol - 100 mg tablet - 1.5 tablet(s) by mouth every morning -calcitriol - 0.25 mcg capsule - 1 capsule(s) by mouth every morning -cholesterol study drug through - 3 pills every evening -colchicine - 0.6 mg tablet - 1 tablet(s) by mouth as needed -furosemide - 40 mg tablet - 2 tablet(s) by mouth every morning, one tablet at 6pm -metoprolol succinate - 50 mg tablets - 2 tablet(s) by mouth every morning -warfarin - 2 mg tablet - 0.5 (one half) tablet(s) by mouth m/w/f, one tablet all other days -vitamin d3 - 1,000 unit capsule - 1 capsule(s) by mouth once a day -ferrous sulfate - 325 mg tablet - 1 tablet(s) by mouth three times a day discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. allopurinol 100 mg tablet sig: one (1) tablet po every other day (every other day). 3. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb ih inhalation q6h (every 6 hours) as needed for wheezes. 8. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 9. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). 10. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 11. warfarin 2 mg tablet sig: one (1) tablet po once a day: dose 2.5 mg coumadin dose 4/20 (inr 1.5). 12. heparin flush (10 units/ml) 2 ml iv prn line flush tunneled access line (e.g. hickman), heparin dependent: flush with 10 ml normal saline followed by heparin as above daily and prn per lumen. discharge disposition: extended care facility: tba discharge diagnosis: failed left ventricular lead placement chronic systolic congestive heart failure coronary artery disease, prior pci/stenting chronic atrial fibrillation acute on chronic renal insufficiency/ hd ascites discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with tylenol incisions: thoracotomy - healing well, no erythema or drainage 2+ lower extremity edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving while taking narcotics please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr. tuesday @ 1:45 pm cardiologist: dr. @ office @ 2:20 pm please call to schedule appointments with your primary care dr. or dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** labs: pt/inr for coumadin ?????? indication atrial fibrillation goal inr 2.0 to 3.0 first draw day *****please arrange for coumadin/inr f/u prior to discharge from rehab*** procedure: venous catheterization, not elsewhere classified hemodialysis venous catheterization for renal dialysis arterial catheterization pulmonary artery wedge monitoring insertion or replacement of epicardial lead [electrode] into epicardium diagnoses: hyperpotassemia coronary atherosclerosis of native coronary artery 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 percutaneous transluminal coronary angioplasty status other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) cardiogenic shock old myocardial infarction other left bundle branch block chronic systolic heart failure personal history of malignant neoplasm of large intestine automatic implantable cardiac defibrillator in situ other ascites diseases of tricuspid valve 

Answer: The patient is high likely exposed to