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: symptomatic pauses, fractured rv lead of biv pacer/icd major surgical or invasive procedure: temporary pacemaker placement rv lead extracted/replaced + new pacemaker placed history of present illness: 83 yo m with history of non-ischemic cardiomyopathy s/p dual chamber pacemaker placement in with upgrade to a dual chamber biv in . he has had three syncopal episodes within the last week (two on and one on day prior to admission), with most significant one the day prior to admission when he fell and hit his head on the plaster board. he was unable to be aroused for approximately 2 minutes according to his wife. was able to be aroused, though was groggy. . at osh ( hospital), he underwent head ct and was found to have a small subarachnoid hemorrhage. cervical and lumbar spine ct were also performed prior to transfer with no evidence of fracture. he was seen in cardiology consultation and had his device interrogated. it was hypothesized at that time that his fidelis rv lead had fractured, which was inhibiting v-pacing resulting in periods of asystole. the timing of these events coincides with his syncopal episodes. attempts to program rv sensing off were unsuccessful. he was transferred to have an extraction of the fedelis lead and a new lead implantation. of note, he was anticoagulated with warfarin for his atrial fibrillation and after inr was noted to be 2.6 at osh, he was given vitamin k 5 mg and then 2 units of ffp. . upon arrival to the floor here the patient reports he had been having episodes of "wooziness" for approximately 2 weeks, noting "hundreds" of episodes where he has to sit down or slow his pace for fear of passing out. it was not until that he actually passed out. . review of systems: (+)ve: presyncope, syncope, neck pain, constipation (-)ve: chest pain, dyspnea, orthopnea, pnd, diarrhea, fever, chills, cough, loss of appetite, loss of bowel or bladder function, dysuria past medical history: 1. cardiac risk factors: - diabetes, - dyslipidemia, + hypertension 2. cardiac history: - cabg: none - percutaneous coronary interventions: none - pacing/icd: s/p pcm upgraded to biv icd for 3rd degree block - atrial fibrillation - non-ischemic cardiomyopathy - complete lbbb vs. ?tachy-brady 3. other past medical history: - cri (cr 1.7 at osh) - gout - esophagitis - temporal arteritis - s/p aaa repair - s/p aortic dissection with repair in social history: lives with wife and another couple in a single family home within community. patient and his wife have five children (3 daughters and 2 sons). - history: denies. -etoh: rare. -illicit drugs: denies. family history: mother died from lung cancer and father died from colon cancer. no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: general: wa elderly man in nad. oriented x3. mood, affect appropriate. heent: contusion of left posterior scalp with ecchymosis extending from site of injury down left posterior neck, became nontender by hd#6. perrl/eomi. sclera anicteric. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: wearing soft collar on admission --> later removed. no jvd, hepatic reflux. cardiac: pmi located in 5th intercostal space, midclavicular line. rrr, normal s1-s2. +iii/vi sem @ lusb. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: nabs, soft/nt/nd. no hsm or tenderness. abd aorta not enlarged by palpation. extremities: wwp, no c/c/e. skin: no stasis dermatitis, ulcers, scars, or xanthomas. +large non-tender ecchymotic area over left posterior scapula. mild ecchymosis of left buttocks. neuro: a&ox3, cns ii-xii intact, strength 5/5 throughout, sensation grossly intact to light touch throughout pulses: right: radial 2+ dp 1+ pt 1+ left: radial 2+ dp 1+ pt 1+ pertinent results: 141 102 45 107 agap=14 3.7 29 1.7 estgfr: 39/47 (click for details) mg: 2.4 102 8.2 11.2 152 33.5 pt: 19.2 ptt: 29.8 inr: 1.8 head ct non-con 1. bilateral subacute hemispheric subdural hematoma measuring 6 mm. 2. hyperdense material noted within the basal cisterns is reminiscent of prior subarachnoid hemorrhage. 3. hyperdense focus located adjacent to the left lateral ventricle may represent a focus of intraparenchymal hemorrhage or cavernous malformation or developmental venous anomaly. for further evaluation of the latter mr with contrast can be obtained. 4. small amount of left occipital subgaleal hematoma. head ct non-con (prior to discharge) pfi: no acute intracranial process. bifrontal subdural hematomas are decreased in attenuation, consistent with evolution of blood products. minimal subarachnoid blood is also again noted. there is no mass effect, midline shift, hydrocephalus, or evidence of acute ischemia. tte the left atrium is moderately dilated. the right atrium is markedly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is moderate global left ventricular hypokinesis (lvef = 30-35%). the right ventricular cavity is moderately dilated with mild global free wall hypokinesis. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. severe tricuspid regurgitation is seen. there is at least moderate pulmonary artery systolic hypertension (may be underestimated secondary to high right atrial pressure). there is no pericardial effusion. impression: moderate global left ventricular systolic dysfunction. dilated right ventricle with mild global systolic dysfunction. mild aortic regurgitation. moderate mitral regurgitation. severe tricupsid regurgitation, mostly around the multiple pacemaker/defibrillator leads. at least moderate pulmonary hypertension. ekg ventricular paced rhythm. compared to the previous tracing of no change. brief hospital course: 83-yo man with htn, afib on coumadin, non-ischemic cmp, ?h/o tachy-brady versus complete heart block, s/p dual chamber pacemaker in with upgrade to dual chamber biv , who presents with presyncope/syncope, falls, and sdh/sah on nchct, found to have a likely fractured rv lead resulting in episodes of syncope, now s/p temporary pacing wire placement in right ij by ep and awaiting lead revision. . #. rhythm: 83-yo man with hypertension, atrial fibrillation, non-ischemic cardiomyopathy, and ? h/o tachy-brady versus complete heart block, s/p dual chamber pacemaker placement in with upgrade to dual chamber biv in . in recent weeks he has been having frequent episodes of dizziness and feeling faint, as well as three syncopal episodes in the last week, most recently one day prior to admission when he fell and hit his head and was unarousable for approx 2 minutes. at hospital, he underwent a nchct that revealed a small sah. c-spine and l-spine cts did not show any evidence of fracture. cardiology was consulted and his device was interrogated, and he was found to be having episodes of asystole that were felt to coincide with these events. it is hypothesized that his fidelis rv lead is fractured which is inhibiting v-pacing and resulting in these episodes of asystole, and attempts to program rv sensing off were unsuccessful, so he was transferred to for extraction of the fidelis lead and implantation of a new lead. he is anticoagulated with an inr of 2.6, so received 5mg po vitamin k and 2units ffp prior to transfer. . on transfer to , he was continued on his home bb and amiodarone, but he continued to have symptomatic pauses as long as 6-7 seconds overnight, with an episode of syncope that correlated with a pause on telemetry. he was seen by ep, who attempted to adjust his pacemaker settings, but he was ultimately taken to the ep lab for placement of a temporary pacing wire . he was transferred to the ccu for continued monitoring and remained stable. pt remained stable over the weekend and did not become bradycardic or hypotensive. pt went for pacemaker revision on . pt did well and was transfered back to the floor. pt did not develop any complications from the procedure. . #. sdh/sah: post-traumatic in setting of syncope/fall while therapeutic on coumadin with inr 2.8. at hospital, he underwent a nchct that revealed a small sah. c-spine and l-spine cts did not show any evidence of fracture. at he was also seen by neurosurgery and underwent urgent nchct, which revealed bilateral subacute-chronic hemispheric sdh, acute post-traumatic sah, a small subgaleal hematoma, and cavernous malformation versus parenchymal hemorrhagic contusion. this was not felt to be significantly different from the serial nchcts he received at osh prior to transfer. he was placed in a soft collar for comfort and received an additional 2mg po vitamin k and 2units ffp for inr 1.8, with unremarkable neuro checks overnight. he received a total of vitamin k 7mg po and 4units ffp w/ inr 1.4. neurologically intact without concerning neuro checks and sdh/sah stable per nsg. his c-spine was clinically cleared on . pt had repeat ct heads without signficant interval change. pt is to have a repeat ct head on and follow up with neurosurgery with dr. in 1 mo. pt also received 3d of vancomycin prior to procedure. vancomycin was d/c'd on and switched to 7 day course of levofloxacin. # pump: echo: ef 30-35% moderate global left ventricular systolic dysfunction. severe tricupsid regurgitation, mostly around the multiple pacemaker/defibrillator leads. pt was hypervolemic and pt was diuresed while in the ccu with torsemide 60 daily, spironolactone 25 daily, and was negative 1l prior to procedure, but still had bilateral rales and received another lasix 40mg iv x1 prior to procedure. pt stable for discharge on per ep and ccu but desaturated to 88% on nc when wean attempted. cxr suggested fluid overload so pt diuresed and was able to wean on . pt sent home w/ vna services (physical therapy) and cardiology/neurosurgery followup instructions medications on admission: - spironolactone 25mg po daily - colchicine 0.6mg weekly on sundays - omeprazole 20mg po daily - metoprolol 50mg po bid - amiodarone 200mg po daily - torsemide 60mg po daily - warfarin 2.5mg po daily - allopurinol 200mg po daily - centrum silver mvi po daily - potassium daily discharge medications: torsemide 60mg po daily after 2 days discharge disposition: home with service facility: vna assoc. of discharge diagnosis: primary: right ventricle lead fracture secondary: syncope, subdural hematoma, hypertension non-ischemic cardiomyopathy, atrial fibrillation, complete left bundle branch block vs. tachy-brady syndrome, chronic renal insufficiency (creatinine 1.7) discharge condition: stable, good. discharge instructions: it was a pleasure taking care of you while you were in the hospital. you were transferred to for revision of your pacer lead. you had been feeling dizzy and light-headed as well as fallen multiple times. it was thought that your pacemaker was not working properly. you had a temporary pacemaker placed intially and then you underwent lead revision. > we made the following changes to your meds: increase your torsemide dose to 80 mg, tid for the next two days. resume regular dose of 60 mg, tid afterwards started an antibiotic, levofloxacin, to be taken daily until started aspirin 325 mg daily stopped your warfarin; please do not restart until you have been seen by dr. > if you develop any symptoms of pain/swelling over pacemaker site, experience dizziness/new falls or fainting, come back in to the emergency room. also contact medical personnel for fevers/chills/chest pain or with any questions or concerns. you were also found to have a bleed in your head. you were seen by neurosurgery and no intervetion was performed. you had a head ct-scan that showed that your bleed was stable. please follow the medications prescribed below. please follow up with the appointments below. please call your pcp or go to the ed if you experience chest pain, palpitations, shortness of breath, nausea, vomiting, fevers, chills, or other concerning symptoms. followup instructions: please follow-up with your cardiologist, dr. , (or his device clinic nurse) this , @ 8:45am. please follow-up w/ dr. with neurosurgery. please call his office at for an appointment within the month. please follow-up with your pcp 1-2 weeks pcp: , . procedure: insertion of temporary transvenous pacemaker system revision of lead [electrode] revision or relocation of cardiac device pocket diagnoses: other primary cardiomyopathies hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation unspecified fall chronic kidney disease, unspecified mechanical complication of automatic implantable cardiac defibrillator subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness subarachnoid hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness 

Answer: The patient is high likely exposed to