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: s/p cardiac arrest major surgical or invasive procedure: icd placment history of present illness: mr. is a 47 year old man recently diagnosed with atrial flutter s/p dccv x2 as well as ablation, and cardiomyopathy of unknown etiology (ef15-20%) who is transferred from after arresting at home and receiving aed shock for hypothermia protocol. . history taken from patient's wife and note. in , mr. to pcp's office with fatigue, doe, and cough. he was treated w/ z-pack for bronchitis, but had no improvement and returned to pcp who then diagnosed him with "arrhythmia." he was sent to for evaluation. on that admission he was diagnosed with atrial flutter and "ischemic" global cardiomyopathy, moderate rv hypokinesis, ef of 15-20%, 3-4% mr. his wife, the etiology of his cardiomyopathy was suspected to be secondary to viral illness. he underwent dccv x2, and was started on amiodarone, coumadin, toprol, lisinopril, and digoxin. he subsequently went back into atrial flutter as an outpatient and was referred to for atrial flutter ablation (per wife no done at that time). . since his cardioversion, mr. had been complaining of lightheadedness. he went to see his cardiologist dr. at jordin, who stopped his "blood pressure" medications. otherwise he was doing well since that visit without any complaints. on the day of admission, the patient was sitting on the couch talking to his mother on the phone. he soon became unresponsive and lost consciousness. his wife called ems, and then proceeded to perform chest compressions on the couch. she states that prior to him losing consciousness he did not complain of chest pain or pressure, palpitation, shortness of breath. he has not had any recent fevers, chills, changes in bladder habits, bloody stools/urine, lower or extremity edema. ems performed cpr, aed shocked x1. patient remained pulseles after shock. he got epi x1 and was intubated. . he was subsequently taken to . he was found to be in atrial fibrillation. he was started on amiodarone. he became hypotensive and was then started on neo and levo for pressure support. a head ct was done and was negative. he received at least 3l in the field. his labs were notable bicarb 17, cr 1.1, cpk 51, trop i 0.1, inr 2.2, dig 0.3. he did not receive cooling there, and was transfered by to . . in the ed, his vs were: t 98.2 hr 102 bp 130/107, rr 18 100% cmv. the patient's ecg showed atrial fibrillation with 1mm lateral std. he was started on artic sun in the ed. he was kept on amio and levo, neo was weaned off. he got cxr that was consistent with pulmonary edema. a rij was placed. his vs on transfer was: 95 125/99 vent 23/min 100%. a bedside us probe did not show any pericardial effusion. past medical history: 1. cardiac risk factors: none 2. cardiac history: - : atrial flutter diagnosed after 15lbs weight loss and prolonged malaise. s/p dc cardioversion x 2 and + aflutter ablation on with creation of a cavo-tricuspid isthmus line of block with bidirectional block. by report, the patient was in sinus after the procedure. - cardiomyopathy identified on echo at osh on : severe ischemic, nearly global cardiomyopathy present with "smoke" in the lv. basal posterior wall with normal contractility. moderate rv hypokinesia. la/ra moderately dilated. + mr, 1+ tr, trace ai, small pericardial effusion. 3. other past medical history: - none social history: he is married with 3 children. his oldest daughter has cerebral palsy. he is currently unemployed, but used to work for a junk yard and then a car dealership. he smoked 1ppd for 25 years, quit after diagnosis of cm. he drinks 4-5 beers consistently every night for the past 25 years. he used cocaine as a teenager (16-17), but has not used any illicits since then. family history: his father passed away of an mi in his 70s. his mother is alive, per wife. has 6 siblings, one sister has . no history of stroke, sudden cardiac death, malignancy. physical exam: general: intubated, sedated. heent: ncat. sclera anicteric. sluggish pupils. neck: supple, lying flat w/ rij in place c/d/i. cardiac: pmi located in 5th intercostal space, midclavicular line. irregularly irregular heart rate. no m/r/g. no thrills, lifts. no s3 or s4. lungs: anterior breath sounds clear, no wheezes/rales. patient on cmv. abdomen: soft, ntnd. cooling pads in place; no organomegaly noted. extremities: cool extremities, with weakly palpable pulses. no edema noted. skin: no stasis dermatitis, ulcers, scars, or xanthomas. neuro: sluggish pupils, not responsive to noxious stimuli, does not open eyes spontaneously pertinent results: admission labs: 08:30pm blood wbc-21.4* rbc-5.10 hgb-15.6 hct-49.2 mcv-96 mch-30.5 mchc-31.6 rdw-14.0 plt ct-231 08:30pm blood pt-29.7* ptt-31.9 inr(pt)-2.9* 08:30pm blood urean-8 creat-0.9 01:00am blood calcium-7.3* phos-6.6* mg-1.9 08:30pm blood tsh-12* 11:56pm blood %hba1c-6.3* eag-134* 08:55am blood caltibc-291 ferritn-476* trf-224 11:42am blood t4-8.3 t3-92 08:30pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 08:32pm blood glucose-253* lactate-3.2* na-144 k-3.5 cl-111 calhco3-15* 08:55 ace, serum 17 . cardiac enzymes: 08:30pm blood ctropnt-0.04* 08:30pm blood ck(cpk)-68 08:30pm blood ck-mb-3 05:02am blood ck(cpk)-80 05:02am blood ck-mb-6 ctropnt-0.04* . discharge labs: 08:15am blood wbc-7.3 rbc-4.09* hgb-12.2* hct-36.2* mcv-89 mch-29.9 mchc-33.8 rdw-14.5 plt ct-149* 08:15am blood pt-13.4 ptt-25.8 inr(pt)-1.1 08:15am blood glucose-89 urean-11 creat-0.6 na-140 k-3.6 cl-105 hco3-26 angap-13 08:15am blood calcium-8.4 phos-4.5 mg-1.9 . echo: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. there is severe global left ventricular hypokinesis (lvef = 20%). systolic function of apical segments is relatively preserved. no masses or thrombi are seen in the left ventricle. the right ventricular cavity is moderately dilated with severe global free wall hypokinesis. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. impression: biventricular cavity enlargement with severe global hypokinesis c/w diffuse process. moderate mitral regurgitation. . cxr: new icd has been placed with leads terminating in expected locations of the right atrium and right ventricle with no evidence of pneumothorax. heart size is normal. ground-glass and reticular opacities have developed in the perihilar regions, with similar appearance to an earlier radiograph of . the rapid fluctuations favor pulmonary edema over an atypical pneumonia. there is also an area of linear atelectasis in the right mid lung region, and there are questionable small pleural effusions posteriorly. . ekg: supraventricular tachycardia. probable atrial flutter with 2:1 block. since the previous tracing no significant change. brief hospital course: 47 year old man recently diagnosed with atrial flutter s/p dccv x2 as well as ablation, and cardiomyopathy of unknown etiology (ef15-20%) who is transferred from after arresting at home and receiving aed shock for hypothermia protocol. . # post cardiac arrest: patient presented after v-fib arrest. hypothermia protocol was initiated on transfer. the etiology of his v-fib arrest was suspected to be secondary to his dilated cardiomyopathy vs prolonged qt. he was cooled and re-warmed. he was initially maintained on levophed and dopamine for pressor support, which were weaned off. his amiodarone drip was continued on transfer but stopped given evidence of junctional rhythm w/ prolonged qt (see below). eeg did not show evidence of seizures. patient self-extubated himself after rewarming and was very agitated. he was treated with ativan. his mental status began returning to baseline subsequently. an echocardiogram was done on this admission that confirmed dilated cardiomyopathy. on , patient went into vf arrest on the floor and was taken for urgent icd placement with overdrive pacing. he was treated with 3 days of antibiotics after icd placement. . # cardiomyopathy: an echocardiogram done on this admission showed biventricular cavity enlargement with severe global hypokinesis ef 20%, and moderate mr. etiology of his cardiomyopathy unknown, but suspected tachycardiac dilated cm. other possibilities include etoh related, viral related. plan was for patient to undergo catheterization, but he went into vf arrest on and taken for urgent icd placement. cardiac catheterization to be done as an outpatient. tsh was checked and was 12. free t3 = 92 and t4 = 8.3 which were within normal limits. ace-levels were checked and also within normal limits. patient was started on an ace-inhibitor while in-patient. . # atrial flutter: on admission patient was in atrial flutter. overnight, rhythm strips and ecg demonstrated junctional rhythm and prolonged qt. amiodarone was stopped, and medications that could prolong qts were avoided. subsequent ecgs showed atrial flutter. patient was started on a beta blocker. on patient went into vf arrest and went for urgent icd placement. he was also started on coumadin for anticoagulation post-procedure. . # elevated tsh: tsh 12, free t3/t4 within normal limits. thyroid panel will need to be repeated as an outpatient. medications on admission: - amiodarone 400 mg po daily - digoxin 125 mcg po daily - lisinopril 5 mg po daily (per daughter not on this medication anymore) - metoprolol succinate 25 mg po daily (per daughter not on this medication anymore) - warfarin 2.5 mg po daily - aspirin 81 mg po daily discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 4. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. disp:*30 tablet(s)* refills:*0* 5. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 3 days. disp:*6 capsule(s)* refills:*0* 6. outpatient lab work inr check discharge disposition: home discharge diagnosis: primary: ventricular fibrillation post cardiac arrest dilated cardiomyopathy discharge condition: a&ox3, self-ambulatory discharge instructions: you were admitted to the hospital because you had a cardiac arrest. we treated you with cooling and rewarming protocol. we were then able to remove you from the breathing machine. soon afterwards, you had another episode of abnormal rhythm. for this reason we placed a defibrillator to prevent further arrhythmias. you will need to get this device checked soon after discharge - please refer to the information below on getting this appointment scheduled. . we made the following medication changes during this hospitalization: (1) you should stop taking amiodarone. (2) you should stop taking digoxin. (3) you should decrease lisinopril from 5 mg to 2.5 mg daily. (4) you should increase your coumadin to 5 mg daily - you will need to get your inr checked as an outpatient to ensure that you are taking the correct dose of this medicine. (5) you need to take an antibiotic called cephalexin up through . (6) you should increase your aspirin dose to 325 mg every day. . it is very important that you see your primary care doctor () within a few days of discharge. he will check your inr to make sure you are getting the right amount of coumadin. we will provide you with a prescription to get this checked. . it is also really important that you schedule an appointment with your cardiologist within the next two weeks. he will need to check your defibrillator to make sure that it is functioning properly. if your cardiologist is unable to set you up with a defibrillator appointment, please call our device clinic soon after discharge at (. followup instructions: (1) please call your primary care doctor within 1 week of discharge. you will need a inr checked - you have a prescription for this attached; you should get your inr checked within 3 days of discharge. (2) please call your cardiologist dr to be seen within the next two weeks. you will also need your defibrillator checked - if dr is unable to set this up for you, please call our device clinic at ( within 2 days of discharge. md, procedure: venous catheterization, not elsewhere classified arterial catheterization implantation or replacement of automatic cardioverter/defibrillator, total system [aicd] diagnoses: other primary cardiomyopathies anemia, unspecified atrial flutter ventricular fibrillation 

Answer: The patient is high likely exposed to