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: demerol attending: chief complaint: cardiac arrest major surgical or invasive procedure: intubated hemodialysis continued history of present illness: 46 y/o m w/ esrd (mwf hd), cad stents ef 20%, icd on coumadin for h/o lv thrombus noted on cath report of ', has recently noted lead fracture on admission to of early after having been unresponsive s/p external aed shock but negative icd interrogation, --repair disrupted by elevated inr. last night, patient found by mother to be in cp/sob with ?shaking on floor and non-responsive to mother's commands, ems (per report, 20 min for ems arrival) noted wct and intubated, cpr, epinephrine with intermittent rosc but aed advised no shocks. in , was pulseless with wide complex tachycardia, treated for hyperkalemia (?spurious result of 11, truly 4.5-5), abg 7.26/33/123 on 50% and glucose 59, got epi x1, shock 200j with rosc therafer. no pressors/fluids required. sbp 100-120 at that time, with hr in 80's. then transferred to for further evaluation on arrival to the ed he was described as awake and moving all 4 , he was not placed on the cooling protocol. his initial vital signs were 97.5 62 107/75 14 100%. he was sedated was prn versed. a repeat k was 5 and lactate 7.4 with ph 7.27. his ekg was interpreted as lbbb unchanged from priors. tte w/ef 25% and 3+ tr. on arrival to micu, patient was tolerating vent w/o difficulty. gcs status not suitable for cooling protocol. patient started on amio gtt after loading dose and ep consulted. patient extubated w/o difficulty this pm - now on nrb. renal awaiting cardiac clearence prior to initiation of hd. . prior to transfer to ccu, patient was extubated, on nrb w/ t 96.7, hr 73, bp120/75, hr 85, rr 19, 98%. past medical history: 1. heart disease: - s/p anterior mi () with tpa and rescue pci of lad --> p104 biliary stent placed in ostial lad --> 4.0x22mm in proximal lad --> 4.0x15mm in mid lad - s/p mi () - icd placed in with pacemaker/icd generator change on - pci () --> lmca: free of disease --> lad: patent previously placed stents with 20% isr in the proximal segment --> lcx: free of flow limitations - s/p cardiac arrest () - ef 20% and lv thrombus 2. hypertension 3. hyperlipidemia: : tc 177; ldl 103; hdl 54 4. end-stage renal disease: - s/p basilic vein brachial artery av fistula 5. h/o line sepsis . cardiac history: cabg: none percutaneous coronary intervention: as above pacemaker/icd placed: as above tte: the left atrium is markedly dilated. the right atrium is markedly dilated. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 10-20mmhg. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is severely dilated. there is severe global left ventricular hypokinesis (lvef = 20 %). the basal lateral wall moves best and the remaining segments are akinetic.. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is markedly dilated with moderate global free wall hypokinesis. there is no mass/thrombus in the right ventricle. the aortic root is mildly dilated at the sinus level. the aortic arch is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. there is no aortic valve stenosis. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. . ett: per notes, myoview in fixed anterior and inferior defects, extending to the apex . cardiac cath: lhc/rhc (pre-op for tx eval): 1. selective coronary arteriography of this right dominant system revealed angiographic evidence of no significant flow limiting coronary artery disease. the lmca was free of disease. the lad had patent previously placed stents with 20% isr in the proximal segment. the cfx was free of flow limitations. 2. left ventriculography was not performed due to the presence of lv thrombus. 3. hemodynamic evaluation demonstrated normal right and left heart filling pressures with not pulmonary htn and preserved cardiac index. 4. right femoral arteriotomy site was successfully closed with a 6f angioseal closure device. filling pressures: ra mean 6; rv 28/8; pa 28/20/16; pcwp ; ci 3.3; svr 1075; pvr 48 social history: remote tobacco (10pk/yr; quit 9yr ago). etoh abuse prior to but none since. no ivdu but remote cocaine use per omr. lives with his parents and is unemployed. has one daughter. family history: there is no family history of premature coronary artery disease (although fater did have cad) or sudden death. physical exam: vs: 96.7 60-70s 120/75 r: 19 sat 100% on 40% fio2 gen: tall, white male, sedated but arousable heent: eom intact, at/nc, equal pupils pulm: coarse breath sounds, no crackles cv: s1/s2 w/diamond shaped murmur heard loudest at apex; jvp to angle of jaw; no rubs or gallops abd: umbilical well healed scar; soft, nt/nd; no hsm ext: no edema; palpable dp pulses bilaterally neuro: ms sedated, arousable and follows commands intermittently; pupils equally round, r facial droop but bilaterally elevates eyebrows; l>r; hand grasp and dorsi/plantarflexion; hyperreflexia of knee, biceps brachi bilaterally; pertinent results: 05:28am ph-7.27* comments-green top 05:45am wbc-15.9*# rbc-3.06* hgb-10.0* hct-32.0* mcv-105* mch-32.7* mchc-31.2 rdw-16.2* 05:45am ck-mb-4 05:45am ctropnt-0.06* 05:28am glucose-100 lactate-7.4* na+-140 k+-5.0 cl--95* tco2-24 ncct comparison: ct head of . findings: study is limited by motion artifact degrading multiple axial slices at the vertex and skull base. some of the axial slices at the vertex were subsequently repeated. despite limitations as described above, there is no evidence of acute hemorrhage, mass lesion, shift of normally midline structures, hydrocephalus, or evidence of major territorial infarct. the -white matter differentiation appears preserved. the major intracranial cisterns are preserved. the extra-calvarial soft tissues are unremarkable. the visualized paranasal sinuses and mastoid air cells appear clear. impression: moderately limited study. while no evidence of major territorial infarct is identified, given patient's status of cardiac pacemaker, a ct perfusion is recommended if continued concern for infarction is present. tte the left atrium is elongated. the right atrium is markedly dilated. the estimated right atrial pressure is 10-20mmhg. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is severely dilated. there is severe global left ventricular hypokinesis (lvef = 20-25 %). 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 ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. significant pulmonic regurgitation is seen. there is no pericardial effusion. impression: dilated and hypertrophied left ventricle with severe global hypokinesis. dilated and hypokinetic right ventricle. moderate to severe tricuspid regurgitation. moderate to severe pulmonary hypertension. compared with the report of the prior study (images unavailable for review) of , the left ventricle is more dilated. the other findings are similar. brief hospital course: 46yo male with pmhx cad, cardiac arrest s/p icd placement, and ef 20% presenting with metabolic derangements and cardiac arrest. appears to have developed aflu/atach then became acidotic/hyperkalemic w/evolution to vfib that was not detected by icd, possibly b/c the acidemia decreased the sensitivity. . # cardiac rhythm: the etiology for his cardiac arrest was initially unclear but included hyperkalemia vs ischemic. because three sets of cardiac enzymes were never elevated, it was believed that this was not due to acs. after further review of osh records, it was proposed that he went int atrial flutter/atrial tachycardia which led to hypoperfusion w/development of acidosis and consequent hyperkalemia leading to evolution into ventricular fibrillation. it was initially thought that his icd did not detect this event because of decreased sensitivity of the leads in the setting of acidemia, but further evaluation by the electrophysiology team concluded that the icd lead anomaly was unrelated to the incident. in his recent admission from 2 wks ago, icd interrogation showed normal sensing function but malfunction of the generator lead; however, it was not fixed because of an inability to correct his elevated inr. therefore, during this admission, the goal was to correct the lead. in the mean time, he was maintained on his amiodarone and lopressor and was in nsr with his baseline lbbb. after being transferred to the cardiology floor, icd revision was planned but the patient developed thrombophlebitis of the right arm on the evening prior to transfer. he was started on cephalexin and an ultrasound demonstrated thrombus throughout the course of the cephalic and in the basillic vein to the mid arm. he was later sent to interventional radiology for picc placement proximal to the clot but nonocclusive, soft thrombus was then identified in his brachial vein of the right arm. note that the left arm holds his av fistula. because the procedure could not be performed while the patient had an ongoing infection with possible vascular involvement, it was postponed until the patient completed his antibiotics. he was also instructed to restart anticoagulation with warfarin. he will be contact by the clinic for readmission. # cad/ischemia: his cardiac enzymes had an mb index of less than 5% over three sets so he ruled out acs. he complained of msk pain over his precordium which was treated with analgesics. he was maintained on asa and an ace inbitior was initiated. he was continued on his home meds (without the acei) at the time of d/c. . # pump: although clinically the patient did not complain of dyspnea and on physicial exam he did not have crackles nor peripheral edema, it was known that he had a dilated cmp. given the setting of his cardiac arrest, we repeated a tte which showed a stable low ef with worsening left ventricular dilatation and no thrombus. # hyperkalemia/esrd: his admission k was 5.7 and initially he was not hd as there was no clear indication. he was treated with kayexelate prn over his first night and his k was maintained around 5.5. he underwent a mini hd session on which was tolerated well, w/a post hd potassium of 4.9. his ekg remained w/o signs of hyperkalemia and he was treated with hd as per renal; he was maintained on his baseline renal meds. # neuro: he was initially arousable but sleepy and confused, unaware of year, location nor president; on exam, had hyperreflexia and positive concerning for upper motor neuron injury; it was unclear whether there may be a sz component as father also has ?sz. neuro saw pt the night of his admission and felt he had diffuse encephalopathy but perhaps a focal lesion on r given hyperreflexia l>r. ncct was done which was unremarkable. the patient had a trial of low dose diazepam w/decrease in myoclonus. the morning after, neuro felt there was improvement in the myoclonus and needed only observation. # anemia/inr: has long-standing anemia likely esrd with an elevated mcv; vitamin b12 and folate were normal and iron studies were c/w anemia of chronic disease. his hct remained stable. his inr was elevated at admission to 1.8 and in his recent admission, it was this intractable inr that had prevented him from getting an icd lead revision. he did not respond to low dose vitamin k. a relative recent us and ct of the abdomen had not shown any liver lesions although he did have a chronically elevated alkphos but exhibited normal albumin levels. per renal, he was to begin epo. . # fen: renal diet . # prophylaxis: heparin sq, bowel regimen . # code: full code . # communication: contact , mother, medications on admission: 1. aspirin 81 mg daily 2. b complex vitamins daily 3. folic acid 1 mg daily 4. b complex-vitamin c-folic acid 1 mg daily 5. metoclopramide 5 mg qidachs 6. sevelamer hcl 800 mg tid 7. simvastatin 40 mg daily 8. metoprolol succinate 75 mg daily 9. ascorbic acid 500 mg daily 10. zolpidem 5 mg tablet po qhs:prn insomnia 11. docusate sodium 100 mg capsule 12. senna 8.6 mg tablet 1 - 2 po bid:prn 13. amiodarone 200 mg daily discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: two (2) po bid (2 times a day). 2. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 3. sevelamer hcl 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 6. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 7. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 8. cephalexin 500 mg capsule sig: one (1) capsule po q8h (every 8 hours) for 7 days: last day is saturday . disp:*21 capsule(s)* refills:*0* 9. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). disp:*60 tablet(s)* refills:*2* 10. metoprolol succinate 50 mg tablet sustained release 24 hr sig: seventy five (75) mg po once a day. 11. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: three (3) adhesive patch, medicated topical daily (daily): please leave on for 12 hours, off for 12 hours. disp:*20 adhesive patch, medicated(s)* refills:*2* 12. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed. disp:*30 tablet(s)* refills:*0* 13. warfarin 2.5 mg tablet sig: one (1) tablet po once a day. 14. metoclopramide 5 mg tablet sig: one (1) tablet po qidachs. 15. zolpidem 5 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. discharge disposition: home discharge diagnosis: primary: cardiac arrest (ventricular tachycardia) venous thrombophlebitis intracardiac device evaluation costochondritis . secondary: end stage renal disease coronary artery disease myocardial infarction dilated cardiomyopathy hypertension hyperlipidemia discharge condition: stable discharge instructions: you were admitted because you had a cardiac arrest. we ressucitated you and corrected abnormalities in your blood chemistries that may have caused your arrest. while you were here, we also evaluated your pacemaker. we determined that it will ultimately require a revision. we also diagnosed you with inflammation and clots in the veins of your right arm. for this, we are giving you antibiotics. after completing treatment with the antibiotics, you will undergo the revision of your icd. you will be contact by dr. office within the next few days for scheduling. . please take all of your medications as prescribed. please keep all of your follow-up appointments. continue taking coumadin. continue taking cephalexin (antibiotic) for seven days as prescribed. last day will be saturday . please call your doctor or return to the hospital if you experience fevers, chills, sweats, chest pain, shortness of breath or anything else of concern. followup instructions: we will schedule an appointment for you to see your primary care doctor, as you need follow-up for the infection and clot in your right arm. you can also follow up on your pain control at this appointment. if you do not hear from his office by tuesday, call to , m. arrange or confirm your appointment. . primary care doctor appointment: pcp: , . . you will be contact by dr. office within the next few days. if you do not hear from his office by tuesday, please call directly: cardiac electrophysiology location: e/ 7 patient phone: ( procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified hemodialysis diagnoses: other primary cardiomyopathies acidosis hyperpotassemia anemia in chronic kidney disease end stage renal disease coronary atherosclerosis of native coronary artery congestive heart failure, unspecified percutaneous transluminal coronary angioplasty status systolic heart failure, unspecified paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure cardiac arrest mechanical complication of automatic implantable cardiac defibrillator old myocardial infarction automatic implantable cardiac defibrillator in situ phlebitis and thrombophlebitis of upper extremities, unspecified tietze's disease 

Answer: The patient is high likely exposed to