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: dizziness/lightheadedness major surgical or invasive procedure: temporary pacemaker wire placement permanent pacemaker placement history of present illness: patient is a 75 yo male with hx of cad, htn, hypercholesterolemia who presented to - this am after developing dizzuness and lightheadedness at home this am. the pt reports he was getting coffee this am when he felt lightheaded, and dizzy but no overt chest pain, palpitations, shortness of breath, syncope. he subsequently sat down and finished his coffee but appeared pale to his wife who checked his pulse and noted it to be irregular and bradycardic with a heart rate of 26. the pt was biba to where an ekg demonstrated complete heart block with junctional escape in the 20s to 30s. otherwise his ecg was significant for lbbb with lad. he was afebrile with hr of 30 and bp of 160/82, with rr of 10 and sao2 of 100%. he was never hypotensive during his osh stay. he received atropine in the ed and his rhythm converted to sinus bradycardia. he was subsequently transferred to for further evaluation and management. . ros: the pt denies any chest pain, palpitations, sob, abd pain, n/v/d, uri, sick contact, insect bites - specifically tick bites, arthritis symptoms, black stools, melana, back pain. past medical history: 1. cad: nstemi in ' when he presented with chest pain (positive top but neg ck) s/p cardiac catheterization with poba of lcx. the pt had a neg thallium stress test in '. 2. hypertension 3. hypercholesterolemia 4. increased intraocular pressure social history: the pt is a retired realtor who lives in with his wife. is visiting his daughter who lives in ma. he has intact adl and iadls at home. tob: quit; former smoked 4-5cig/day for 40 years but quit 20+years ago etoh: occasional family history: father: cad, copd, tob+ mother: none and : none physical exam: vitals: t: 96.9, hr: 56, bp: 147/52, rr: 10, sao2: 100% ra gen: well appearing middle aged man who appears younger than stated age. conversing fluently in full sentences. nad heent: eomi, anicteric, op clear, mmm neck: no jvd, no a waves. chest: cta bilaterally anteriorly cv: rrr, s1, s2. abd: soft, nt, nd, bs+ groin: right groin line in place without obvious echymosis, hematoma, bruits. ext: wwp, no c/c/e neuro: a+o x3, appropriate. . . pertinent results: 12:50pm wbc-10.3 rbc-4.88 hgb-15.6 hct-43.6 mcv-89 mch-32.0 mchc-35.9* rdw-13.3 12:50pm plt count-194 12:50pm neuts-73.9* bands-0 lymphs-21.0 monos-2.9 eos-1.4 basos-0.9 12:50pm pt-12.0 ptt-25.0 inr(pt)-1.0 12:50pm glucose-150* urea n-11 creat-1.1 sodium-132* potassium-3.4 chloride-95* total co2-26 anion gap-14 12:50pm ck(cpk)-62 12:50pm ctropnt-<0.01 .................. radiology final report chest (portable ap) 10:10 pm comparison: . ap chest radiograph: there has been interval placement of a pacing lead that appears to be entering via the ivc. tip is seen overlying the right ventricle. otherwise no significant change is seen from prior study with stable cardiac and mediastinal contours. no focal consolidations or pleural effusions identified. ................... tte : conclusions: the left atrium is normal in size. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is mild-moderate pulmonary artery systolic hypertension. there is a partially echo filled space anterior to the distal right ventricular free wall which most likely represents a fat pad. impression: preserved global and regional biventricular systolic function. no definite pericardial effusion identified. mild-moderate pulmonary artery systolic hypertension. ...................... exercise mibi reason: cad s/p pci, ? ischemia radiopharmeceutical data: 3.2 mci tl-201 thallous chloride; 22.0 mci tc-m sestamibi; history: chest pain. history of heart block and pacer placement. summary of the preliminary report from the exercise lab: exercise protocol: modified resting heart rate: 60 resting blood pressure: 170/90 exercise duration: 7.5 min. peak heart rate: 77 percent max predicted hr: 53% peak blood pressure: 176/90 symptoms during exercise: none reason exercise terminated: stopped at patient request ecg findings: uninterpretable due to left bundle branch block interpretation: imaging protocol: gated spect resting perfusion images were obtained with tl-201. tracer was injected 15 minutes prior to obtaining the resting images. exercise images were obtained with tc-m sestamibi. this study was interpreted using the 17-segment myocardial perfusion model. the image quality is good. uptake is seen in the left axilla and arm, likely venous in etiology. left ventricular cavity size is normal. resting and stress perfusion images reveal uniform tracer uptake throughout the myocardium. gated images reveal normal wall motion. the calculated left ventricular ejection fraction is 63%. no prior studies. impression: normal myocardial perfusion study at the level of exercise achieved. normal ejection fraction. brief hospital course: a/p: 75 yo male with history of htn, cad, inc chol, who presented earlier today with symptoms of dizziness and lightheadedness. found to be in heart block, received atropine in the ed. . 1. cv: a. bradycardia: the pt is currently in nsr, however was found to be in high degree av block thought to be paroxysmal av block secondary to diseased intrinsic conduction system. the pt has a history of mi in the past with lcx disease which may partially explain the conduction disease (but not well). other etiologies of chb include lyme disease, viruses, med, toxins, rheumatoid disorders, however these all seem unlikely. cardiac enzymes were negative. precise etiology of av block remains unclear. temporary pacing wires were placed by ep fellow via fluoro and patient underwent placement of a permanent pacemaker on . patient tolerated the procedure well. he will follow-up in the device clinic on . . b. cad: the pt has a history of cad with ptca in the past but had normal stress test in '. given symptomatic bradycardia as above, we did not aggressively treat his blood pressure or heart rate given risk for further bradycardia or hypotension. he was continued on asa 325 mg qd and zocor 10mg qd. on he had an episode of chest pain which was sub-sternal, difficult to characterize, then moved to r side. responded to sl ng x 2 and morphine. no associated sob, n/v. ekg unrevealing. ce sent. pulsus was 2. hd stable with sbp 130s, hr 70s. he underwent a pmibi which showed a normal myocardial perfusion study at the level of exercise achieved. normal ejection fraction. he was able to exercise for 7.5 mins. he did not have any anginal symptoms. no further episodes of chest pain while in-patient. prior to discharge was restarted on atenolol and lisinopril after placement of pacer. . 2. hypertension: beta blocker and thiazide diuretics that patient takes as an out-patient were initially held given his bradycardia. after pacer placement these were restarted. patient was also started on lisinopril for better blood pressure control. he will follow-up with his pcp weeks for further titration of his anti-hypertensives and will have his electrolytes checked at that time. . 3. hyperglycemia on admission labs: the pt does not carry a history of dm, and this could reflect a stress response. fasting am sugars was within normal limits at time of discharge, however, patient was advised to follow-up with his pcp regarding his blood sugar. he should be monitored for fasting and post prandial hyperglycemia and should have an hga1c checked. . medications on admission: allergies: nkda . medications: 1. metoprolol xl 50mg once daily 2. indapamide (thiazide diuretic) 2.5mg once daily 3. zocor 10mg once daily 4. asa 325mg once daily 5. eye drops - cosopts for right eye and ?xelotan for both eyes discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. indapamide 2.5 mg tablet sig: one (1) tablet po once a day. 4. cosopt 2-0.5 % drops sig: one (1) gtt ophthalmic twice a day: right eye. 5. xalatan 0.005 % drops sig: one (1) gtt ophthalmic at bedtime. 6. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis complete heart block .. secondary diagnoses hypertension cad hypercholesterolemia discharge condition: good discharge instructions: you were admitted for heart block and had a pacemaker placed. you should follow up in device clinic as arranged. you should return to the ed with increasing pain at the pacer site, fevers, chills, palpitations, fainting, chest pain, shortness of breath, or for any other problems that concern you. followup instructions: you have an appointment at the device clinic on at 10 am in the building on the . . you should follow up with your pcp and your primary cardiologist when you return to . you will need to see a cardiologist that specializes in pacer makers. you should have your blood pressure checked by your pcp as you may need to have your blood pressure medications adjusted. you should also have your pcp check your blood sugar as it was intermittently elevated while you were in the hospital. procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle insertion of temporary transvenous pacemaker system diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension percutaneous transluminal coronary angioplasty status atrioventricular block, complete old myocardial infarction 

Answer: The patient is high likely exposed to