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: disopyramide attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: 76-year-old woman with h/o dm2, htn, hl, cva on warfarin with residual l sided weakness presented to dr. office on and was found to be in afib with rvr with hr 150s. patient denied any symptom at that time. she did report some dyspnea with exertion in . of note, patient was recently found to have a breast nodule on mammogram which is being worked up. she has been having significant anxiety over this. on presentation to the ed, afeb, hr 140, bp 181/124, 97%ra. her exam was unremarkable. ce neg x 1. ecg showed afib with rate in the 140s, without any ischemic changes. inr 3.7. she received metoprolol 10 mg iv x 2, 5 mg iv x 4, labetolol 10 mg iv x 1, metoprolol 25 mg po x 1. her hr decreased to 105-115, and bp 135/87. was admitted to for further management. on arrival to floor, patient was asymptomatic. on review of systems, she denies any prior history of deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: dm2 dyslipidemia hypertension cva, residual l-sided weakness, on warfarin hypothyroidism cardiac risk factors: diabetes(+), dyslipidemia(+), hypertension(+) cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none social history: married. family history: no family history of early mi, otherwise non-contributory. physical exam: vs: afeb, 121/96, 120, 98%ra general: elderly woman in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 8 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. 2/6 systolic murmur at llsb. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. some crackles at both bases. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ pertinent results: 08:00pm ck(cpk)-81 08:00pm ctropnt-<0.01 08:00pm ck-mb-notdone 08:00pm tsh-1.4 03:10pm pt-35.1* ptt-26.8 inr(pt)-3.7* 02:00pm glucose-126* urea n-27* creat-1.5* sodium-140 potassium-3.7 chloride-103 total co2-25 anion gap-16 02:00pm estgfr-using this 02:00pm ck(cpk)-47 02:00pm ctropnt-<0.01 02:00pm ck-mb-notdone 02:00pm wbc-10.1# rbc-4.83 hgb-13.5 hct-40.9 mcv-85 mch-27.9 mchc-33.0 rdw-15.2 02:00pm neuts-83.3* lymphs-12.7* monos-3.2 eos-0.1 basos-0.6 02:00pm plt count-389 discharge labs 05:50am blood wbc-9.1 rbc-4.04* hgb-11.1* hct-34.4* mcv-85 mch-27.5 mchc-32.2 rdw-14.7 plt ct-318 05:50am blood pt-16.2* ptt-31.3 inr(pt)-1.5* 05:50am blood glucose-122* urean-15 creat-0.9 na-138 k-4.3 cl-104 hco3-23 angap-15 05:50am blood calcium-8.8 phos-3.2 mg-1.9 07:09am blood %hba1c-7.0* 08:00pm blood tsh-1.4 05:30am blood digoxin-0.7* reports/imaging tte the left atrium is markedly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). the right ventricular cavity is moderately dilated with mild global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is mild valvular mitral stenosis (area 1.5-2.0cm2). an eccentric, anteriorly-directed jet of severe (4+) mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a small pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mild mitral stenosis. severe eccentric mitral regurgitation. moderate to severe tricuspid regurgitation. moderate pulmonary hypertension. carotid series complete:impression: right ica no stenosis . left ica no stenosis . rib films: there is bibasilar atelectasis, and there are bilateral pleural effusions, small to moderate. the heart is enlarged. in addition, there are multiple non-displaced rib fractures in the lower right. no definite displaced rib fractures are seen on the left. this could be better assessed with ct if this is a clinical concern. cxr impression: mild heart failure with bilateral pleural effusions. likely atelectasis at the lung bases, although repeat radiography following appropriate diuresis recommended to assess for underlying infection. cxr impression:retrocardiac atelectasis. worsening bilateral pleural effusions. rib xray: here is bibasilar atelectasis, and there are bilateral pleural effusions, small to moderate. the heart is enlarged. in addition, there are multiple non-displaced rib fractures in the lower right. no definite displaced rib fractures are seen on the left. this could be better assessed with ct if this is a clinical concern. cardiac cath: report not yet available brief hospital course: brief hospital course by problem # atrial fibrillation: afib likely atrial enlargement from valvular disease. she does have a history of hypothyroidism, on replacement, tsh normal in . no excessive alcohol or caffeine. initially she did not respond to beta blockers and so was rate-controlled with diltiazem. she then converted to sr spontaneously and was maintained in sr with disopyramide. her qtc was prolonged at ~500 after starting the long-acting form of the drug. patient was transferred to the ccu for better monitoring while the disopyramide washed out. she then developed torsades and cardiac arrest as below. after torsades resolved, her medications were subsequently adjusted so she was on diltiazem for rate control, amiodarone 200mg po bid x 2 weeks (then 200mg daily) for rhythm and rate control and digoxin 0.125 daily. for anticoagulation her coumadin was held for breast biopsy and cath. she was placed on a hep gtt for ppx while awaiting procedures. she was discharged on lovenox with bridge to coumadin. she was lower dose of coumadin given interaction with amiodarone and will need close monitoring of inr. for her outpatient dental procedure (prior to cardiac surgery), she will hold the warfarin without a lovenox bridge. she was discharged with of hearts monitor. # torsades de pointes/cardiac arrest: pt was transferred to ccu on for management of torsades de pointes. she was given 4mg mg iv and started on standing mg repletion. disopyramide was discontinued since she was felt to have long qt and torsades secondary to disopyramide. she was noted to have increasing ectopy on telemetry in pm and again went into vt with loss of consciousness and pulse. code blue was called. she received external shocks x 2 and was intubated for airway protection. she received epi and atropine and lidocaine bolus. she was started on isoproterenol and subsequently levophed for hypotension. femoral line placed under sterile conditions during code. after this episode, she had occasional runs of nsvt but no further sustained vt. on , she was weaned off levophed and groin line was d/c'd. around noon, she developed svt with hrs 160s trending down to 120s which appeared to be afib. isoproterenol was discontinued. she was started on metoprolol 12.5 which was uptitrated as tolerated then changed to diltiazem with improved heart rate control. she was subsequently extubated. she had residual chest wall pain after cpr and rib films revealed non displaced rib fractures. pain was was controlled on tylenol. # mild volume overload: initially patient had left-sided failure with evidence of pulmonary edema and pleural effusions on imaging and minimal basilar crackles on exam, likely secondary to the atrial fibrillation. no evidence of right-sided failure. no history of chf. on tte had severe valvular disease (see below) that was most likely the cause of her chf. diuretics were held in light of acute kidney injury and after patient converted to nsr symptoms of chf resolved. # severe mr : on tte done to work up a murmur on exam and atrial fibrillation patient had severe mr . cardiac surgery was consulted and felt a mvr and tvr were required. the patient underwent some pre-op studies including a cath that showed clean coronaries. she will follow up with dr. in 2 weeks to schedule her surgery. # : cr 1.5 from baseline of 1.1. likely to poor forward secondary to afib with rvr. initially losartan and triamterene/hctz were held. creatinine trended down. patient was given lasix for diuresis given evidence of chf on exam as above. with lasix had creatinine bump so further diuresis was held, however, patient converted to sinus rhythm and had self-diuresis thereafter with lessening of her chf symptoms. she was restarted on losartan at 25mg daily (home dose 100mg daily) before discharge. # h/o cva: on warfarin at home. was on heparin gtt while inpatient for procedures and then lovenox bridge to warfarin on discharge due to high risk (chads2 score 6). # abnl mammogram: patient recently had birads 4 abnormality on mammogram and was scheduled for breast biopsy. was bridged from coumadin onto hep gtt and underwent biopsy as inpatient on . preliminary results were negative for malignancy, and final results will be forwarded to her pcp for further management. # dm2: was maintained on iss while hospitalized but will continue oral hypoglycemics as outpatient. # htn: slightly hypertensive initially in admission. controlled with losartan and coreg which were subsequently held while diltiazem was uptitrated. losartan resumed before discharge as above. # code: full medications on admission: losartan 100 mg qday triamterene-hctz 37.5-25 mg 3x/week warfarin 2 mg qday atorvastatin 20 mg qday glyburide 5 mg qday levothyroxine 50 mcg qday metformin 500 mg qday calcium carbonate-vit d 1 tab discharge medications: 1. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 3. glyburide 5 mg tablet sig: one (1) tablet po once a day. 4. metformin 500 mg tablet sig: one (1) tablet po once a day: do not start taking until evening dose. 5. calcium 500 + d 500 (1,250)-200 mg-unit tablet sig: two (2) tablet po twice a day. 6. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. diltiazem hcl 240 mg capsule, sustained release sig: one (1) capsule, sustained release po bid (2 times a day). disp:*60 capsule, sustained release(s)* refills:*2* 9. outpatient lab work please check inr, digoxin level on friday and call results to dr. at 10. lovenox 60 mg/0.6 ml syringe sig: one (1) subcutaneous twice a day for 10 days: or until inr is > 2.0. disp:*10 qs* refills:*2* 11. coumadin 1 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 12. acetaminophen 500 mg tablet sig: two (2) tablet po every eight (8) hours. 13. cozaar 25 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnosis: atrial fibrillation severe mitral regurgitation acute renal failure torsades de pointes secondary: chronic renal failure htn dm2 discharge condition: the patient was afebrile and hemodynamically stable prior to discharge. discharge instructions: you were admitted to the hospital with difficulty breathing and an abnormal heart rhythm. you were started on medications to control your heart rate. unfortunately, a side affect of one of your medications caused a complicated rhythm that required cpr and intubation. luckily, you recovered from both but did have some rib fractures as a result of the cpr. . while you were here you had an ultrasound of your heart that showed a leaky valve. the cardiologists and cardiac surgeons think they you will need this repaired. in preparation for your valve repair you had a cardiac catheterization. this showed no blockages in your coronary arteries. you had a breast biopsy as well and the final results were still pending at the time of discharge. please follow up with dr. for the final results. . dr. will also follow your rib fractures. you can take tylenol and tramadol for control of the pain but no other intervention was needed at this time. . you still need surgical clearance from your dentist. your dentist can fax the clearance to the cardiac surgery office at ( (attn dr. . . your inr (coumadin level) was high while you were here. we held your coumadin so that you could have your cardiac cath and your breast biopsy. you will start taking your couamdin again at a lower dose. please check your inr on friday . you should continue taking the lovenox shots twice daily until your inr is greater than 2.0. dr. will monitor your inr and let you know when you can stop taking the lovenox. . medication changes: start: lovenox 60 mg injected twice a day start: digoxin 0.125mg daily start: diltiazem sr 240 mg twice a day start: amiodarone 200 mg twice a day start: tramadol 50 mg twice daily stop taking diazide and decrease the cozaar to 25 mg daily stop taking metformin, you can restart on at your evening dose decrease your coumadin dose to 1 mg daily. . please come back to the emergency room or call your doctor if you have fainting, light-headedness, dizziness, palpitations, chest pain, shortness of breath, abdominal pain, nausea, vomiting, weight gain more than 3 lbs in one day, leg swelling, or other concerning symptoms. followup instructions: psychiatry: provider: , md phone: date/time: 10:30 . primary care: please follow up with your primary care doctor, , () on wednesday at 1:45pm. . cardiac surgery: provider: . phone: date/time: at 1:00pm . cardiology: provider: , md phone: date/time: 11:20 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified combined right and left heart cardiac catheterization coronary arteriography using two catheters insertion of endotracheal tube cardiopulmonary resuscitation, not otherwise specified closed [percutaneous] [needle] biopsy of breast diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation hematoma complicating a procedure other chronic pulmonary heart diseases chronic kidney disease, unspecified paroxysmal ventricular tachycardia rheumatic heart failure (congestive) 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 other late effects of cerebrovascular disease other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants accidents occurring in residential institution diseases of tricuspid valve closed fracture of multiple ribs, unspecified other disorders of muscle, ligament, and fascia nonspecific abnormal electrocardiogram [ecg] [ekg] cardiac rhythm regulators causing adverse effects in therapeutic use mitral stenosis with insufficiency mammographic microcalcification 

Answer: The patient is high likely exposed to