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: cardiomyopathy and heart failure major surgical or invasive procedure: -pacer/defibrillator generator change, attempted lead placement - mini left thoracotomy with lv epicardial lead placement. history of present illness: this 66 year old black male with significant non-ischemic cardiomyopathy who underwent icd implant in . he has nyha class ii congestive heart failure with an ef of 30%. the patient was hospitalized in for a chf exacerbation treated with intravenous diuretics. the patient reports a moderate limitation with physical activity and a low energy level. the patient reports shortness of breath with mild exertion relieved with rest. the patient denies lightheadedness, palpitations, pre syncope, syncope or chest pain. the patient denies rest symptoms. recent interrogation of his device revealed that he had episodes of non sustained vt, no episodes of sustained vt and no therapies were delivered. the optivol index was noted to be high implying ongoing heart failure. it was decided to proceed with upgrading his current device to a biv/icd. past medical history: non ischemic cardionyopathy s/p gastric bypass hypertension gout obstructive sleep apnea social history: married and retired police officer. he denies tobacco or illicit drug use. upon questioning, the patient has an extensive h/o alcohol use. he admits to being a heavy social drinker. family history: grandmother with cad but no premature cad in family. mother with cancer, sister with dm. physical exam: admission: pulse: 67 resp:20 o2 sat: not recorded -on room air b/p 138/87 height: 5 feet 8 inches wt: 240 lbs general: skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema varicosities: none neuro: grossly intact pulses: femoral right: left: dp right:2+ left:2+ pt : left: radial right: left: carotid bruit-none right: 2+ left:2+ pertinent results: 05:23am blood wbc-6.2 rbc-3.66* hgb-11.1* hct-32.0* mcv-88 mch-30.5 mchc-34.8 rdw-13.5 plt ct-171 02:58am blood wbc-7.9 rbc-3.56* hgb-10.3* hct-32.3* mcv-91 mch-28.8 mchc-31.8 rdw-14.0 plt ct-118* 06:03am blood urean-24* creat-1.6* na-140 k-4.2 05:23am blood glucose-136* urean-21* creat-1.5* na-141 k-3.8 cl-103 hco3-29 angap-13 02:58am blood glucose-127* urean-25* creat-1.6* na-143 k-4.2 cl-109* hco3-27 angap-11 12:51am blood glucose-109* urean-30* creat-2.3* na-142 k-4.8 cl-111* hco3-22 angap-14 03:13pm blood glucose-108* urean-29* creat-2.7* na-140 k-5.0 cl-108 hco3-24 angap-13 02:37am blood urean-25* creat-2.2* na-141 k-4.3 cl-107 hco3-23 angap-15 06:03am blood alt-26 ast-31 ld(ldh)-262* alkphos-93 amylase-143* totbili-1.2 02:58am blood lipase-28 06:03am blood albumin-3.4 07:15am blood %hba1c-6.8* 09:28am blood type-art temp-38.0 po2-112* pco2-54* ph-7.24* caltco2-24 base xs--4 echo echocardiography report , tte (complete) done at 12:12:19 pm final referring physician information , cardiac electrophysiology , 4 , status: inpatient dob: age (years): 66 m hgt (in): 68 bp (mm hg): 108/57 wgt (lb): 240 hr (bpm): 101 bsa (m2): 2.21 m2 indication: coronary artery disease. left ventricular function. right ventricular function. shortness of breath. icd-9 codes: 786.05, 423.3, 424.0 test information date/time: at 12:12 interpret md: , md test type: tte (complete) son: bzymek, rdcs doppler: full doppler and color doppler test location: west echo lab contrast: none tech quality: adequate tape #: 2009w000-0:00 machine: other echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.5 cm <= 4.0 cm left atrium - four chamber length: *6.4 cm <= 5.2 cm right atrium - four chamber length: *5.5 cm <= 5.0 cm left ventricle - stroke volume: 44 ml/beat left ventricle - cardiac output: 4.44 l/min left ventricle - cardiac index: 2.01 >= 2.0 l/min/m2 left ventricle - lateral peak e': 0.18 m/s > 0.08 m/s left ventricle - ratio e/e': 4 < 15 aortic valve - peak velocity: 0.9 m/sec <= 2.0 m/sec aortic valve - peak gradient: 3 mm hg < 20 mm hg aortic valve - lvot vti: 14 aortic valve - lvot diam: 2.0 cm aortic valve - valve area: *2.8 cm2 >= 3.0 cm2 mitral valve - e wave: 0.8 m/sec mitral valve - e wave deceleration time: 201 ms 140-250 ms tricuspid valve - peak velocity: 0.0 m/sec tr gradient (+ ra = pasp): *30 mm hg <= 25 mm hg pulmonic valve - peak velocity: *2.4 m/sec <= 1.5 m/sec findings this study was compared to the prior study of . left atrium: dilated la. right atrium/interatrial septum: mildly dilated ra. a catheter or pacing wire is seen in the ra. left ventricle: normal lv wall thickness. dilated lv cavity. suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. depressed lvef. right ventricle: mildly dilated rv cavity. cannot assess regional rv systolic function. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. mild thickening of mitral valve chordae. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: pulmonic valve not well seen. pericardium: trivial/physiologic pericardial effusion. no echocardiographic signs of tamponade. general comments: suboptimal image quality - poor subcostal views. suboptimal image quality - body habitus. the rhythm appears to be a-v paced. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions the left atrium is dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is dilated. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. lv systolic function appears depressed (?30%) but images are suboptimal for assessment of wall motion. the right ventricular cavity is mildly dilated with grossly preserved contractility but views are suboptimal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. there are no echocardiographic signs of tamponade. compared with the prior study (images reviewed) of , left ventricular systolic function appears more vigorous in the setting of tachycardia. electronically signed by , md, interpreting physician 14:57 brief hospital course: mr. was admitted to the on for placement of an epicardial lead. he was worked-up in the usual preoperative manner and was ready for surgery. on the generator was upgraded but attempts at transvenous lead placement were unsuccessful by the electrophysiology service. on he was taken to the operating room where he underwent a left minithoracotomy with placement of epicardial ventricular leads. (please see operative note for details.) postoperatively he went to the post anesthesia care unit. he developed epigastric pain and a surgery consult was obtained. no acute surgical issues were found beyond colonic ileus and he was transferred to the cardiac surgery intensive care unit for monitoring. his creatinine rose to 2.2. antigas medications and promotility agents were given, narcotics were stopped and he improved. attempts at gastric and rectal tube placement were unsuccessful (there was no stomach distention). his ct was removed, he was mobilized and over two days the ileus resolved, flatus passed and his diet was advanced from clears to regular heart healthy. as he was hydrated, urine output picked up and his creatinine normalized to his baseline of 1.7. he was placed back on his preoperative medications and transferred to the floor. by post-operative day 6 he was ready for discharge to home. he was tolerating a regular diet, ambulating and moving his bowels. wounds were clean and healing well. arrangements were made for follow up and instructions discussed with him. medications on admission: calcium carbonate 500mg daily tamsulosin 0.4mg po daily spironalactone 25mg daily crestor 40mg daily prilosec 20mg daily lasix 20mg daily finasteride 5mg daily allopurinol 100mg daily asa 81 mg daily coreg 6.25 mg tid discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 4. rosuvastatin 20 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). disp:*30 tablet(s)* refills:*2* 5. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). disp:*30 capsule, sust. release 24 hr(s)* refills:*2* 6. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. carvedilol 12.5 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 10. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 11. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain/fever. 12. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). discharge disposition: home with service facility: vna discharge diagnosis: attempted placement pacemaker leads left thoracotomy and placement of ventricular leads for biventricular pacemeker/defifrillator non ischemic cardiomyopathy s/p virtuoso dual chamber icd hypertension sleep apnea chronic renal insufficiency s/p gastric bypass surgery gout discharge condition: good discharge instructions: monitor wounds for signs of infection. these include redness, drainage or increased pain. report any fever greater then 100.5. report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. no lotions, creams or powders to incision until it has healed. please shower daily. no bathing or swimming for 1 month. no lifting greater then 10 pounds for 10 weeks from date of surgery. no driving for 1 month or while taking narcotics for pain. call with any questions or concerns followup instructions: dr. in 1 month (surgeon) (). dr. in weeks.() dr. in weeks procedure: implantation or replacement of cardiac resynchronization defibrillator pulse generator only [crt-d] replacement of automatic cardioverter/defibrillator lead(s) only revision or relocation of cardiac device pocket diagnoses: other primary cardiomyopathies obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified chronic kidney disease, unspecified other specified cardiac dysrhythmias other left bundle branch block chronic systolic heart failure paralytic ileus automatic implantable cardiac defibrillator in situ obesity, unspecified bariatric surgery status 

Answer: The patient is high likely exposed to