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: accupril attending: chief complaint: hypotension, weakness major surgical or invasive procedure: none history of present illness: patient is an 81 year-old male with a history of severe dchf, cad s/p cath (prox lad), restictive cardiomyopathy, myocardial biopsy + for amyloid, a-fib on coumadin, htn, hl, hypothyroidism, recently discharged s/p large-volume pericardiocentesis presenting from home with hypotnesion. vna checked patient's inr earlier in the week, came back at 5.0, measured a blood pressure at 60/p, called ems. after 250 cc bolus given by ems, bp increased to 80/palp. on arrival to the ed, vitals were t 98.1 hr 130s in afib bp 73/44. after 2 x 500 cc ns bolus, bp increased to sbp 80. patient was asymptomatic, reporting no chest pain, dizziness, sob, palpitations. cxr showed cardiomegaly, but decreased size compared to last week. echo was done at the bedside, and showed a pericardial effusion, unlcear about the size compared to last week, no tamponade physiology. triple lumen catheter was placed, and patient was started on levofed. at time of transfer, hr 132 bp 55/27 rr 25 97% 2l. foley was put in, patient had put out 275 cc by time of transfer. . on review of systems, he does endorse increasing weakness and poor po intake the last several days. he also reports early satiety. he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. s/he 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, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: diabetes, dyslipidemia, hypertension 2. cardiac history: - percutaneous coronary interventions: - : 95% lesion in the proximal lad, which was stented with a cypher stent . 3. other past medical history: - chronic permanent atrial fibrillation - amyloid/restrictive cm - severe diastolic dysfunction of the left ventricle (ef 50-55%) - restrictive cardiomyopathy of the left ventricle - moderate to large pericardial effusion - right ventricular contractile dysfunction - severe tricuspid regurgitation - severe pulmonary hypertension. - htn - hypercholesterolemia - hyperthyroidism - bph - oa s/p total knee replacement - osa on bipap at home social history: lives alone at home, completely independent in adls. has a live-in house keeper. smoked 1ppd x 20yrs, quit 20 yrs ago. glasses of wine per night previosuly, but now drinks milk instead. family history: mother died of heart disease at young age. brother has ca and cad. son recently died of ca in his 50's. physical exam: general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of 10 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: ctab in anterior fields. abdomen: mildly distended. soft, nt. no hsm or tenderness. extremities: 2+ pitting edema to mid-shin b/l. 1+ pedal pulses bilaterally. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: admission labs: . 05:15pm blood wbc-11.4* rbc-3.73* hgb-10.9* hct-33.4* mcv-90 mch-29.2 mchc-32.6 rdw-16.0* plt ct-276 05:15pm blood pt-45.2* ptt-37.0* inr(pt)-4.8* 05:15pm blood glucose-105* urean-90* creat-3.5*# na-131* k-5.4* cl-99 hco3-19* angap-18 05:15pm blood ck-mb-9 ctropnt-0.29* 05:15pm blood ck(cpk)-338* 03:33am blood calcium-9.2 phos-7.4*# mg-2.5 05:28pm blood glucose-99 lactate-1.5 k-5.4* . discharge labs: 02:12am blood wbc-8.9 rbc-3.36* hgb-10.0* hct-30.3* mcv-90 mch-29.6 mchc-32.9 rdw-15.7* plt ct-236 02:12am blood pt-21.8* ptt-31.1 inr(pt)-2.0* 02:12am blood glucose-136* urean-77* creat-2.6* na-138 k-4.7 cl-108 hco3-19* angap-16 03:33am blood ck(cpk)-296 03:33am blood ck-mb-8 ctropnt-0.27* 02:12am blood calcium-7.9* phos-5.5*# mg-2.2 03:39am blood lactate-1.3 . echo : the left atrium is moderately dilated. there is symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricular free wall is hypertrophied. right ventricular chamber size is normal. with depressed free wall contractility. the aortic root is mildly dilated at the sinus level. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. the pulmonic valve leaflets are thickened. there is a loculated pericardial effusion, measuring 2.0 cm, behind the lateral wall of the lv with the patient in left lateral decubitus position. there is no free-flowing pericardial fluid elsewhere. impression: loculated pericardial effusion as described above. biventricular wall thickening, c/w known diagnosis of cardiac amyloidosis. mild right ventricular systolic dysfunction. mild aortic and mitral regurgitation. compared with the prior study (images reviewed) of , the findings are similar. brief hospital course: 81 year-old male with a history of severe dchf, cad s/p cath (prox lad), restictive cardiomyopathy, myocardial biopsy + for amyloid, a-fib on coumadin, htn, hl, hypothyroidism, recently discharged s/p large-volume pericardiocentesis presenting from home with hypotension, dehydration. . #. palliative care: after conversation with patient and patient's family, patient decided that he would like to go home with hospice care and would like comfort measures only. his medication regimen was revised as outlined below. palliative care was consulted and home hospice was set up for the patient upon discharge. . #. hypotension: patient hypotensive at baseline, with sbps usually in the 80s. etiology of worsening hypotension was thought to be secondary to dehydration and overdiuresis in the setting of no po intake for several days. echo showed no increase in size of pericardial effusion and patient had no signs of tamponade. torsemide was held and patient was given ivfs. levophed was weaned off and patient's maps remained in the 50s, at his baseline, for the remainder of the admission. . # chf: restrictive cm with myocardial biopsy positive for amyloid, taken last week. echo showed an extremely small lv cavity. torsemide was held throughout admission as patient was hypovolemic. he was discharged with the plan to weigh himself every day and to take torsemide iof his weight goes up by 3 lbs in one day. he has scheduled follow-up with dr. . . # c. diff colitis: patient began to have profuse diarrhea and c. diff toxin came back positive. he was discharged on po vancomycin and bismuth/probiotic for symptom control. . #. gout flare: patient given a prednisone taper for gout flare on right foot with improvement in symptoms. . # cad: aspirin and statin was discontinued as patient made cmo as above. . #. rhythm: patient has chronic atrial fibrillation. patient discharged on metoprolol 100 xl. coumadin was discontinued as patient made cmo as above. . # hld: statin discontinued as patient made cmo as above. . #. osa: remained on cpap. patient will go home with cpap. medications on admission: 1. aspirin 325 mg po daily (daily) 2. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 3. budesonide-formoterol 160-4.5 mcg/actuation hfa aerosol inhaler sig: one (1) puff inhalation twice a day. 4. metformin 500 mg tablet sig: one (1) tablet po once a day. 5. vitamin d 50,000 unit capsule sig: one (1) capsule po once a week. 6. nitroglycerin sublingual 7. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po at bedtime as needed for pain. 8. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 9. torsemide 20 mg tablet sig: one (1) tablet po once a day. 10. warfarin 5 mg tablet sig: one (1) tablet po weekdays. 11. warfarin 1 mg tablet sig: 4.5 tablets po once a day: sat and sun only. 12. ferrousul 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. 14. multi-day tablet sig: one (1) tablet po once a day. 15. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 16. metoprolol succinate 100 mg tablet sustained release 24 hr discharge medications: 1. budesonide-formoterol 160-4.5 mcg/actuation hfa aerosol inhaler sig: one (1) puff inhalation twice a day. 2. metoprolol succinate 100 mg tablet sustained release 24 hr sig: 0.5 tablet sustained release 24 hr po once a day. 3. prednisone 20 mg tablet sig: two (2) tablet po daily (daily) for 3 days. disp:*6 tablet(s)* refills:*0* 4. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 5. torsemide 20 mg tablet sig: one (1) tablet po once a day as needed for weight gain: please only take prn for weight inc more than 3 pounds in 1 day or 5 pounds in 3 days. 6. lactobacillus acidophilus capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 7. vancomycin 125 mg capsule sig: one (1) capsule po four times a day for 12 days. disp:*48 capsule(s)* refills:*0* 8. bismuth maximum strength 525 mg/15 ml suspension sig: fifteen (15) ml po four times a day as needed for diarrhea: please take 2 hours before or after vancomycin. discharge disposition: home with service facility: hospice discharge diagnosis: amyloid cardiomyopathy acute kidney injury chronic diastolic congestive heart failure atrial fibrillation pericardial effusion discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with very low blood pressure. this is from your amyloid heart disease and likely will not get better. you will have hospice services at home that will help you be comfortable and stay at home. you requested that the foley catheter be kept in for now, you can have the visiting nurse remove that at any time if you want. you were diagnosed with a bowel infection called c difficile. you will be on antibiotics for a total of 2 weeks to treat this infection. the diarrhea should slowly resolve. it is recommended that you eat a diet with white rice, white toast, bananas and applesauce. please avoid any milk products. we made the following changes to your medicines: 1. please stop taking aspirin, atorvastatin, vitamin d, nitroglycerin, oxycodone, tamsulosin, warfarin, iron, multivitamin and potassium. 2. start taking prednisone for 3 days to treat your gout 3. start taking vancomycin pills to treat the infection in your bowel. 4. start taking acidophillus as needed to help with the diarrhea 5. start taking pepto bismol as needed to help with the diarrhea weigh yourself every morning, call dr or np if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. followup instructions: department: cardiac services when: monday at 10:00 am with: dr. building: sc clinical ctr campus: east best parking: garage department: medical specialties when: wednesday at 8:20 am with: dr. /dr. building: sc clinical ctr campus: east best parking: garage procedure: venous catheterization, not elsewhere classified diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified 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 hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified unspecified disease of pericardium intestinal infection due to clostridium difficile primary pulmonary hypertension long-term (current) use of anticoagulants knee joint replacement chronic diastolic heart failure acute gouty arthropathy other amyloidosis nutritional and metabolic cardiomyopathy 

Answer: The patient is high likely exposed to