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: atenolol / atorvastatin / carbamazepine / chlorhexidine / codeine / fentanyl / oxycodone / propoxyphene / demerol attending: chief complaint: icd firing major surgical or invasive procedure: attempted vt tract ablation percutaneous coronary intervention history of present illness: 68m with h/o cad (prior mis, cabg, chf), copd on baseline o2, cri, dm, iacd placed for afib/vt in , presents for vt storm with multiple icd firings. . pt was recently admitted to hospital for icd firing on , discharged after restarting amiodarone. pacer was interogated and showed afib. . after discharge pt was repeatedly shocked at home, on the way to the ed and in the ed for vt. he reports no sob, palpitations, fevers/chills or cp but feels chest heaviness, heat wave, and clammy prior to firings. pt reports many waves of heat, only some (about a dozen) resulting in shock. on arrival pt afebrile, a-paced at 70, with bp 120/60s. pt was ruled out for mi with ces neg x 2, cr at baseline at 1.7. dig level was checked after dose and was 1.9. pt was bolused and started on amio gtt and most recent vt and shock was at 3am on . he also received iv ativan, and 5mg iv dilaudid. . ros: currently pt denies sob, cp, palpitations, abd pain, back pain. past medical history: 1. cardiac risk factors: diabetes, dyslipidemia, hypertension 2. cardiac history: cad, mix2 -cabg: 3v -percutaneous coronary interventions: -pacing/icd: 3. other past medical history: -copd on home o2. -afib -cri -osa -diabetes with peripheral neuropathy -bph -kyphoplasty l1-3, c5-6 fusion, chronic lower back pain -systolic chf ef 25-30% in -diverticulosis -gerd -lacunar cva social history: works as security guard, daughter is nurse (previously ccu) -tobacco history: has not smoked in last year. family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: general: wdwn male in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa (dry). no xanthalesma. neck: supple with jvp of 8 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. well healed sternal scar. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. decreased bs at r base. abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. palpable dps and pts. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: 04:55am blood wbc-7.6 rbc-4.37* hgb-12.4* hct-39.2* mcv-90 mch-28.3 mchc-31.6 rdw-14.5 plt ct-251 01:02am blood wbc-12.0* rbc-3.90* hgb-11.2* hct-35.1* mcv-90 mch-28.7 mchc-31.8 rdw-14.7 plt ct-183 04:16am blood wbc-8.1 rbc-3.61* hgb-10.3* hct-33.2* mcv-92 mch-28.6 mchc-31.1 rdw-15.0 plt ct-215 07:45am blood wbc-12.0* rbc-3.41* hgb-10.3* hct-31.6* mcv-93 mch-30.1 mchc-32.6 rdw-15.4 plt ct-298 04:37am blood neuts-70 bands-0 lymphs-7* monos-21* eos-2 baso-0 atyps-0 metas-0 myelos-0 04:55am blood pt-13.1 ptt-27.1 inr(pt)-1.1 05:46pm blood pt-14.7* ptt-71.9* inr(pt)-1.3* 07:45am blood pt-14.4* ptt-27.7 inr(pt)-1.2* 11:26pm blood glucose-173* urean-36* creat-2.1* na-138 k-4.5 cl-99 hco3-31 angap-13 06:37am blood glucose-94 urean-39* creat-1.9* na-136 k-5.1 cl-101 hco3-26 angap-14 01:02am blood glucose-108* urean-50* creat-2.5* na-134 k-4.7 cl-100 hco3-21* angap-18 07:45am blood glucose-83 urean-87* creat-1.8* na-137 k-4.5 cl-102 hco3-28 angap-12 09:05pm blood ck-mb-notdone ctropnt-0.04* 04:16am blood ck-mb-notdone ctropnt-0.05* 09:05pm blood ck(cpk)-45* 10:55am blood d-dimer-6615* 03:00am blood vanco-10.0 01:42am blood type-art po2-299* pco2-46* ph-7.35 caltco2-26 base xs-0 06:58pm blood type-art po2-86 pco2-46* ph-7.34* caltco2-26 base xs--1 01:42am blood glucose-116* lactate-0.8 01:42am blood freeca-1.13 ccath: final diagnosis: 1. three vessel coronary artery disease. 2. patent lima-lad. 3. successful pci of the lcx/om with drug-eluting stent. cxr: asymmetric chf. an underlying infectious infiltrate in the right lower lung cannot be excluded. tte: the left atrium is normal in size. the left ventricular cavity size is normal. there is moderate regional left ventricular systolic dysfunction with basal to mid inferolateral and inferior akinesis. views are suboptimal so regional wall motion could not be fully assessed. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. an eccentric, posteriorly directed jet of at least moderate (2+) mitral regurgitation is seen. mitral regurgitation is not fully visualized. the tricuspid valve leaflets are mildly thickened. there is no pericardial effusion. ct chest: 1. moderate, mostly loculated, right pleural effusion and small, dependent freely layering left pleural effusion. 2. dense opacity at right lung base adjacent to pleural effusion likely represents atelectasis and less likely focal infection. 3. bilateral ground-glass opacities with septal thickening and bronchial wall thickening likely represent hydrostatic edema, but viral pneumonia may produce a similar pattern. 4. mediastinal lymphadenopathy with the largest lymph node conglomerate located subcarinally. although potentially related to hydrostatic edema or infection, given the large size of the subcarinal lymph nodes, there is concern for malignancy. followup ct in 6 weeks after treatment of the patients acute conditoin is recommended. 5. two nodular foci in the right upper lobe may represent focal areas of infection and less likely malignant lung nodules. these may also be reassessed at the follow up ct scan. 6. small amoung of ascites is noted. hypodense lesion in the upper pole of the left kidney likely represents a cyst. brief hospital course: 68m with mmp presents with vt storm and icd firing, transferred from outside hospital for ep ablation. . # ventricular tachycardia: patient presented from outside hospital with vt storm, initially thought to be of ischemic etiology due to scar tissue. tsh and digoxin level were within normal limits. patient had been loaded on amiodarone at outside hospital and was continued on amiodarone drip at 0.5mg/hr and beta blocker on presentation to . on the night of admission, patient had frequent runs of nsvt, longest 15 beats, which started while he was sleeping. while awake, patient reported feeling a sensation of "warmth" during some of these runs of nsvt. he was started on low dose metoprolol (both patient and daughter do not recall reason for listed atenolol allergy) and amiodarone drip dose was increased to 1mg/hr, after which frequency of nsvt runs decreased quickly. during attempted ep ablation of vt tract the next morning, electrophysiology team was able to map out patient's left ventricle and felt that vt was coming from right ventricle. patient reported having chest pain during ep procedure, so the procedure was cut short, and patient was sent for cardiac catheterization with the presumption that his vt may have been of ischemic etiology. the patient had a pci of the lcx/om with drug-eluting stent, however, felt that this wasn't in the right location to be causing his vt. the patient had no further runs of vt and no further ep procedure was done. if he develops vt in the future he may need his right ventricle mapped to look for a focus of the vt. the patient will follow up with dr. as an outpatient. # shortness of breath: patient experienced worsening shortness of breath during hospitalization, likely multifactorial. he presented with two weeks of worsening productive cough and was treated for right lower lobe pneumonia with broad spectrum antibiotics; only normal oropharyngeal flora grew from his sputum culture. patient appears to have long history of hospitalizations for copd and chf exacerbations with prolonged courses of recovery. he was found to have a right sided pleural effusion on admission to ; he was noted to have had this effusion in the past which was previously drained and found to be transudative. effusion appeared to be loculated on lateral decubitus films taken during this hospitalization. patient's o2 requirement increased post ep and cath procedures. he was thought to have aspirated during the ep procedure, so flagyl was added to his antibiotic regimen. pulmonary embolism was considered but felt to be of low suspicion. lower extremity ultrasound was negative for dvts bilaterally. ultimately, he was treated for copd exacerbation with steroids, despite minimal wheezing on exam, after which his symptoms improved. he was discharged home with services on oxygen (which he had prior to this hospitalization). # copd exacerbation: patient has prior smoking history, intermittently requires o2 at home, usually with chf exacerbations. he has had multiple known exacerbations for chf and copd in the past with prolonged recovery. his oxygen requirement was variable with up to 6l nc and a face tent. he was started on iv methylprednisolone and then prednisone taper. his oxygen requirement decreased to 4l nc. he will follow up with his pcp post discharge for further management. he was discharged with advair. # coronary artery disease: patient was ruled out for mi at the outside hospital, and ekg was without evidence of acute ischemia. patient was continued on home aspirin, statin, plavix, and beta blocker. patient was sent to cath lab immediately after having chest pain in the ep lab. cardiac catheterization showed three vessel coronary artery disease, 100% stenosis of mid lad but patent lima-lad graft, and significant disease in the left circumflex. the left circumflex had 90% proximal stenosis before the origin of the av branch and an 80% stenosis after the av and before om1, and was totally occluded distally. a drug-eluting stent was placed in the proximal-mid circumflex. the svg-pda and svg-om were known occluded and were not looked at. a femoral bruit was noted post procedure, not known to be old, but femoral ultrasound showed no pseudoaneurysm or fistula. patient did have a couple of episodes of chest pain in the day post catheterization with no ekg changes; he noted that the chest pain was similar to pain he experiences at home sometimes for which he does nothing. # hypertension: blood pressure was well controlled during hospitalization. he was discharged on his home low dose of tamsulosin, metoprolol. he will follow up with his primary care physician for further management. # hyperlipidemia: he was continued on zetia/simvastatin. # afib: well rate controlled, currently a paced. on no anticoagulation although chads score is 6. he was continued on aspirin and plavix. # cri: at baseline 1.7. he was given mucomyst prior to cardiac catheterization. # diabetes: patient was continued on basal glargine plus an insulin sliding scale during this hospitalization. his blood sugars were elevated while on steroids for copd exacerbation. # bph: he was continued on his home meds. medications on admission: lisinopril 2.5mg po daily lasix 40mg po qod (last on ) kcl 10meq qod lantus 30u qhs novolog 10u tid proscar 5mg po daily flomax 0.4mg po daily paroxetine 30mg po daily plavix 75mg po daily digoxin 0.125mg po daily asa 81mg po daily zetia 10mg po daily simvastatin 20mg po daily omeprazole 20mg po daily amiodarone 400mg po daily colace 100mg po daily senna 8.6mg po at bedtime ambien 5mg po qhs prn discharge medications: 1. insulin glargine 100 unit/ml solution sig: twenty (20) units subcutaneous at bedtime. 2. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 3. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*11* 5. paroxetine hcl 30 mg tablet sig: one (1) tablet po once a day. 6. aspirin 325 mg tablet sig: one (1) tablet po once a day. 7. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 8. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 9. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 10. amiodarone 200 mg tablet sig: 1.5 tablets po daily (daily). disp:*45 tablet(s)* refills:*2* 11. nitroglycerin 0.3 mg tablet, sublingual sig: tablet, sublinguals sublingual prn (as needed) as needed for chest pain: take 3 minutes apart, if you still have chest pain after 3 tablets, call 911. 12. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 13. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). disp:*1 disk with device(s)* refills:*2* 14. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 16. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*2* 17. dextromethorphan-guaifenesin 10-100 mg/5 ml syrup sig: five (5) ml po every four (4) hours as needed for cough. 18. novolog 100 unit/ml solution sig: per sliding scale units subcutaneous three times a day: before meals per sliding scale attached. 19. prednisone 10 mg tablet sig: three (3) tablet po once a day for 2 days: take on and . 20. prednisone 10 mg tablet sig: two (2) tablet po once a day for 2 days: take on and . 21. prednisone 10 mg tablet sig: one (1) tablet po once a day for 2 days: take on and . disp:*20 tablet(s)* refills:*0* discharge disposition: home with service facility: vna of southeastern mass. discharge diagnosis: ventricular tachycarida coronary artery disease acute on chronic congestive heart failure, acei held due to increased creatinine. chronic obstructive pulmonary disease discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - independent discharge instructions: you had ventricular tachycardia while you were at home which required the addition of more amiodarone and metoprolol. we were not able to complete an ablation at this time because of chest pressure during the ablation. a cardiac catheterizaion showed blockages in your left circumflex artery that were opened with 2 drug eluting stents. it is very important that you take your plavix and aspirin every day for at least one year and possibly longer. do not stop taking plavix for any reason unless dr. tells you not to. medication changes: 1. start plavix to keep the stents open 2. increase aspirin to 325 mg daily 3. stop taking omeprazole and digoxin 4. start taking ranitidine instead of omeprazole 5. stop taking lisinopril and lasix for now 6. stop taking potassium supplements until you restart your lasix. 7. decrease your lantus to 20 unit for now, you have a humalog sliding scale that you can use. you may need to decrease the lantus as your prednisone dose decreases. 8. start taking prednisone for you copd. you will take 30 mg for 2 days, then 20 mg for 2 days, then 10 mg for 2 days, then d/c. 9. decrease your amiodarone to 300 mg daily 10. start taking advair twice daily to help your breathing. . a ct scan of your chest showed that you had some enlarged lymph nodes in your chest. you also had some nodules in your right upper lung lobe. you should get another ct scan of your chest in 6 weeks time. . weigh yourself every morning, call dr. if your weight goes up more than 3 lbs in 1 day or 6 pounds in 3 days. . you cannot drive until after you see dr. on and he tells you it is ok to do so. followup instructions: primary care and pulmonology: , w. phone: date/time: friday at 11:15 am. . cardiology: , i. phone: date/time: at 2:20pm. . procedure: coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart catheter based invasive electrophysiologic testing non-invasive mechanical ventilation cardiac mapping insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: other chronic pain coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified acute kidney failure, unspecified coronary atherosclerosis of autologous vein bypass graft hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified paroxysmal ventricular tachycardia other and unspecified hyperlipidemia hypotension, unspecified pneumonitis due to inhalation of food or vomitus personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits lumbago acute on chronic systolic heart failure chest pain, unspecified diverticulosis of colon (without mention of hemorrhage) arthrodesis status 

Answer: The patient is high likely exposed to