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: chest pain major surgical or invasive procedure: ventricular tachycardia ablation history of present illness: 82f h/o cad s/p cabg, htn, dm, cri, bilateral ras s/p stenting, h/o atrial flutter transferred from osh after presenting with chest pain and found to have stable wide complex tachycardia. had been feeling well until the morning of admission when she developed diarrhea and nausea with emesis x 1. began to experience sscp radiating to the back at 5pm that was unrelieved by nitro. no associated sob, diaphoresis. has not had angina since cabg. the patient called ems who found her in stable wide complex tachycardia with rate 200's. given 2x lidocaine boluses with resolution of the tachycardia and chest pain. presented to ed where she again developed wide complex tachycardia captured on ecg, likely vt. given amiodarone boluses and placed on amiodarone gtt with termination of arrythmia. transferred to for further evaluation. currently cp free. denies resting sob, edema, pnd, or orthopnea. endorses doe with 1 flight stairs. no abdominal pain. past medical history: 1. htn 2. chf (ef 50-60%) 3. cad s/p cabg (; lima->lad, svg->om1, svg->rca) 4. s/p mi () 5. dm2 6. bilateral ras s/p stents () 7. right carotid stenosis 8. s/p appendectomy () 9. s/p cholecystectomy () 10. spinal stenosis; s/p surgery () 11. chronic renal insufficiency (baseline cre 2.3) 12. bilateral cataracts 13. s/p colonoscopy () 14. h/o atrial flutter 15. h/o chronic anemia (baseline hct 30-32) social history: the patient lives at home with her husband. she has a 30-pack-year smoking history, but none currently. she does not drink alcohol. family history: nc physical exam: t 99.4 hr 60 bp 180/60 left arm, 180/72 right arm rr 23 sao2 95% on 2l nc weight 193 lbs general: wdwn, nad, breathing comfortably on ra heent: perrl, eomi, anicteric sclera, conjunctivae pink, mm moist neck: supple, trachea midline, no thyromegaly or masses, no lad, no carotid bruits cardiac: rrr, s1s2 normal, 2/6 systolic murmur @ apex, jvp 12 cm pulmonary: ctab abdomen: +bs, soft, nontender, nondistended, no hsm extremities: warm, 2+ dp pulses, no edema neuro: a&ox3, speech clear and logical, cnii-xii intact, moves all extremities pertinent results: admission labs: * hematology - 10:23pm blood wbc-15.6*# rbc-4.06* hgb-13.3# hct-37.5 mcv-93 mch-32.8* mchc-35.5*# rdw-13.6 plt ct-171 10:23pm blood neuts-93.5* bands-0 lymphs-4.3* monos-2.1 eos-0.1 baso-0 10:23pm blood plt ct-171 03:22am blood pt-11.7 ptt-20.5* inr(pt)-1.0 06:26am blood ret aut-1.6 . * chemisty - 10:23pm blood glucose-438* urean-95* creat-3.3* na-142 k-4.2 cl-107 hco3-20* angap-19 10:23pm blood ck(cpk)-270* 03:22am blood alt-21 ast-35 ld(ldh)-293* ck(cpk)-323* alkphos-112 amylase-202* totbili-0.4 . discharge labs: * hematology - . * chemistry - . ecg (): sinus, 89bpm, lad, lvh, q-waves iii/avf, ste's iii/avf, new lbbb compared to . cxr, portable (): no acute process . cardiac mr (): . right . prior studies - . cath (): comments: 1. resting hemodynamics demonstrated systolic hypertension and mildly elevated biventricular filling pressures. the cardiac index was normal at 3.8 l/min/m2. 2. selective native coronary arteriography demonstrated total occlusion of all coronary arteries proximally. 3. selective graft angiography was performed. the lima to lad was widely patent. the rca filled well via collaterals from the lad. the svg to om1 was widely patent. the svg to rca was totally occluded proximally. final diagnosis: 1. three vessel native coronary artery disease. 2. patent lima to lad and svg to om1. 3. normal cardiac output. 4. systolic hypertension. . tte (): conclusions: the left atrium is mildly dilated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is hypokinesis of the inferior and posterior walls, but the overall ejection fraction is well-preserved (50-60 percent). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are moderately thickened. there is no significant aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: left ventricular hypertrophy with preserved left ventricular ejection fraction, inferior-posterior hypokinesis, and probable diastolic dysfunction of the left ventricle. 06:26am blood ck(cpk)-115 amylase-28 07:10am blood amylase-100 03:22am blood lipase-194* 06:26am blood lipase-128* 07:10am blood lipase-109* 10:23pm blood ck-mb-27* mb indx-10.0* ctropnt-0.33* 03:22am blood ck-mb-39* mb indx-12.1* ctropnt-1.92* 11:15am blood ck-mb-27* mb indx-11.0* ctropnt-1.43* 06:26am blood ck-mb-10 mb indx-8.7* ctropnt-0.92* 10:23pm blood calcium-9.8 phos-3.4 mg-2.4 06:26am blood caltibc-242* vitb12-249 folate-greater th ferritn-133 trf-186* 03:22am blood tsh-1.6 brief hospital course: 82f with cad s/p cabg, chf, dm2, cri presents with sscp and stable vt. no more episodes vt or cp during admission. unable to induce vt on ep study but underwent empiric vt ablation based on mapping. . # wide complex tachycardia: likely vt based on osh ecg given left axis, atypical rbbb; thought to be originating from prior inferior mi rather than new ischemia. at presentation, the patient was asymptomatic and in sinus. transferred from osh on amiodarone gtt but discontinued to aide in ability to induce vt at ep study. no more vt episodes during admission. underwent cardiac mr mapping. at ep study on , they were unable to induce vt. the patient underwent presumptive ablation of inferior/septal myocardial . f/u with dr. next week. . # cad: s/p cabg with 2/3 grafts patent on cath. cardiac enzymes positive in the setting of rapid sustained vt. concern for acs as may have new obstructing graft lesion however given that symptoms of chest pain resolved when arrythmia terminated thought to be less likely. she was contiued on asa, plavix, statin, beta blocker, and nitrate. heparin gtt was discontinued. cardiac mr was performed (see above for results) for mapping prior to ablation. no cardiac cath given less likely vt from active ischemia and poor baseline renal function. she was restarted on all of her home dose medications prior to discharge. . # chf: preserved ef on last echo, likely distolic dysfunction. elevated jvp (possibly related to tr) but no edema or rales on exam. she was given a low sodium diet, daily weights, strict i/os. lasix was initially held as thought slightly volume depleted from vomiting and diarrhea prior to admission, supported by exam and pre-renal indices. she maintained good sao2 and was restarted on lasix 40mg was restarted at discharge. . # htn: elevated bps at admission in the setting of not receiving her home medications. initially, clonidine and acei were held to give room to up-titrate beta-blocker given vt and concern for acs. bps remained slightly elevated at discharge (sbp 130-170). she was restarted on home dose metoprolol, clonidine, isordil, and acei. . # acute on cri: non-oliguric. cre peaked at 3.3 (baseline of 2.3). most likely etiology is pre-renal from either hypovolemia (poor po intake/vomiting), poor forward flow, although also possible renal artery restenosis. indices supported pre-renal etiology (fena 0.22%, uosm 564) and improved to baseline during admission with holding lasix. restarted on acei and lasix at discharge. . # abdominal symptoms: nausea, vomiting, and diarrhea the day of presentation. no abdominal pain. afebrile but with elevated wbc count. normal lfts but elevated amylase and lipase (? vomiting) tjat then normalized prior to discharge. all symptoms have resolved since admission. most likely viral gastroenteritis. . # anion gap metabolic acidosis: no ketones in urine. most likely renal failure, vomiting, diarrhea. delta-delta ~1 therefore pure ag disorder. calculated serum osms 313. now resolved. . # dm: elevated blood glucose, minimal response to iv insulin and was briefly on insulin gtt for tight glucose control, then placed on home insulin regimen with good response. . # anemia: hct normal at presentation (likely due to hemoconcentration), then decreased to 28 but remained table. baseline hct is approx 30. guaiac positive x1 during admission but no melena / hematochezia. iron studies suggest acd, likely renal failure. b12 and folate normal. was on epo in the past, but no longer taking. continued aspirin, plavix for cardioprotection. would recommend outpatient gi follow-up. . medications on admission: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 6. gabapentin 100 mg capsule sig: one (1) capsule po hs (at bedtime). 7. lasix 120 mg tablet sig: one (1) tablet po daily (daily). 8. insulin nph-regular human rec 100 unit/ml (70-30) suspension sig: forty (40) units subcutaneous with breakfast. 9. insulin nph human recomb 100 unit/ml suspension sig: thirty (30) units subcutaneous with dinner. 10. clonidine 0.1 mg tablet sig: one (1) tablet po bid (2 times a day). 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. 12. hydrocodone-acetaminophen 7.5-750 mg tablet sig: one (1) tablet po qhs: prn as needed for pain. 13. niacin 500 mg tablet sig: one (1) tablet po at bedtime. 14. lisinopril 5 mg tablet sig: one (1) tablet po twice a day. 15. axid 150 mg capsule sig: one (1) capsule po once a day. 16. multivitamin tablet sig: one (1) tablet po once a day. discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 6. gabapentin 100 mg capsule sig: one (1) capsule po hs (at bedtime). 7. lasix 40 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 8. insulin nph-regular human rec 100 unit/ml (70-30) suspension sig: forty (40) units subcutaneous with breakfast. 9. insulin nph human recomb 100 unit/ml suspension sig: thirty (30) units subcutaneous with dinner. 10. clonidine 0.1 mg tablet sig: one (1) tablet po bid (2 times a day). 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. 12. hydrocodone-acetaminophen 7.5-750 mg tablet sig: one (1) tablet po qhs: prn as needed for pain. 13. niacin 500 mg tablet sig: one (1) tablet po at bedtime. 14. lisinopril 5 mg tablet sig: one (1) tablet po twice a day. 15. axid 150 mg capsule sig: one (1) capsule po once a day. 16. multivitamin tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: primary: ventricular tachycardia . secondary: 1. htn 2. chf (ef 50-60%) 3. cad s/p cabg (; lima->lad, svg->om1, svg->rca) 4. s/p mi () 5. dm2 6. bilateral ras s/p stents () 7. right carotid stenosis 8. s/p appendectomy () 9. s/p cholecystectomy () 10. spinal stenosis; s/p surgery () 11. chronic renal insufficiency (baseline cre 2.3) 12. bilateral cataracts 13. s/p colonoscopy () 14. h/o atrial flutter 15. h/o chronic anemia (baseline hct 30-32) discharge condition: stable discharge instructions: 1)please take all medications as prescribed, as listed in the discharge instructions. 2)please schedule follow-up with your primary care physician and cardiologist upon discharge. 3)please return to ed immediately if you experience worsening chest pain, shortness of breath, nausea, vomiting, sweating, fevers, chills, bleeding, or other concerning symptoms. followup instructions: , m follow-up appointment should be in 1 week . provider: , . call to schedule appointment in 1 week. procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach injection or infusion of other therapeutic or prophylactic substance cardiac mapping magnetic resonance imaging of chest and myocardium diagnoses: acidosis anemia in chronic kidney disease intermediate coronary syndrome congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status chronic kidney disease, unspecified paroxysmal ventricular tachycardia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure peripheral vascular complications, not elsewhere classified long-term (current) use of other medications old myocardial infarction diastolic heart failure, unspecified other nonspecific abnormal serum enzyme levels volume depletion, unspecified intestinal infection due to other organism, not elsewhere classified aneurysm of artery of lower extremity 

Answer: The patient is high likely exposed to