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: shellfish / norvasc / univasc attending: chief complaint: "popping sensation in head" major surgical or invasive procedure: - ventricular tachycardia ablation history of present illness: the patient is a 74 year old male with a history of coronary artery disease ( lcx occlusion s/p ptca), infarct-related cardiomyopathy with lvef 35-40% and monomorphic vt s/p dual chamber icd implantation in for primary prevention who presents to the emergency department with intermittent episodes of "popping sensation in his head." he was in his normal state of health until this past friday morning when he was in the car and he suddenly developed a sensation of flushing in his ears followed by a jolt in his head, which lasted seconds. this sensation has repeated itself approximately ten times since friday. he has never had this sensation before. he denies palpitations, chest pain, syncope, pre-syncopal symptoms. he reports some dyspnea on exertion over the past several weeks, which he attributes to upper respiratory tract infection. he denies orthopnea, weight gain, lower extremity edema. his icd was last interrogated on , since last clinic visit in there were no sustained arrhythymias, 6 nsvt. the vt detection is between 150 and 188, fast vt detection is between 188 and 250 while the vf detection is greater than 250 beats per minute. the vt therapy equals anti-tachy pacing followed by 5 shocks between 20 and 35 joules, fast vt therapy equals anti-tachy pacing followed by 5 shocks between 20 and 35 joules, whereas the vf therapy equals anti-tachy pacing during charging followed by 6 shocks between 24 and 25 joules his device is programmed to treat rates greater than 150 bpm inthe vt zone, rates greater than 188 bpm in the vf zone. the brady portion of his device is in the mvp mode aai/ddd lower rate 55 bpm. the mode switch feature is on for atrial rates greater than 171 bpm. in the ed, initial vitals were: 97.4 72 147/86 16 98%. initial ekg showed sinus rhythm, rate 57, normal axis with old inferior and high lateral twi with several pvc of right bundle, superior axis morphology. during evaluation, he developed similar symptoms and on telemetry had nsvt at a rate in the low 200s lasting up to ten seconds. cardiology interrogated icd, which revealed 255 episodes of fast vt (>188bpm) since last interrogated, 244 pace terminated episodes (atp), 11 shock terminated episodes (20j then 30j if refractory). cbc, chemistry, troponin unremarkable. cxr showed aicd in place with no acute process. he was started on amiodarone 150mg bolus and drip without improvement in nsvt. he was then started on lidocaine drip with improvement in nsvt and now with infrequent pvc. on review of systems, s/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. s/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, ankle edema, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: dyslipidemia, hypertension 2. cardiac history: - percutaneous coronary interventions: ptca lcx - pacing/icd: virtuoso dual-chamber icd placed for primary prevention after holter monitor showed frequent pvc and nsvt, referred for ep study (madit i criteria). device last interrogated -> device programmed to treat rates greater than 150 bpm inthe vt zone, rates greater than 188 bpm in the vf zone. thebrady portion of his device is in the mvp mode aai/ddd lower rate55 bpm. the mode switch feature is on for atrial rates greater than 171 bpm. 3. other past medical history: - coronary artery disease s/p inferior mi in and recurrent inferior mi in s/p ptca to lcx - infarct-related cardiomyopathy with lvef 35-40% - obstructive sleep apnea, not on cpap - knee oa s/p surgery for meniscal tear - abdominal aortic aneurysm s/p repair social history: - works in sales - lives w/ wife in - tobacco history: former smoker - etoh: infrequent (once per month) - illicit drugs: denies family history: - mother: died from mi in early 60s - father: unknown physical exam: admission exam: vs: bp:127/75 hr: 67 rr: 16 o2: 95% 2lnc general: nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: no jvd. supple cardiac: pmi located in 5th intercostal space, midclavicular line. regular rhythm, s1, s2, no murmur appreciated, distant heart sounds lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. 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+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ discharge exam: unchanged from above. pertinent results: admission labs: 11:10pm blood wbc-7.9 rbc-4.97 hgb-16.1 hct-47.5 mcv-96 mch-32.4* mchc-33.9 rdw-13.2 plt ct-143* 06:18am blood pt-11.4 ptt-27.1 inr(pt)-1.1 11:10pm blood glucose-116* urean-20 creat-1.0 na-136 k-3.8 cl-103 hco3-26 angap-11 06:18am blood ck(cpk)-192 11:10pm blood ctropnt-<0.01 11:10pm blood calcium-9.7 phos-3.4 mg-2.1 11:10pm blood tsh-2.5 imaging: -tte () - the left atrium is dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is severe regional left ventricular hypokinesis with akinesis of the inferior and inferolateral walls, apical inferior wall and apex (lvef = 25-30%). the inferior septum is hypokinetic. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened (?#). significant aortic stenosis is present (not quantified). trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. an eccentric, anteriorly directed jet of moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is an anterior space which most likely represents a prominent fat pad. compared to the findings of the prior study of , left ventricular systolic function has deteriorated. impression: severe left ventricular systolic dysfunction with overall ef of 25-30% and wall motion abnormalities as described above. moderate mr, trace tr and ai. aortic stenosis is present. however, the severity cannot be reliably estimated given depressed systolic function. -cxr () - no acute chest pathology; there is no radiographic evidence for pulmonary edema. -kub () - 1. prominent air-filled mildly dilated loops of small bowel are most consistent with an ileus, although a partial or early small-bowel obstruction cannot be excluded. 2. marked gastric distention. -cxr () - ngt ends in the fundus of a moderately to severely distended stomach. there is no free subdiaphragmatic gas. the transverse colon is at least moderately dilated. lung volumes are low exaggerating heart size, probably top normal. no pneumothorax or pleural effusion. transvenous right atrial and right ventricular pacer defibrillator leads are in standard placements respectively. -kub () - 1. ng tube in proper position within the stomach. 2. interval decrease in gastric distention and dilation of small bowel loops. -kub () - the ng tube tip is coiled at the level of the gastroesophageal junction and should be further advanced. the stomach bubble has slightly decreased since the prior study. there is no definitive evidence of free air. there is no evidence of bowel dilatation. brief hospital course: 74 year old male with a history of coronary artery disease s/p inferior myocardial infarction, infarct-related cardiomyopathy with lvef 25-30% and icd implantation in for primary prevention who presents to the emergency department with non-specific symptoms found to have intermittent monomorphic ventricular tachycardia with appropriate icd shock. . # ventricular tachycardia - after icd interrogation, it was found that he had many episodes of nsvt, some of which required antitachycardia pacing and eventually shocks. he was initially started on a lidocaine drip in an attempt to suppress the vt. this was stopped after less than 24 hours because of nausea and some vomiting which may have been caused by the lidocaine. he subsequently underwent a vt ablation. they were unable to induct any vt during the procedure but a substrate ablation was performed in the area of scar from his prior mi. he did not have any more vt after the procedure, only frequent pvcs with groups up to 3 beats at a time (which had also been noted from prior to admission on his icd/pacer interrogation). antiarrhythmics were held after the procedure, he was only continued on metoprolol. he will be anticoagulated for 3 months after the ablation because of the elevated risk for stroke. he was started on warfarin at discharghe. for bridging, he was initially on a heparin gtt which was transitioned to lovenox 100mg sc q12h, which he will continue until his inr is therapeutic. . # nausea/vomiting - at presentation, he had some mild nausea, some of which was attributed to the lidocaine drip which was started at admission. however, after the vt ablation, for which he had general anesthesia, his nausea was significantly worse. he had projectile bilious vomiting and a kib showed significant gastric dilation. this was presumed to be a post-anesthesia ileus, he had a similar reaction after his aaa repair which required decompression with an ngt. an ngt was placed again this admission and his symptoms improved. his abdominal exam remained benign with no tenderness to palpation. the tube was removed after 48 hours when his kub showed resolving gastric dilation. he was able to tolerate po intake prior to discharge. . # cad - he did not have any complaints of chest pain and his cardiac enzymes were negative. he was continued on aspirin and his beta blocker was changed from atenolol to metoprolol. . # hyperlipidemia - continued on home dose of atorvastatin . #code status this admission - full code . #transitional issues - will continue on lovenox 100mg sc q12h until inr is therapeutic - started on coumadin with subtherapeutic inr at discharge, will have inr checked on tuesday - atenolol was changed to metoprolol during this admission - should follow-up with the device clinic after discharge, will need to call for the appointment as he was discharged on a weekend. will see dr. as an outpatient. medications on admission: - atenolol 50 mg a day - aspirin 81 mg a day - atorvastatin 40 mg a day - seroquel 25 mg at night - vitamin d - ibuprofen p.r.n. discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. :*30 tablet(s)* refills:*0* 4. enoxaparin 100 mg/ml syringe sig: one hundred (100) mg subcutaneous q12hours (): continue until your inr is and then continue only the coumadin - as outlined by your primary care physician. :*20 doses* refills:*0* 5. metoprolol succinate 50 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. :*30 tablet extended release 24 hr(s)* refills:*0* 6. quetiapine 25 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 7. cholecalciferol (vitamin d3) oral 8. outpatient lab work please check inr given patient's need for anticoagulation. check on tuesday, . . fax results to pcp: , md discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: 1. ventricular tachycardia status-post ablation procedure . secondary diagnoses: 1. coronary artery disease 2. ischemic cardiomyopathy (ef=25-30%) discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , . it was a pleasure taking care of you during your admission to . you were admitted to the cardiac care unit because you were found to have frequent episodes of ventricular tachycardia (vt) which was causing your icd to discharge. you had a vt ablation and did not have any further episodes of vt afterwards. after receiving general anesthesia, you had nausea and projectile vomiting which required placement of a nasogastric tube, which has subsequently been removed. your symptoms improved and the tube was removed prior to discharge. . you were started on warfarin for anticoagulation after your ablation procedure. you will also continue to take lovenox injections every 12 hours until your inr (a test of how thin your blood is) is between . you should have your inr checked on tuesday. you can take the attached prescription to any phlebotomy laboratory and have the results faxed to your pcp . . * as discussed with dr. , your cardiology attending this admission, you are okay to perform some lifting after a resting period (resume mild lifting less than 5-lbs on tuesday, ). you are able to travel and continue driving, in discussion with dr. . * . * if your icd device fires once, and you feel well following this, you may resume your normal activities and call your outpatient cardiologist with 1-2 days. . * if your icd device first multiple times or your feel unwell following this, then proceed to the emergency room. . the following changes have been made to your medications: . start: metoprolol succinate xl 50 mg by mouth daily start: lovenox 100 mg subcutaneous every 12-hours until your inr is between . your doctor will tell you when to stop this medication. start: warfarin 5 mg by mouth daily . the following medications were discontinued this admission: discontinue: atenolol followup instructions: we will email dr. regarding an appointment for next week. her office will call regarding scheduling. . department: when: wednesday at 2:00 pm with: , md building: (, ma) campus: off campus best parking: on street parking . department: cardiac services when: tuesday at 9:30 am with: icd call transmissions building: none none campus: at home service best parking: none . department: cardiac services when: wednesday at 10:00 am with: device clinic building: sc clinical ctr campus: east best parking: garage procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach cardiac mapping diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery unspecified essential hypertension percutaneous transluminal coronary angioplasty status paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation paralytic ileus automatic implantable cardiac defibrillator in situ insomnia, unspecified osteoarthrosis, localized, not specified whether primary or secondary, lower leg 

Answer: The patient is high likely exposed to