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: penicillins attending: chief complaint: s/p cardiac arrest major surgical or invasive procedure: arterial line placement intubation history of present illness: 65 yo m with history of pancreatic ca s/p whipple , afib, chf with lvef 25-30%, and type ii dm who present s/p cardiac arrest today. he originally presented to hospital as outpatient for planned , which was cancelled due to tachycardia, relative hypotension, and inability to find oxygen sat. patient then left the hospital to go home and had a witnessed vfib arrest with intubation in field and epi down ett. was shocked out of vfib. fs at that time was 132. . *per phone conversation with patient's wife* in last few weeks patient had been complaining to his wife that he was more short of breath with exertion. wife reports that patient acted like he had given up on life as he had no motivation to do even the smallest thing like change his underwear. she notes that he was sleeping through most of the day. patient also may have been a bit more confusion lately. patient finished 6.5 weeks of radiation therapy last week. patient has also finished multiple cycles of gemcitabine chemotherapy. of note, wife is very angry about the fact that patient was released to home from gi procedure suite today. she resports that she feels it was inappropriate to send a "half-dead" man home. . in the emergency department, vitals at presentation were: t 96.6, hr 112, bp 125/32, and intubated with o2sat 100%. patient had multiple impaging procedures including negative ct head, ct abd/pelvis showing large simple ascites, cta chest without pe but did show multiple right rib fractures and sternal fracture. currently being cooled (target reached at 33 c) and on a midazolam drip. ekg without concern for stemi, and cardiology feels this is close to his baseline ekg. prior to transfer to the icu vitals were: t 92 98, hr , bp 101/58, rr 25, o2sat 100% on ac mode vt 560, f 22, peep 5, fio2 100%. past medical history: past medical history: - type ii dm - chf with an ef of 30% - cad s/p mi - h/o atrial fibrillation on coumadin - chronic renal insufficiency (baseline creatinine 1.3) - adenocarcinoma of the pancreas s/p whipple in / with positive margins, currently undergoing adjuvant chemotherapy with gemcitabine (about three cycles in); most recent chemotherapy (gemcitabine) was two weeks ago, per patient . past surgical history: - sinus surgery - (l)le bypass for nonhealing toe ulcer - ercp with stent placement - whipple procedure as above social history: lives in with wife. retired it tech. has one son age 31, one daughter age 35 with special needs. no current or past etoh use, no current or past tobacco use. family history: mother h/o breast ca at early age. father cad. brother died from lung ca, heavy smoker. sister has dementia. physical exam: vs: t 33 c, hr 99, bp 100/59, rr 22, o2sat 100% vent: ac with vt 560, f 22, peep 5, fio2 100% gen: intubated and sedated, appears cachectic heent: scleral edema, perrl 3->2 mm neck: ej iv catheter at right neck pulm: anterior chest bruising card: tachycardic, nl s1, nl s2, no m/r/g abd: largely obscured by placement of artic sun pads, though bs+, soft, no grimace with palpation ext: stage iii ulcer on right heel, ble with woody edema, bue + pitting edema neuro: sedated, no rigidity of muscular tone . pertinent results: admission labs 11:17pm type-art temp-33 rates-22/ tidal vol-609 peep-5 o2-50 po2-255* pco2-22* ph-7.38 total co2-14* base xs--9 -assist/con intubated-intubated 11:17pm lactate-2.5* 09:19pm type- ph-7.23* comments-green top 09:19pm lactate-2.6* 09:19pm freeca-1.04* 09:07pm glucose-112* urea n-33* creat-1.6* sodium-144 potassium-5.8* chloride-118* total co2-16* anion gap-16 09:07pm ck(cpk)-352* 09:07pm ck-mb-55* mb indx-15.6* ctropnt-0.73* 09:07pm digoxin-0.2* 09:07pm wbc-9.8 rbc-3.10* hgb-9.6* hct-30.4* mcv-98 mch-30.8 mchc-31.5 rdw-21.7* 09:07pm plt count-191 09:07pm pt-16.9* ptt-33.6 inr(pt)-1.5* 08:10pm glucose-107* urea n-34* creat-1.6* sodium-140 potassium-8.6* chloride-117* total co2-16* anion gap-16 08:10pm ck(cpk)-412* 08:10pm ck-mb-53* mb indx-12.9* ctropnt-0.63* 08:10pm calcium-7.7* phosphate-3.7 magnesium-1.4* 03:21pm type-art tidal vol-520 o2-100 po2-329* pco2-30* ph-7.30* total co2-15* base xs--9 aado2-362 req o2-64 -assist/con intubated-intubated 01:55pm urine hours-random 01:55pm urine hours-random 01:55pm urine gr hold-hold 01:55pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 01:55pm urine color-yellow appear-clear sp -1.016 01:55pm urine blood-neg nitrite-neg protein-25 glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 01:38pm glucose-119* lactate-4.0* na+-143 k+-5.7* cl--118* tco2-15* 01:30pm urea n-33* creat-1.7* 01:30pm estgfr-using this 01:30pm estgfr-using this 11:59am type-art po2-294* pco2-28* ph-7.39 total co2-18* base xs--6 intubated-not intuba 01:30pm fibrinoge-220 01:30pm plt count-239 01:30pm pt-16.4* ptt-33.4 inr(pt)-1.5* 01:30pm wbc-6.7 rbc-3.38* hgb-10.4* hct-33.3* mcv-99* mch-30.8 mchc-31.3 rdw-21.8* 01:30pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg . discharge labs 05:43am blood wbc-10.6 rbc-2.76* hgb-8.6* hct-26.8* mcv-97 mch-31.1 mchc-32.0 rdw-21.8* plt ct-134* 01:52am blood wbc-8.8 rbc-2.98* hgb-9.3* hct-29.2* mcv-98 mch-31.0 mchc-31.7 rdw-21.8* plt ct-169 04:46am blood wbc-9.4 rbc-3.20* hgb-10.0* hct-30.8* mcv-96 mch-31.3 mchc-32.5 rdw-21.5* plt ct-177 04:46am blood neuts-95.6* lymphs-1.8* monos-2.4 eos-0.1 baso-0 05:43am blood plt ct-134* 01:52am blood plt ct-169 12:54pm blood pt-17.0* ptt-113.2* inr(pt)-1.5* 04:46am blood plt ct-177 05:43am blood glucose-120* urean-39* creat-2.1* na-139 k-4.9 cl-113* hco3-18* angap-13 07:49pm blood glucose-120* urean-39* creat-2.0* na-138 k-5.0 cl-113* hco3-18* angap-12 04:04pm blood glucose-124* urean-39* creat-1.9* na-140 k-5.0 cl-114* hco3-19* angap-12 01:52am blood glucose-256* urean-37* creat-1.7* na-142 k-5.2* cl-113* hco3-16* angap-18 04:46am blood alt-31 ast-64* ld(ldh)-370* ck(cpk)-372* alkphos-132* totbili-1.0 09:07pm blood ck(cpk)-352* 04:46am blood ck-mb-62* mb indx-16.7* ctropnt-0.67* 09:07pm blood ck-mb-55* mb indx-15.6* ctropnt-0.73* 08:10pm blood ck-mb-53* mb indx-12.9* ctropnt-0.63* 05:43am blood calcium-7.8* phos-4.5 mg-1.9 07:49pm blood calcium-7.7* phos-4.5 mg-2.0 04:04pm blood calcium-7.6* phos-4.1 mg-2.0 01:52am blood calcium-7.9* phos-4.2 mg-2.1 05:43am blood phenyto-9.0* 07:49pm blood phenyto-8.8* 09:07pm blood digoxin-0.2* 01:30pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 08:32am blood type-art temp-36.1 rates-12/14 peep-5 fio2-30 po2-110* pco2-35 ph-7.34* caltco2-20* base xs--5 -assist/con intubat-intubated 03:37am blood type-art temp-35.0 rates- tidal v-450 peep-5 fio2-30 o2 flow-6.3 po2-92 pco2-34 ph-7.33* caltco2-19* base xs--6 intubat-intubated vent-controlled 01:57am blood type-art temp-34.3 rates- tidal v-450 peep-5 fio2-30 po2-89 pco2-31* ph-7.33* caltco2-17* base xs--8 intubat-intubated vent-controlled 11:44pm blood type-art temp-33.6 rates- tidal v-450 peep-5 fio2-30 po2-93 pco2-28* ph-7.31* caltco2-15* base xs--10 intubat-intubated vent-controlled 10:36pm blood type-art temp-33.3 rates- tidal v-450 peep-5 fio2-30 o2 flow-6.2 po2-132* pco2-32* ph-7.27* caltco2-15* base xs--10 intubat-intubated vent-controlled 04:42pm blood lactate-1.8 cl-114* . reports regular rhythm at 97 beats per minute. in leads v5-v6 there are p waves so this is probably sinus rhythm at 97 beats per minute. marked low voltage in the limb leads persists. the right bundle-branch block pattern persists with a qrs duration which has widened to 158 milliseconds. there is poor r wave progression laterally and low voltage in all leads. there are small q waves in leads ii, iii and avf with st segment elevation in those leads. consider acute inferior myocardial infarction. . ct head w/o contrast impression: no acute intracranial process. . chest ct w contrast . no central pe or dissection. suboptimal evaluation of the posterior pulmonary circulation secondary to large bilateral pleural effusions with associated compressive atelectasis. 2. focal small foci of gas in the anterior upper abdomen on the last image of non-contrast sequence. free air cannot be excluded. 3. large amount of abdominal ascites. 4. multiple right and left rib fractures and a sternal fracture. these may be related to recent resuscitative efforts. 5. ground-glass opacity in the right middle lobe may be a pulmonary contusion versus infection versus aspiration. this is new since . . ct abdomen large volume ascites with no evidence of free air.. . echo the left atrium is elongated. the right atrium is moderately dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is severe regional left ventricular systolic dysfunction with near akinesis of the inferior and inferolateral walls and hypokinesis of the remaining segments. the anterior septum contracts best (lvef 25-30%). the estimated cardiac index is depressed (<2.0l/min/m2). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is dilated with moderate global free wall hypokinesis. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. severe (4+) mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. significant pulmonic regurgitation is seen. there is no pericardial effusion. compared with the prior study (images reviewed) of , the estimated pulmonary artery systolic pressure is now highter. . cxr cardiomegaly, large bilateral pleural effusions greater on the right side with associated atelectases are unchanged. et tube, ng tube, and right central catheter remain in place. there is no pneumothorax. cardiomediastinal silhouette is unchanged. brief hospital course: 65 yo m with history of pancreatic ca s/p whipple , afib, chf with lvef 25-30%, and type ii dm who present s/p cardiac arrest today. is being cooled with artic sun. #. vfib cardiac arrest: most likely etiology was either new ischemia or automaticity from old scar in setting of dilated ischemic cardiomyopathy with lvef of 25-30%. patient's exam and history was consistent with decompensated heart failure of at least several week duration. less likely cause of cardiac arrest would be digoxin toxicity given patient recently started that medication and has history of renal insufficiency. cta chest was overall a poor study given large pleural effusions, though no apparent pe or aortic dissection. patient fortunately had relatively rapid defibrillation and during code. he was being cooled followed by warmed on artic sun for neuro protection and has reached temperature goal of 33 c. 48hr eeg showed possible seizure activity consistent with ischemic injury; consult neuro to evaluate eeg family meeting once warmed and off sedation to discuss goals of care and prognosis, and it was decided to enact comfort care measures. . #hypotension: likely secondary to worsening heart failure in the setting of fluid overload. n.epi and vasopressin as needed for map > 60; phenylephrine prn for additional pressure support . #. acute on chronic kidney injury:most likely due to atn in setting of arrest mr wife and son decided they wanted to fully withdraw care. dr met with them and answered all questions - pt was extubated and all pressors were turned off. placed on morphine for comfort. at approx. 12:45pm, i was notified by the nurse the patient had passed away with his family at bedside. . i examined the patient and he was not responsive to auditory or tactile stimuli. i observed 1 minute of no breaths or respiratory effort. i auscultated no breath sounds or heart sounds for 1 minute. the patient did not have a corneal reflex or pupilllary reaction to direct light bilaterally. i declared the patient dead at 12:57 pm and notified his family who were in the hallway outside the icu. his wife and son denied a autopsy. medications on admission: per discharge* 1) atorvastatin 40 mg qhs 2) lipase-protease-amylase 5,000-17,000-27,000 capsule, tid w/meals 3) metoprolol tartrate 25 mg po daily 4) trazodone 50 mg po hs 5) insulin glargine 8 units subcutaneous daily 6) humalog 100 unit/ml 1-12 units subcutaneous qid 7) aspirin 81 mg po daily 8) pantoprazole 20 mg q24h 9) furosemide 40 mg tablet po daily 10) digoxin 0.125 mg daily 11) tamsulosin 0.4 mg daily 12) ferrous gluconate daily discharge medications: patient has passed away discharge disposition: expired discharge diagnosis: patient has passed away discharge condition: patient has passed away discharge instructions: patient has passed away followup instructions: patient has passed away procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours arterial catheterization diagnoses: coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified other specified forms of chronic ischemic heart disease acute respiratory failure anoxic brain damage cardiogenic shock long-term (current) use of insulin ventricular fibrillation acute on chronic systolic heart failure malignant neoplasm of pancreas, part unspecified 

Answer: The patient is high likely exposed to