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: pravachol / levaquin / bactrim / zyvox attending: chief complaint: worsening dyspnea on exertion major surgical or invasive procedure: right heart catheterization picc line placement history of present illness: the patient is a 65 yo m with pmh significant for ischemic cardiomyopathy with ef 15%, cardiac cirrhosis, s/p cabg & , -ventricular icd, s/p vt ablation, h/o cva, s/p right cea presents with volume overload with planned right heart cath in the am and possible milrinone initiation. the patient has been having worsening fatigue, lower ext swelling, sob and increasing weights at home. his lasix was increased to 80mg daily and also started on metolazone 5mg on mondays and fridays. the patient continued to have worsening a symptoms of volume overload and it was decided to admit him for a right heart cath and possible initiation of milrinone. . on arrive to the floor the patient feels well, but reports continued fatigue and volume overloaded. . on review of systems, he denied 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. 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, palpitations, syncope or presyncope. past medical history: dyslipidemia hypertension severe ischemic cardiomyopathy with lvef of 15% status post biventricular pacer icd () status post vt ablation x 3 (, , ?) af fib on coumadin s/p cabg: and again in cerebrovascular accident () with no residual neuro deficits s/p carotid endarterectomy, right, in appendiceal perforation with colostomy cardiac cirrhosis gout hypothyroidism social history: he is married with 3 children. he is a retired business man. he previously drank 1 glass a wine per week, but no longer does. he never drank more than 1-2 drinks per day. he does not smoke, but has a history of pipe smoking, quit in . family history: his father developed a cva at age 88 and also had lung cancer. his mother is alive and well at years of age physical exam: on admission: vs: t=97.1 bp=94/62 hr=66 rr=20 o2 sat= 100% ra general: appears chronically ill, in no acute distress. oriented x3. mood, affect appropriate. heent: ncat. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple, jvd elevated at approx 9-10cm. no carotid bruits. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. heart: rr, nl s1/s2, no s3/s4. apical holosystolic murmur @ llsb. no thrills, lift. pmi displaced laterally. abdomen: soft, protuberant and distended with a fluid wave. no hsm noted, bs present. extremities: 2+ bilateral pitting edema. there is no cyanosis or clubbing. skin: diffuse purpura and discoloration; evidence of venous stasis in le bilaterally. no open lesions, ulcers. pulses: right: carotid 1+ radial 1+ dp 1+ pt 1+ left: carotid 1+ radial 1+ dp 1+ pt 1+ discharge physical exam: pertinent results: labs on admission: 09:25pm glucose-133* urea n-116* creat-3.1* sodium-130* potassium-3.7 chloride-90* total co2-25 anion gap-19 09:25pm estgfr-using this 09:25pm alt(sgpt)-22 ast(sgot)-30 ld(ldh)-232 alk phos-242* amylase-74 tot bili-1.7* 09:25pm lipase-63* 09:25pm albumin-3.9 calcium-9.4 phosphate-4.4 magnesium-2.8* 09:25pm wbc-5.1 rbc-3.37* hgb-10.3* hct-32.1* mcv-95 mch-30.4 mchc-32.0 rdw-19.1* 09:25pm plt count-80* 09:25pm pt-32.6* ptt-40.9* inr(pt)-3.3* right heart cathterization: comments: 1. resting hemodynamics revealed elevated right and left heart filling pressures with rvedp 21 mmhg and pcwp (mean) 25 mmhg. the cardiac index was depressed at 1.64 l/min/m2. final diagnosis: 1. elevated right and left heart filling pressures. 2. depressed cardiac index. brief hospital course: 65m with ischemic cardiomyopathy (chronic systolic chf, ef 15%), cardiac cirrhosis, s/p cabg & , -ventricular icd, s/p vt ablation, h/o cva, s/p right cea presents with volume overload with planned right heart cath and milrinone initiation. # decompensated systolic heart failure of ischemic etiology: ischemic cardiomyopathy (chronic systolic chf, ef 15%), fluid overloaded on exam. he was admitted for aggressive diuresis with lasix gtt and metolazone. milrinone gtt initiated after right heart catheterization on . the patient was transferred to the ccu for invasive hemodynamic monitoring to trial and titrate milrinone. after starting iv milrinone, the patient's hemodynamics improved markedly, with ci improving from 1.6 to 2.3 l/min/m2; on milrinone 0.25 mcg/kg/hr, ci was 2.3 l/min/m2, on 0.5 mcg/kg/hr, ci was 2 l/min/m2. concomitant with the milrinone trial, the patient was volume optimized with aggressive diuresed on metolazone, a lasix gtt, and eplerenone; the patient was transitioned from carvedilol to metoprolol while being diuresed to help maintain mean arterial pressures and he was eventually transitioned to po torsemide from lasix. preload was also optimized with reprogramming of the patient's bv-pacer to lengthen the pr interval; after this was done, ci was 2.9 l/min/m2. no changes were made to the patient's antiarrhtymic medications dofetilide and quinine. the patient remained hemodynamically stable throughout admission without requiring pressure support. discharged on metolozone, torsemide, metoprolol succinate, eplerenone, dofetilide, and milrinone as detailed below. coumadin was held upon discharge due to inr 3.7, with plans for the patient follow-up as detailed below. . # history of af: remained stably paced w/-ventricular icd, s/p vt ablation, anticoagulated on coumadin. continued dofetilide and quinine. . # congestive cirrhosis: followed by hepatology; continue regimen of rifaxamin, lactulose (dosed for bm daily) to improve encephalopathy. . # renal insufficiency: secondary to poor cardiac output, continued to monitor, renally dose medications. . # gout: well controlled. patient was continued on renally dosed allopurinol, prednisone. . # hypothyroidism: last tsh 13, ft4 1.1 (). continued levothyroxine. medications on admission: prednisone 5mg daily asa 81mg daily carvedilol 12.5mg alprazolam 0.25mg qhs synthroid 50mcg qam vit c metolazone 5mg daily quinine 324mg qhs lactulose 45ml (titrate to 3 bm per day) allopurinol 100mg daily dofetilide 0.25mg inspra 25mg lasix 80mg daily rifaximin 550mg tramadol prn pain coumadin 4mg daily discharge medications: 1. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. alprazolam 0.25 mg tablet sig: one (1) tablet po at bedtime. 4. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 5. vitamin c oral 6. quinine sulfate 324 mg capsule sig: one (1) capsule po hs (at bedtime). 7. lactulose 10 gram/15 ml solution sig: forty five (45) ml po twice a day: titrate to 3 bm per day. 8. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 9. rifaximin 550 mg tablet sig: one (1) tablet po bid (2 times a day). 10. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 11. eplerenone 25 mg tablet sig: one (1) tablet po daily (daily). 12. dofetilide 125 mcg capsule sig: one (1) capsule po q12h (every 12 hours). disp:*60 capsule(s)* refills:*2* 13. metolazone 2.5 mg tablet sig: one (1) tablet po once a day. 14. milrinone in d5w 200 mcg/ml piggyback sig: one (1) intravenous infusion (continuous infusion). disp:*1 drip* refills:*0* 15. milrinone infusion milrinone 1 mg/ml solution;give 0.25 mcg/kg/min continuous weight is 73.7 kg.; please compound to 400 mcg/ml; disp# *** 30*** (thirty) bag; refills: **11** 16. outpatient lab work please check chem 7, inr/pt and cbc on friday and call results to dr. / at 17. torsemide 20 mg tablet sig: three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* 18. 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* discharge disposition: home with service facility: , discharge diagnosis: primary diagnosis: ischemic cardiomyopathy secondary diagnoses: cardiac cirrhosis, dyslipidemia, hypertension, s/p biventricular pacer icd (), s/p vt ablation x 3 (, , ?), atrial fibrillation, s/p cabg (, ), cerebrovascular accident () with no residual neuro deficits, r carotid endarterectomy (), gout, hypothyroidism discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you during your admission. you were admitted for fluid overload. you were given diuretics and underwent a right heart catheterization. you were then transferred to the cardiac intensive care unit for monitoring while you were given milrinone to help increased your cardiac output. . the following changes were made with your medications: 1. decrease metolozone to 2.5 mg daily 2. stop carvedilol, start metoprolol succinate 25mg daily instead 3. stop taking furosemide (lasix), take torsemide instead to remove excess fluid 4. stop taking warfarin (coumadin) 5. decrease eplerenone to once daily only 6. decrease dofetalide to .125 mg ( previous dose) because of your worsened kidney function. 7. start milrinone intravenously to help your heart beat more effectively. . please continue all other home medications as prescribed. . 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 9:00 am with: , np building: sc clinical ctr campus: east best parking: garage . department: cardiac services when: monday at 9:20 am with: , md building: sc clinical ctr campus: east best parking: garage . department: cardiac services when: wednesday at 11:00 am with: , np building: sc clinical ctr campus: east best parking: garage procedure: venous catheterization, not elsewhere classified coronary arteriography using two catheters pulmonary artery wedge monitoring right heart cardiac catheterization central venous catheter placement with guidance diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified hyposmolality and/or hyponatremia unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified other specified forms of chronic ischemic heart disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure long-term (current) use of anticoagulants automatic implantable cardiac defibrillator in situ hepatic encephalopathy accidents occurring in residential institution acute on chronic systolic heart failure mechanical complication of other vascular device, implant, and graft 

Answer: The patient is high likely exposed to