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: no known allergies / adverse drug reactions attending: chief complaint: refractory ventricular tachycardia major surgical or invasive procedure: - left-sided video-assisted thorascopic surgery (vats) with sympathectomy history of present illness: 67 year old female with idiopathic dilated cardiomyopathy (? viral myocarditis 10 years ago) with lvef of 20% sp biv icd, moderate mitral regurgitation (improved on recent echo), who is s/p l vats for sympathectomy in setting of recurrent vt. the patient is currently endorsing pain in her incision site and is rather somnolent. she is in nsr currently. . the patient has had a long course of admissions since for recurrent vt and icd firings. she was found to have multiple inducible vts arising from the septum, lateral wall and apex. septal origin of vt precluded ablation. she was started on mexilitine. she continued to have frequent sustained vt. anterior septal ablation was attempted, but she did experience recurrent vt and shocks x2. she was readmitted and had successful stellate ganglion block and was started on qunidine. about one week later, she did have recurrent palpitations. she was readmitted for repeat stellate ganglion block. dr. saw the patient on and reprogrammed the icd to have lv pace before the rv by 50msec to improve low cardiac output since her main issue is low co and orthostasis. he started midrodrine 5mg tid. . at time of admission, the patient felt well, her last episode of firing and palpitations was 4 days ago. no symptoms since then. reports sob with ambulation from bedroom to kitchen, this is chronic x 12 years. no chest pain. . review of systems on review of systems, she 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. she denies recent fevers, chills or rigors. she 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, ankle edema. past medical history: 1. cardiac risk factors: none. 2. cardiac history: idiopathic dilated cardiomyopathy (?viral myocarditis), ef 20-25%%. -cabg: none. -percutaneous coronary interventions: -pacing/icd: icd and biv device 3. other past medical history: - osteoarthritis - h/o gout - stellate ganglion block x2 social history: tobacco history: denies. -etoh: rare -illicit drugs: denies. the patient lives with her husband. family history: negative for premature atherosclerotic cardiovascular disease and sudden death. there is no diabetes or hypertension in the family history. son: viral induced dm1 father- mi mother- died at 93 physical exam: admission physical examination: vs: t= 97.5 bp=89/49, hr= 72 rr=18o2 sat=100%ra 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: supple with jvp of 7 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. soft 1/6 systolic murmur left sternal border. no thrills, lifts. no s3 or s4. 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: stasis dermatitis on bilateral shins, 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 notable for r hand-cold; l hand-warm, otherwise unchanged. perrl. pertinent results: admission labs: 09:47pm blood wbc-6.8 rbc-3.40* hgb-10.9* hct-32.5* mcv-96 mch-32.0 mchc-33.5 rdw-13.4 plt ct-204 09:47pm blood pt-11.0 ptt-35.7 inr(pt)-1.0 09:47pm blood glucose-108* urean-34* creat-1.5* na-142 k-4.3 cl-103 hco3-27 angap-16 07:15am blood alt-23 ast-21 ld(ldh)-185 alkphos-72 totbili-0.3 09:47pm blood calcium-8.6 phos-4.0 mg-2.4 . microbiologic data: urine culture - pending . imaging studies: chest (portable ap) - small left apical pneumothorax. subcutaneous gas in left chest wall. new surgical clips projecting over left upper mediastinum. final radiology report pending. . chest (portable ap) - pending discharge labs: 04:39am blood wbc-8.6# rbc-3.46* hgb-11.0* hct-33.5* mcv-97 mch-31.8 mchc-33.0 rdw-13.7 plt ct-182 04:39am blood glucose-95 urean-23* creat-1.0 na-141 k-4.1 cl-107 hco3-26 angap-12 04:39am blood alt-24 ast-33 ld(ldh)-193 alkphos-67 totbili-0.4 04:39am blood albumin-3.2* calcium-8.7 phos-4.1 mg-2.3 brief hospital course: impression: this is a 67-year-old woman with an idiopathic dilated cardiomyopathy with lvef of 20% (? viral myocarditis, non-ischemic) status-post biventricular icd placement, moderate mitral regurgitation, recurrent episodes of multifocal ventricular tachycardia who is status-post partial ablation in and stellate ganglion block (x 2) who presented for sympathectomy procedure. . # recurrent, multifocal ventricular tachycardia - the patient has a history of recurrent, multifocal ventricular tachycardia for which she has undergone partial ablation and stellate ganglion block twice, previously. she went to the operating room with thoracic surgery on and had a left-sided video-assisted thoracoscopic surgery (vats) procedure with sympathectomy without issues. she was monitored on telemtry without significant issues and her electrolytes were optimized. her incisions were clean, dry and intact without evidence of drainage. her cxr the evening of her procedure did demonstrate a small, ipsilateral apical pneumothorax, however, her oxygen saturations were optimal and she had no dsypnea symptoms, so this was closely monitored conservatively. a repeat cxr in the am on showed pneumothorax of unchanged size on preliminary read, but the final read should be followed up. . # prior transaminitis - the patient had prior transminitis noted while she was being treated with amiodarone and mexiletine; these were thought to be the culprit agents driving her abnormal liver tests. however, they were also elevated on last admission when both of these medications were held. congestive hepatopathy was also considered, but she appeared euvolemic on exam with reassuring jvp, no crackles, and no peripheral edema. lfts were reassuring this admission. . # idiopathic dilated cardiomyopathy - patient has a history of idiopathic dilated cardiomyopathy with an lvef of 20% (thought to be attributed to viral myocarditis, non-ischemic in origin) and she is status-post biventricular icd placement, with evidence of moderate mitral regurgitation of her 2d-echo imaging. she has had heart failure for roughly 12-yeras and is currently being managed on a beta-blocker, torsemide and with an aldosterone-antagonist, which were all continued this admission. she has not been on an acei/ given her chronic renal insufficiency. . # chronic renal insufficiency - the patient has a baseline creatinine of 1.4-2.0. on this admission, her creatinine was stable in the 1.3-1.5 range. her medications were renally dosed, and nephrotoxins were avoided. . # osteoarthritis - on exam, she has mild heberdan's nodules noted in her distal extremities. the patient notes her symptoms are relieved with tylenol only. . # gout - we continued her home dosing of allopurinol 100 mg po daily without issues. she had no evidence of acute flare this admission. . transition of care issues: 1. code status during this admission: full code 2. contact: husband, , 3. pending studies: please follow up final read of cxr done . medications on admission: allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). alprazolam 0.25 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for anxiety. torsemide 20 mg tablet sig: one (1) tablet po daily (daily). acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. metoprolol succinate 50 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po bid (2 times a day). magnesium oxide 400 mg tablet sig: one (1) tablet po once a day. midodrine 5mg tid (started few days ago) discharge medications: 1. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 4. alprazolam 0.25 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for anxiety. 5. torsemide 20 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 500 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. 7. magnesium oxide 400 mg tablet sig: one (1) tablet po daily (daily). 8. midodrine 5 mg tablet sig: one (1) tablet po tid (3 times a day). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*0* 11. oxycodone 5 mg tablet sig: one (1) tablet po every four (4) hours as needed for pain: avoid taking this medication while consuming alcohol; or if you anticipate driving. disp:*40 tablet(s)* refills:*0* 12. metoprolol succinate 50 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po twice a day. discharge disposition: home discharge diagnosis: primary diagnosis: 1. recurrent ventricular trachyarrhythmia . secondary diagnoses: 1. idiopathic dilated cardiomyopathy discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: patient discharge instructions: . you were admitted to the coronary care unit (ccu) at on 6 following your left-sided video-assisted thorascopic surgery (vats) with sympathectomy for your recurrent ventricular arrhythmia. you tolerated the procedure well and were discharged home in stable condition. . please call your doctor or go to the emergency department if: * you experience new chest pain, pressure, squeezing or tightness. * you develop new or worsening cough, shortness of breath, or wheezing. * you are vomiting and cannot keep down fluids, or your medications. * if you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include: dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit, or have a bowel movement. * you experience burning when you urinate, have blood in your urine, or experience an unusual discharge. * your pain is not improving within 12 hours or is not under control within 24 hours. * your pain worsens or changes location. * you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. * you develop any other concerning symptoms. . changes in your medication reconciliation: . * upon admission, we added: start: oxycodone 5 mg (1-2 tablets) by mouth every 4 hours as needed for pain. avoid taking this medication if your anticipate driving or if you are consuming alcohol. start: colace 100 mg by mouth twice daily and senna 8.6 mg (1 tablet) by mouth twice daily, for constipation. . * the following medications were discontinued on admission and you should not resume: none . * you should continue all of your other home medications as prescribed, unless otherwise directed above. followup instructions: name: , m. location: healthcare - address: 15 brothers way,, , phone: ** the office is working on an appt for you in the next week and will call you at home with an appt. if you dont hear from them in the next two days, please call them directly to book. . department: thoracic surgery when: thursday at 3:00 pm with: , md building: sc clinical ctr campus: east best parking: garage md procedure: transpleural thoracoscopy other sympathectomy and ganglionectomy diagnoses: other primary cardiomyopathies mitral valve disorders chronic kidney disease, unspecified paroxysmal ventricular tachycardia automatic implantable cardiac defibrillator in situ osteoarthrosis, unspecified whether generalized or localized, hand ganglion, unspecified 

Answer: The patient is high likely exposed to