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: dyspnea and fatigue major surgical or invasive procedure: shocked x1 when in vt history of present illness: pt. is an 81 yo female with pmh of diastolic hf, htn, afib, and tchy/brday syndrome s/p pacer placement recently admitted this month for dyspnea who comes in complaining of one week of increasing fatigue, dyspnea, and productive cough. she reports that she was improved upon last discharge last week, but since has noted worsening sob at rest and upon exertion, fatigue, and productive cough. she reports that she has been taking her medications as directed. she denies other upper respiratory symptoms, pnd, le edema, cp, palpitations, abd pain, f/c, n/v, other focal signs of infection. she chronically unable to lay flat because of dizziness. she reports constipation with no bm for the past week. because of this her appetitie has been decreased, though she is still taking po fluid. . in the ed her cxr was unchanged. first set of ces were flat. ekg revealed baseline lbbb. she was seen by cardiology who requested admission to check pacer. . ros: negative for fevers, chills, chest pain, shortness of breath, cough, abdominal pain, nausea, vomiting, diarrhea, dysuria. otherwise negative in detail. past medical history: 1. chronic diastolic heart failure 2. hypertension 3. paroxysmal atrial fibrillation - on amiodarone treatment between and , then discontinued due to her history of lung interstitial disease 4. tachy-brady syndrome s/p dual chamber pacemaker placement 3. tia 17 years ago 4. hypercholesterolemia 5. osteoporosis 6. hypothyroidism (recently diagnosed) 7. left cataract surgery in 8. left ankle surgery status post fracture 20 years ago 9. s/p appendectomy social history: social history is significant for the absence of current tobacco use. the patient had smoked previously and quit 24 years ago. there is no history of alcohol abuse. the patient is retired and lives in an independent living community. had worked as a bookkeeper. family history: there is no family history of premature coronary artery disease or sudden death. her mother passed away at 88 years of age from alzheimer's disease. father passed away at 88 years of age from parkinson's disease. brother passed away at 60 years of age from myocardial infarction. brother passed away at 87 years of age from a stroke. physical exam: vs: 98.3 104/48 65 18 93%ra gen: well-appearing, nad heent: sclera anicteric, perrl, eomi, op clear, mmm neck: supple, no lad, no increased jvd cv: rrr, distant, no m/g/r pulm: ctab, no w/r/r abd: soft, distended, nt, nd, +bs ext: no c/c/e neuro: aaox3, cn ii-xii grossly intact, moving all extremities well pertinent results: studies: cxr : (dictation). pacemaker with unchanged leads. minor linear atelectasis. no acute cardiopulmonary abnormality . cxr : findings: in comparison with the study of , there is a somewhat better inspiration but otherwise little change. again there is evidence of elevated pulmonary venous pressure with bilateral pleural effusions and bibasilar atelectasis. the cardiac silhouette is at the upper limits of normal in size and the pacemaker device remains in place. endotracheal tube and nasogastric tube are in similar position. . abdominal film : impression: progressive distention of small and large bowel, most likely representing worsening ileus. however, given this interval progression, close interval follow up is recommended, as a mechanical bowel obstruction cannot be entirely excluded. . cardiac cath : final diagnosis: 1. coronary arteries are normal. 2. reduced left ventricular function with apical hypokinesis. 3. cardiogenic shock with cardiac index from 1.8-2.0 l/min/m2. 4. slight improvement in pulmonary artery saturation and cardiac index with reduction of alpha pressor agents. . echo : impression: hyperdynamic biventricular systolic function with moderate lvot obstruction and moderate mitral regurgitation at the pacing rate of 100 bpm. lessened lvot obstruction and mitral regurgitation with pacing rate of 80 bpm. compared with the prior study (images reviewed) of , lv function is more hyperdynamic and lvot obstruction is identified. mitral regurgitation is now more severe. . labs 06:00pm blood ck-mb-6 probnp-371 06:10pm blood ctropnt-<0.01 01:15am blood ck-mb-notdone ctropnt-<0.01 10:25am blood ck-mb-5 ctropnt-<0.01 06:00pm blood ck(cpk)-138 01:15am blood ck(cpk)-67 10:25am blood ck(cpk)-65 . 06:00pm blood wbc-9.8# rbc-4.41 hgb-13.0 hct-39.1 mcv-89 mch-29.4 mchc-33.2 rdw-13.6 plt ct-279 06:00pm blood glucose-69* urean-31* creat-1.2* na-129* k-6.6* cl-92* hco3-22 angap-22* 06:00pm blood pt-38.0* ptt-44.9* inr(pt)-4.1* . 03:22am blood wbc-5.1# rbc-2.99*# hgb-9.0* hct-28.6* mcv-96 mch-30.1 mchc-31.4 rdw-14.0 plt ct-94*# 03:22am blood glucose-266* urean-42* creat-2.6* na-140 k-4.4 cl-102 hco3-13* angap-29* 03:22am blood calcium-6.0* phos-5.0* mg-1.8 03:22am blood pt-97.6* ptt-91.4* inr(pt)-12.9* 03:22am blood alt-* ast-8452* ld(ldh)-9135* alkphos-54 totbili-0.7 dirbili-0.3 indbili-0.4 04:01am blood lactate-13.3* 04:01am blood type-art po2-62* pco2-25* ph-7.19* caltco2-10* base xs--16 brief hospital course: the patient was an 81 yo female with h/o diastolic hf(ef 70%), htn, afib, and tachy/brady syndrome s/p pacer placement who was admitted for lethargy and sob with plans to interrogate her pacemaker to look for an arrhythmia. her pacemaker was interrogated and no abnormalities were found. she was ruled out for an mi with 3 sets of negative cardiac enzymes. her cxr was negative for pna. her cough and sob was thought to be secondary to bronchitis. she complained of urinary frequency and suprapubic tenderness and had a uti with no signs of an upper tract infection. her uti was treated with ciprofloxacin. . during her hospitalization she was constipated with abdominal distention and a kub revealed dilated loops of small bowel. she had not had a bowel movement for one week prior to admission and was started on colace, senna, miralax, and a bisacodyl suppository. on the evening of the she complained of nausea and on the morning of she had an episode of straining in the bathroom and was found down in her room. code blue was called and she was coded for pea arrest. she received 3mg epinephrine, 1 mg atropine, 3 amps of bicarb, dextrose, insulin, calcium for a potassium of 5.7 which was 3.8 upon rechecking. during her pea arrest, she had an episode of vt which was shocked x 1 to sinus rhythm. ep was called to bedside and paced her at 110. after aproximately 15 minutes of cpr, she regained her pulse. she was started on dopamine, levophed on the floor. bp stabilized in the systolic 80-90s, she was intubated on ac and requiring high levels of peep. she was transferred to the ccu. . while in the ccu she was in nsr in the 80s and captured at 60. her abdomen was distended and she required multiple pressors. the event precipitating the pea arrest was unclear. shock was treated with pressors and ivf. she was emprirically covered with vancomycin, cipro, and flagyl. she also received a bicarb drip for mixed acidosis. her cxr showed fluid overload but she continued to be given ivf aggresively due to her hypotension. the patient was also in arf in the setting of her shock. a kub showed dilated loops of small bowel with no clear evidence of obstruction but it could not be excluded. surgery was consulted but the patient was not stable enough for any surgical intervention. a ct scan of her abdomen was necessary to evaluate her adominal process however despite frequent re-evaluations the patient was never stable enough to tolerate going for a ct scan. . we communicated with her daughter, , throughout her stay in the ccu and initially the patient was full code. during the course of the evening and early morning the patient required blood transfusions for a dropping hct. in the early morning of when the patient was requiring blood transfusions and continuing to require pressors, the daughter told the team over the phone that her mother would not want this and that she wanted to change her mother's code status to cmo and dnr. the daughter came into the hospital accompanied by other family members. at that point the family requested we stop her pressors and the blood transfusions. the patient remained intubated. the patient expired shortly afterwords and the family decided not to have an autopsy. medications on admission: 1. warfarin 2 mg tablet sig: one (1) tablet po once daily at 4 pm. 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. lisinopril 40 mg tablet sig: one (1) tablet po once a day. 4. diltiazem hcl 240 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). disp:*30 capsule, sustained release(s)* refills:*2* 5. metoprolol tartrate 100 mg tablet sig: one (1) tablet po twice a day. 6. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 7. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 8. calcium oral 9. vitamin d oral 10. disopyramide 100 mg capsule, sustained release sig: two (2) capsule, sustained release po q12h (every 12 hours). disp:*120 capsule, sustained release(s)* refills:*2* 11. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). 12. aldactone 25 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge medications: patient expired discharge disposition: expired discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures insertion of endotracheal tube artificial pacemaker rate check diagnoses: acidosis urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified atrial fibrillation paroxysmal ventricular tachycardia constipation, unspecified other and unspecified hyperlipidemia acute respiratory failure cardiac arrest cardiogenic shock osteoporosis, unspecified postinflammatory pulmonary fibrosis long-term (current) use of anticoagulants cardiac pacemaker in situ personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits chronic diastolic heart failure 

Answer: The patient is high likely exposed to