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: monosodium glutamate attending: chief complaint: worsening mitral valve function, admit for evaluation for repair major surgical or invasive procedure: cardiac catheterization mitral valve repair, oversewing of left atrial appendage history of present illness: 59 year old gentleman has a history of cardiomyopathy, previous cardiac arrest and s/p icd implant in . he has a history of ventricular tachycardia and has had 2 prior ablation procedures in the summer of after recurrent ventricular tachycardia and multiple aicd shocks. he was also started on amiodarone in following his ablations after sotalol was unsuccessful. he also has a history of atrial fibrillation for 15 years and more recently atrial flutter. on , he underwent an unsuccessful atrial flutter ablation and had an electrical cardioversion of atrial fibrillation to sinus rhythm, however he reverted back to atrial fibrillation again 1-2 days after his cardioversion. he was seen by dr. on at which time his ekg revealed left atrial tachycardia with 3:1 conduction. in early , the patient was hospitalized at hospital with what he describes as hf. he underwent echocardiogram which revealed increased la size and worsening mitral regurgitation. he now presents for cardiac catheterization and surgical evaluation past medical history: mitral regurgitation cardiac arrest hypertrophic cardiomyopathy acute on chronic diastolic heart failure hyperlipidemia dyslipidemia h/o atrial fibrillation renal failure embolic stroke with no residual fractured rib left side gout depression tonsillectomy appendectomy obstructive sleep apnea ??????cannot tolerate cpap anxiety pneumonia and in social history: lives alone. instructor in risk reduction for the state, teaches classes for people convicted of dwi- currently on medical leave. walks dog 30 minutes daily regularly, kayaking, mountain climbing -tobacco history: quit 26 years ago, 30pkyr -etoh: none since -illicit drugs: none family history: mother, brother and : "had what i have (cardiomyopathy)." otherwise non-contributory. physical exam: pulse: 75 resp: 16 o2 sat: 100% ra b/p right: 111/70 left: 124/82 height: 188 cm weight: 81.6 kg general: no acute distress, thin skin: dry intact right lower abd surgical scar heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur abdomen: soft non-distended non-tender bowel sounds + no palpable masses extremities: warm , edema none varicosities: none neuro: alert and oriented x3 nonfocal pulses: femoral right: +2 left: +2 dp right: doppler left: doppler pt : doppler left: doppler radial right: +1 left: +1 carotid bruit right: no bruit left: no bruit pertinent results: 08:35am blood wbc-9.8 rbc-4.15* hgb-10.9* hct-34.4* mcv-83 mch-26.2* mchc-31.7 rdw-15.4 plt ct-306# 05:05am blood wbc-12.1* rbc-3.97* hgb-10.3* hct-32.8* mcv-83 mch-26.0* mchc-31.5 rdw-15.4 plt ct-181 08:35am blood glucose-131* urean-28* creat-1.0 na-137 k-3.5 cl-100 hco3-28 angap-13 08:35am blood mg-2.0 admission labs . 12:30pm blood wbc-7.4 rbc-5.46 hgb-14.3 hct-44.3 mcv-81* mch-26.2* mchc-32.3 rdw-15.2 plt ct-436 12:30pm blood pt-21.8* ptt-26.2 inr(pt)-2.0* 12:30pm blood glucose-88 urean-25* creat-1.4* na-143 k-4.5 cl-106 hco3-28 angap-14 12:30pm blood alt-54* ast-48* ld(ldh)-229 alkphos-267* amylase-54 totbili-0.8 12:30pm blood lipase-37 07:05am blood calcium-9.6 phos-3.9 mg-2.0 04:50pm blood albumin-3.6 12:30pm blood albumin-4.1 12:30pm blood %hba1c-6.0* eag-126* cardiac cath comments: 1. selective coronary angiography of this right dominant system demonstrated no significant coronary artery disease. the lmca had a 40% lesion. the lad, lcx, and rca were without any angiographically apparent coronary artery disease. 2. limited resting hemodynamic measurement revealed elevated left and right sided filling pressures. the mean ra was moderately elevated at 14 mmhg. rvedp was moderately elevated at 15 mmhg. pcw mean was severely elevated at 25 mmhg. there was moderate pulmonary artery hypertension with pa of 49/30 mmhg. the cardiac index was calculated using the fick equation and showed a severely reduced cardiac index of 1.5 l/min/m2. . final diagnosis: 1. no angiographically significant coronary artery disease. 2. moderate right ventricular diastolic dysfunction. 3. severe left ventricular diastolic dysfunction. 4. moderate pulmonary artery hypertension. 5. reduced cardiac index. . ekg atrial flutter, average ventricular rate 82. marked leftward axis at minus 58 degrees. intraventricular conduction delay with a qrs duration of 168 milliseconds. there are marked st-t wave changes in the lateral precordial leads and poor r wave progression in leads v1-v4. compared to the previous tracing of the rate is faster and there are no longer ventricular premature beats. the previously described lateral st segment depressions persist unchanged. read by: , m. intervals axes rate pr qrs qt/qtc p qrs t 82 0 168 430/468 0 -58 115 . cxr findings: there is massive cardiomegaly. an aicd is identified in appropriate position. there is no focal consolidation, effusion, or pneumothorax. impression: massive cardiomegaly. otherwise, no acute cardiopulmonary process. . echo impression: posterior mitral leaflet prolapse associated with eccentric + mitral regurgitation and a markedly dilated left atrium. spontaneous echo contrast in the descending thoracic aorta suggestive of reduced forward stroke volume. . carotids impression: no significant carotid artery stenosis (less than 40% on the right, and no stenosis on the left). intra-op echo pre-cpb:1. the left atrium is markedly dilated. mild spontaneous echo contrast is present in the left atrial appendage. no thrombus is seen in the left atrial appendage. 2. the right atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. the coronary sinus is dilated (diameter >15mm). agitated saline was injected into the right arm and returned to the svc. 3. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. lv systolic function appears depressed. no masses or thrombi are seen in the left ventricle. 4. the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. 5. there are simple atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. 6. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. no aortic regurgitation is seen. 7. the mitral valve leaflets are moderately thickened. an eccentric, posteriorly directed jet of moderate (2+) mitral regurgitation is seen. there was posterior leaflet prolapse(p2) and restriction. the anterior leaflet also had some prolapse of a3. the mitral annulus is dilated to 4.3 cm. 8. moderate tricuspid regurgitation is seen. the tricuspid annulus is dilated to 4.9 cm. 9. there is a small pericardial effusion. drs. and notified in person of the results. post-cpb: on infusion of epinephrine, phenylephrine. av pacing. well-seated annuloplasty ring in the mitral position. trivial mr, trace stenosis with a peak gradient of 4 mmhg and mean of 2 mmhg. mva is now 2.4 cm2. lvef is now 45% on inotropic support with persistent anterioseptal hypokinesis, although this could represent temporary pacing artifact. rv function appears normal. tr is improved to mild. aortic contour is normal post decannulation. brief hospital course: 59yom with h/o hocm, previous cardiac arrest with icd placement at hospital , prior 2 ablation procedures in summer , chronic afib/flutter on coumadin, cva yrs ago, recently admitted for chf exacerbation at , who was admitted for atach ablation and device upgrade to pacer/icd, then found on echo to have worsening mr la, and is admitted for workup for mitral valve repair 1. mitral valve repair: workup for mvr included cath showing clean coronaries but mod rv diastolic dysfxn, severe lv diastolic dysfxn, mod pa htn, reduced ci. echo showed ef 55%, posterior mitral leaflet prolapse with eccentric + mr and markedly dilated la. carotids with <40% on r and nothing on l. dental clearance was obtained. ua was negative. cxr with cardiomegaly, but no other acute process. lft's were elevated, of unclear etiology, but downtrending. pt was admitted and coumadin was held for surgery. when inr was less than 1.5, a heparin gtt was started. 2. rhythm: pt in afib in the 70's, occasional nsvt 3-5 beats but asymptomatic, and icd did not fire through admission (v-sensing, not dependent). pt was continued on home amiodarone 200mg daily, metoprolol 12.5 mg , dilt er 240 mg daily. coumadin was held as above and heparin gtt was started when inr drifted to subtherapeutic levels. 3. chronic renal failure: his cr was 1.4 on admission which appears to be his baseline at least since . cr on discharge was 1.0. 4. h/o chf: known diastolic failure, mr, with ef 55%. did not appear volume overloaded and was continued on home lasix 20mg po bid, lisinopril 5mg daily. the patient was admitted to the cardiac surgery service and brought to the operating room on where the patient underwent mitral valve repair and oversewing of the left atrial appendage. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. vancomycin was used for surgical antibiotic prophylaxis, given his inpatient stay of longer than 24 hours. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was confused in the immediate post-op period. narcotics were eliminated and he cleared mentally. he was a&ox3 by the time of discharge. the patient's aicd was interrogated and pacing wires were discontinued on pod 1. coumadin was resumed for atrial fibrillation. chest tubes were discontinued without complication. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. the patient was transferred to the telemetry floor for further recovery. the patient was evaluated by the physical therapy service for assistance with strength and mobility. he did develop a hoarse voice. cool nebs were administered and voice was improving by the time of discharge. by the time of discharge on pod 6 the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. the patient was discharged to rehab in good condition with appropriate follow up instructions. medications on admission: alprazolam - (prescribed by other provider) - 1 mg tablet - 1/2-1 tablet(s) by mouth three times a day as needed amiodarone - (prescribed by other provider; dose adjustment - no new rx) - 200 mg tablet - 1 tablet(s) by mouth once a day diltiazem hcl - (prescribed by other provider) - 240 mg capsule, sust. release 24 hr - 1 capsule(s) by mouth once a day furosemide - (prescribed by other provider) - 20 mg tablet - 1 tablet(s) by mouth twice a day lisinopril - (prescribed by other provider) - 5 mg tablet - 1 tablet(s) by mouth daily metoprolol tartrate - (prescribed by other provider) - 25 mg tablet - 0.5 (one half) tablet(s) by mouth twice a day simvastatin - (prescribed by other provider) - 20 mg tablet - one tablet(s) by mouth daily temazepam - (prescribed by other provider) - 15 mg capsule - 1 capsule(s) by mouth as needed for for sleep venlafaxine - (prescribed by other provider) - 50 mg tablet - 1 tablet(s) by mouth twice a day warfarin - (prescribed by other provider) - 3 mg tablet - 1 tablet(s) by mouth once a day until inr >2 discharge medications: 1. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 2. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 3. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 4. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 5. venlafaxine 50 mg tablet sig: one (1) tablet po twice a day. 6. temazepam 15 mg capsule sig: capsules po hs (at bedtime) as needed for insomnia. 7. magnesium oxide 400 mg tablet sig: 0.5 tablet po twice a day. 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever, pain. 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 12. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 13. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 14. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 15. temazepam 15 mg capsule sig: one (1) capsule po hs (at bedtime) as needed for sleep . 16. alprazolam 0.25 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for anxiety . 17. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 18. warfarin 5 mg tablet sig: one (1) tablet po once a day: dose to change daily for goal inr for atrial fibrillation. 19. metoprolol succinate 25 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po once a day. discharge disposition: extended care facility: rehab discharge diagnosis: mitral regurgitation pmh: cardiac arrest hypertrophic cardiomyopathy acute on chronic diastolic heart failure hyperlipidemia dyslipidemia h/o atrial fibrillation renal failure embolic stroke with no residual fractured rib left side gout depression tonsillectomy appendectomy obstructive sleep apnea ??????cannot tolerate cpap anxiety pneumonia and in discharge condition: alert and oriented x3 nonfocal ambulating with assistance sternal pain managed with ultram prn discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns followup instructions: please call to schedule appointments surgeon dr. 1pm primary care dr. , in weeks cardiologist dr. , l in weeks dr. to resume management of coumadin dosing on discharge from rehab (confirmed with ) procedure: extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters diagnostic ultrasound of heart angiocardiography of right heart structures annuloplasty excision, destruction, or exclusion of left atrial appendage (laa) diagnoses: obstructive sleep apnea (adult)(pediatric) mitral valve disorders congestive heart failure, unspecified gout, unspecified atrial fibrillation other chronic pulmonary heart diseases depressive disorder, not elsewhere classified atrial flutter chronic kidney disease, unspecified paroxysmal ventricular tachycardia other and unspecified hyperlipidemia automatic implantable cardiac defibrillator in situ personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits diseases of tricuspid valve chronic diastolic heart failure 

Answer: The patient is high likely exposed to