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: lovenox / keflex attending: chief complaint: vt storm major surgical or invasive procedure: ventricular tachycardia ablation history of present illness: 59yom with nonischemic cardiomyopathy (ef 35% in ), s/p biv/icd device in with recent admission for firing in , chronic afib on dabigatran, htn, pulm htn, ckd who presents with increasing frequency of icd firing, having gone off 9 times today, 14 times total in past 1.5 weeks. first episode of was about 1.5 weeks ago, was seen in clinic 6 days ago and things settled down by then. yesterday was at bed bath and beyond when received first shock and has been going in and out of vt storm since. pt denies any chest pain or shortness of breath, however right before he gets shocked he experiences feelins of heartburn, jaw pain, diaphosesis and palpitations. he does not have any sx of heart failure despite recent decrease in torsemide from 40->30 mg/daily and aldactone 25mg -->12.5 mg. volume status is euvolemic currently. . he was recently admitted to the hospital in for an increasing frequency of symptomatic ventricular tachycardia noted on device interrogations. it was noted that he was on amiodarone 200mg daily instead of 400mg daily when these episodes occurred. cardiac catheterization (left sided) was done which showed no evidence of coronary artery disease. his amiodarone dose was increased to 600 mg daily with plan to decrease to 200mg twice daily after two weeks - which he is currently on. prior to this admission, he reports that whenever he got defribrillated he would be out and did not feel anything. . on review of systems, s/he 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. s/he denies recent fevers, chills or rigors. s/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, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. . in the er, initial vs: he received lidocaine bolus and was started on a gtt. on transfer from the er, vs 98.6 po 92/67 70 15 96&2l past medical history: -recent infected right leg hematoma (, completed bactrim ) -nonischemic cardiomyopathy s/p biv icd implantation: ef 40%, ?viral -hypertension -systolic chf: secondary to cardiomyopathy, ef 40% -heart block: etiology unclear, r sided ppm placed then replaced with icd (r)/biv ppm (l) () -atrial fibrillation -tracheobronchomalacia (recently diagnosed on ct chest ) -sarcoidosis involving lungs, lymph nodes, ?heart -pulmonary hypertension -subglottic stenosis -ventral hernia repair w/ prolonged respiratory failure, hospitalization -obstructive sleep apnea (central and obstructive, untreated) -obesity -depression -panic attacks -ckd, baseline cr. ~1.5 -neuropathy, following gastric stapling in - left ankle reconstruction, bilateral knee surgeries cardiac risk factors: -diabetes, -dyslipidemia, +hypertension . cardiac history: biventricular pacemaker/icd, in social history: former consultant, married with two children but wife recently left him. just went to daughter's college graduation. no current tobacco or alcohol use. family history: father had coronary artery disease and hypertension. mother had hypertension, diabetes, ear tumor. brother had renal cell carcinoma. physical exam: admission physical examination: vs:bp=96/62.hr=71 rr= 18.o2 sat= 99%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 flat. cardiac: pmi located in 5th intercostal space. heart sounds were distant with no appreciable murmurs, rr, normal s1, s2. 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: no stasis dermatitis, 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: vs: bp 100s/ 60s hr 60s-70s rr: 14 96% ra cardiac: rub heard best over precordium s/p ablation procedure remainder of pe unchanged from admission pertinent results: admission labs: 03:05am blood wbc-7.1 rbc-4.62 hgb-13.5* hct-40.3 mcv-87 mch-29.3 mchc-33.6 rdw-15.4 plt ct-224# 03:05am blood neuts-80.2* lymphs-13.4* monos-4.6 eos-1.5 baso-0.4 03:05am blood glucose-138* urean-45* creat-2.1* na-141 k-3.9 cl-104 hco3-24 angap-17 03:05am blood ck(cpk)-82 03:05am blood ck-mb-5 03:05am blood ctropnt-0.04* 03:05am blood calcium-8.9 phos-3.6 mg-2.4 03:05am blood digoxin-0.7* 01:39pm blood digoxin-0.6* discharge labs: 05:30am blood wbc-8.1 rbc-3.61* hgb-10.8* hct-31.8* mcv-88 mch-30.0 mchc-34.0 rdw-15.5 plt ct-183 05:30am blood glucose-100 urean-30* creat-1.7* na-143 k-3.8 cl-110* hco3-25 angap-12 05:30am blood calcium-8.2* phos-2.3* mg-2.2 chest (portable ap) study date of low lung volumes, no acute cardiopulmonary process portable tte (focused views) done lv systolic function appears depressed. with depressed free wall contractility. there is no pericardial effusion. poor image quality portable tte (focused views) done the right ventricular cavity is dilated with depressed free wall contractility. there is moderate pulmonary artery systolic hypertension. there is a small pericardial effusion. the effusion appears circumferential. there are no echocardiographic signs of tamponade. no right atrial or right ventricular diastolic collapse is seen portable tte (focused views) done lv systolic function appears depressed. rv free wall contractility is depressed. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a very small pericardial effusion. impression: very small residual pericardial effusion pathology results scar tissue, norm tissue (2 jars) 1. heart, "scar tissue," biopsy (a): minute fragment of loose connective tissue with mild acute and chronic inflammation and macrophages; see note. 2. heart, "normal tissue," biopsy (b): fragment of myocardium with no diagnostic abnormalities recognized; see note. note: eight (8) levels examined on both samples. there is no evidence of inflammation, amyloid, iron deposition, or granulomas. no necrosis of myocytes or degeneration is noted. case reviewed with dr. . brief hospital course: 59yom with nonischemic cardiomyopathy (ef 35% in ), s/p biv/icd device in with recent admission for firing in , chronic afib on coumadin, htn, pulm htn, osa, ckd who presents with vt storm. # ventricular tachycardia: the pt was admitted to the ccu and started on a lidocaine drip from rhythm control. he underwent a vt ablation procedure for prior multiple episodes of vtach s/p icd firings. he was found to have vt with multiple morphologies, epicardial in origin. the procedure was complicated by a rv puncture during difficult epicardial access resulting in a stable pericardial effusion without signs of tamponade physiology. following the procedure the pt was restarted on amiodarone and mexilitene and sent back to ccu for observation. he was noted to have a new pericardial rub present on pe following procedure. this was felt to be due to pericardial inflammation as well as from the small effusion post procedure. he had one episode of asymptomatic hypotension following the ablation procedure with sbps in 70s that required dopamine administration but ultimately responded to fluid boluses. dopamine was able to be weaned off. an echo obtained during the hypotensive episode showed pericardial constriction which was believed to be due to inflammation post procedure. the effusion size was noted to be trivial. also repeat serial echos on succeeding days showed the pericardial effusion to be stable in size without evidence of tamponade. he was started on a 3 day course of steroids to help resolve the pericardial inflammation s/p ablation which he finished prior to discharge. no further episodes of vtach were noted on tele after the ablation was performed. the pt also had no further episodes of hypotension either. his home amiodarone dose was reduced to 200mg daily from and mexiletine 150mg tid was added to his home regimen for rhythm control. # chf- upon admission the pt appeared euvolemic. he developed bilateral crackles at the lung bases during this admission following fluid boluses due to an episode of hypotension. diuresis was resumed with his home dose of torsemide and the pleural effusion improved. prior to discharge the pt was restarted on digoxin 125mcg daily, metoprolol tartrate was reduced to 12.5mg from 50mg in setting of baseline low sbps and hrs consistently in 60s post ablation. his torsemide dose was also reduced to 30mg qod from daily. he was continued on aspirin, spironolactone and lisinopril at his home doses. #a.fib- initially his home dose of pradaxa was held prior to vt ablation and then was resumed post procedure for anticoagulation. he remained rate controlled during this hospitalization. #chronic kidney disease- his baseline cr is approximately 1.9 per omr records. on admission his cr was 2.1 which was believed to be due to poor forward flow s/p his multiple episodes of vtach prior to admission. we continued to trend renal function and prior to discharge his cr trended down to 1.7. his lisinopril was restarted prior to discharge. # pt slept with home bipap at 14-16/11 with 2l o2 his home settings. he slept well with the device on at night. #transitional- he has follow up appointments with his pcp and cardiology following this admission. his blood pressures and volume status should be re-evaluated at these follow up visits considering we changed his home medication regimen during this admission. medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler prn allopurinol - 150mg daily amiodarone - 200 mg budesonide-formoterol - 160 mcg-4.5 mcg/actuation hfa inhaler - 1 puff inh twice a day clindamycin phosphate - 1 % lotion - apply to bumps on chest twice daily as needed qday as needed for prn clobetasol - 0.05 % solution - at bedtime to the affected area dabigatran etexilate - 150 mg digoxin - 125 mcg daily fluocinolone - 0.01 % oil - apply to areas of rash daily qday as needed apply to damp skin as needed, avoid face ketoconazole - 2 % shampoo - apply as directed lisinopril - 2.5 mg daily metoprolol succinate - 100 mg daily omeprazole - 40 mg sertraline - 50 mg qdaily spironolactone - 12.5 mg daily torsemide - 30 mg daily vardenafil - 10 mg prn aspirin - (otc) - 325 mg daily discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. allopurinol 100 mg tablet sig: 1.5 tablets po daily (daily). 3. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 4. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po bid (2 times a day). 6. mexiletine 150 mg capsule sig: one (1) capsule po q8h (every 8 hours). disp:*90 capsule(s)* refills:*2* 7. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 9. dabigatran etexilate 150 mg capsule sig: one (1) capsule po bid (2 times a day). 10. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical (2 times a day) as needed for rash on back. 11. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 12. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 13. torsemide 20 mg tablet sig: 1.5 tablets po qod (). 14. spironolactone 25 mg tablet sig: 0.5 tablet po daily (daily). discharge disposition: home discharge diagnosis: ventricular tachycardia scarcoidosis congestive heart failure chronic atrial fibrillation hypertension pulmonary hypertension chronic kidney disease gout tracheobronchomalacia subglottic stenosis -ventral hernia repair -obstructive sleep apnea - on cpap -obesity -depression -panic attacks discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. , you were admitted to the hospital after you had several firings of your icd device. you underwent an ablation in the cath lab to help prevent future events. you also had low blood pressures post-procedure and required medications and fluids to increse your blood pressure. the doses of your heart medications were changed and you will need to follow up with your cardiologist in the next 5-7 days. medication changes: -amiodarone 200 mg daily (from twice daily) -digoxin 125 ugm daily (restart) -metoprolol tartrate 12.5 mg twice daily (dose reduced) -spirnolactone 12.5 mg daily (continue) -torsimide 30 mg every other day (dose reduced) -mexiletine 150 mg three times a day (new medication) -asprin 325 mg daily (continue) -lisinopril 2.5 mg daily (continue) -pradaxa 150 mg daily (continue) addtionally please weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: department: cardiology -please schedule an appointment with dr. for department: cardiac services when: at 2:30 pm with: device clinic building: sc clinical ctr campus: east best parking: garage department: when: thursday at 11:30 am with: dr / post clinic phone: building: sc clinical ctr south campus: east best parking: garage this appointment is with a hospital-based doctor as part of your transition from the hospital back to your primary care provider. this visit, you will see your regular primary care doctor in follow up md procedure: other electric countershock of heart catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach non-invasive mechanical ventilation cardiac mapping biopsy of heart intracardiac echocardiography diagnoses: other iatrogenic hypotension obstructive sleep apnea (adult)(pediatric) esophageal reflux congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation other chronic pulmonary heart diseases sarcoidosis accidental puncture or laceration during a procedure, not elsewhere classified chronic kidney disease, unspecified paroxysmal ventricular tachycardia cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure chronic systolic heart failure long-term (current) use of anticoagulants constrictive pericarditis lung involvement in other diseases classified elsewhere other diseases of trachea and bronchus stenosis of larynx fitting and adjustment of other cardiac device cardiomyopathy in other diseases classified elsewhere 

Answer: The patient is high likely exposed to