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: history of present illness: this patient is a 64-year-old man with a history of congestive heart failure, diabetes mellitus type 2, rheumatic heart disease status post aortic valve replacement and mitral valve replacement with mechanical valves on transferred from hospital after he presented there on complaining of nausea, vomiting, and weakness for two days. at the outside hospital, the patient was found to be hypotensive with systolic blood pressure to the 70s, hyperkalemic with potassium of 6.9, digitoxin toxic level of 2.9, and acute renal failure with bun and creatinine of 96/10, and coagulopathic with an of 8.9. patient had recently been admitted to on with a mild congestive heart failure exacerbation. patient at that admission was diuresed with lasix with good result and discharged on with a bun and creatinine of 20/1.1. following discharge, the patient was taking lasix 80 mg , aldactone, glucophage, lisinopril, which had just been started at discharge. one day after discharge on , the patient began experiencing lightheadedness, nausea, vomiting, weakness for which he cut his ace inhibitor dose in half. patient at this time, denied other symptoms such as fever, chills, chest pain. at the outside hospital, patient underwent a renal ultrasound which was negative for hydronephrosis or other acute process. patient was also given d50 +10 units of insulin, 1 amp of sodium bicarb, kayexalate, 1 amp of calcium gluconate, all for his hyperkalemia. patient was also bolused with normal saline and put on a dopamine drip as well as a dobutamine drip for his low systolic blood pressure to the 70s. patient was also given 1 amp of digibind for his digoxin level of 2.6. patient's repeat potassium was 5.6 at the outside hospital. on arrival to , the patient's systolic blood pressure decreased to the 60s while in the parking lot, so his dopamine drip was increased to 5 mcg/kg/minute. patient at this time, also complained of chest tightness and vomited once in the parking lot. past medical history: 1. transient ischemic attacks. 2. anxiety. 3. rheumatic heart disease status post mitral valve repair and aortic valve repair in complicated by atrial fibrillation and asystole requiring ddd pacemaker placement, also complicated by pericardial effusion and pleural effusions. status post chest tube and pleurodesis as well as a pericardial window. 4. congestive heart failure. ejection fraction greater than 55% one year ago, reportedly 25-30% by the outside hospital. 5. benign prostatic hyperplasia. 6. esophageal dysmotility. 7. status post cholecystectomy. 8. diabetes mellitus type 2. social history: patient married, retired manager, former tobacco and alcohol use, but quit in . allergies: no known drug allergies. medications at admission: 1. aldactone 12.5 once a day. 2. digoxin 0.125 once a day. 3. lasix 80 twice a day. 4. lisinopril 5 once a day. 5. flomax 0.4 once a day. 6. metformin 500 twice a day. 7. aspirin 81 once a day. 8. coumadin 4 once a day. 9. protonix 40 once a day. 10. serzone 300 once a day. 11. ambien 10 once a day. 12. lipitor 10 once a day. 13. coreg 6.25 3x a day. 14. advair twice a day. physical exam on admission: vital signs: heart rate of 70, blood pressure 95/37, map of 57, oxygen saturation of 100% on 2 liters nasal cannula, temperature 98.6, respiratory rate 14. general: caucasian man lying in bed in no apparent distress, breathing comfortably. heent: normocephalic, atraumatic. oropharynx clear. moist mucous membranes. extraocular muscles are intact. pupils are equal, round, and reactive to light and accommodation, no jugular venous distention, no bruits. heart: regular, rate, and rhythm, s1, s2 normal, 2/6 systolic murmur. lungs are clear to auscultation bilaterally, mild expiratory wheezes. abdomen: normoactive bowel sounds, nontender, and nondistended, no hepatosplenomegaly. extremities: no clubbing, cyanosis, or edema, 2+ pulses throughout. neurologic: alert and oriented times three. no focal deficits. genitourinary: foley in place draining red urine. laboratories on admission: complete blood count: white blood cell count 11.4, hematocrit 33.7, platelets of 157, mcv 90. coagulation: pt 41.4, 11.3, ptt 43.3. electrolytes: sodium 127, potassium 5.1, chloride 91, bicarb 19, bun 97, creatinine 10, glucose 129, calcium 8.6, phosphate 5.1, magnesium 2.2. anion gap 17. electrocardiogram: a-v paced at 70, increased artifact, but no peaked t waves. concise summary of hospital course: 1. hypotension: patient is hypotensive likely due to dehydration. given patient's chest tightness in the parking lot, cardiac enzymes were sent and the patient ruled out for myocardial infarction. therapeutically, the patient was switched from his dopamine and dobutamine drips to norepinephrine drip. patient also given normal saline boluses of 250 cc x4 on the day of admission. the patient was monitored closely for signs of pulmonary edema as his ejection fraction was suspected to be low. blood and urine cultures were also sent to rule out an infection, although the patient did not have fever, cough, or other symptoms or signs of infection. all cultures were negative at the time of discharge. the patient's hypotension responded well to normal saline boluses, and were in the 120 range. patient's norepinephrine drip was tapered and stopped, and the patient's systolic blood pressure remained in the 100-115 range. 2. acute renal failure: likely combination of prerenal due to his hypovolemia as well as secondary to his high dose of lasix, aldactone, lisinopril, and metformin at admission. renal consult was brought in and believed that the acute renal failure was related to medication toxicity as well as hypotension leading to acute tubular necrosis. the patient was initially considered for possible dialysis at admission, however, his potassium and other electrolytes on repeat had improved markedly. after two days in the hospital, the patient's electrolytes are all within normal limits. starting on the second day after admission began diuresing briskly likely due to his iv fluid boluses as well as his post-acute tubular necrosis diuresis. patient's ace inhibitor, glucophage, lasix, and digoxin were all held throughout his hospital stay. 3. nausea and vomiting: patient's symptoms at presentation were likely related to digoxin toxicity and acute renal failure. patient was given zofran iv once at admission, and had no complaints of nausea or vomiting throughout his hospital stay. 4. congestive heart failure: patient's beta blocker, aspirin, and ace inhibitor were all held. an echocardiogram performed at the bedside in the medical intensive care unit revealed a left ventricular ejection fraction of greater than 55%, no aortic or mitral regurgitation, no pericardial effusion. after numerous iv fluid boluses, the patient developed some crackles about half way up his lungs bilaterally. patient at this point was kept fluid even to maintain perfusion to his kidneys while minimizing pulmonary edema. 5. hematuria: likely due to post atn versus trauma upon foley placement. the patient's hematuria decreased throughout his hospital stay and was monitored throughout. 6. diabetes mellitus type 2: patient's fingerstick glucose remained in the 100 range throughout his hospital stay and did not require regular insulin-sliding scale. fingersticks were checked every 4-6 hours. 7. coagulation: patient's coagulopathy at admission was reversed with 6 units of fresh-frozen plasma and vitamin k iv. patient's came to within normal limits after these interventions. the patient was maintained on a heparin drip throughout his hospital stay as he has mechanical valves. patient was restarted on coumadin on at 4 mg. the patient's coagulopathy on admission was likely due to increased physiologic coumadin due to his acute renal failure. 8. fluids, electrolytes, and nutrition: patient maintained on a renal, cardiac diet, which was tolerated well throughout his hospital stay. as mentioned, the patient was given 250 normal saline boluses to keep his intake and out take even throughout his hospital stay. patient's potassium decreased from his elevated levels to within normal limits with in one day of his hospital stay. 9. chronic obstructive pulmonary disease versus asthma: patient continued on his home dose of advair throughout his hospital stay. patient also placed on albuterol nebulizers prn as well as fluticasone 110 mcg two puffs . patient had intermittent periods of audible wheezing which responded well to nebulizers. 10. prophylaxis: patient on heparin drip, proton-pump inhibitor throughout his hospital stay. 11. communication: with patient and wife. 12. code status: full. 13. access: left femoral line was placed upon admission. left groin hematoma developed, but was stable and was continued on a pressure dressing. condition on discharge: stable. discharge diagnoses: 1. hypotension. 2. acute renal failure. 3. congestive heart failure. 4. diabetes mellitus. 5. chronic obstructive pulmonary disease/asthma. 6. coagulopathy. 7. anxiety. discharge medications: 1. famotidine 20 iv q12. 2. odanzetron 2 mg iv q6h prn. 3. insulin-sliding scale starting at 1 unit of regular insulin for fingerstick glucose of 151-200, and increasing by 1 unit for every 50 of glucose. 4. salmeterol diskus 50 mcg one inhalation per q12h. 5. fluticasone 110 mcg two puffs inhaled twice a day . 6. lorazepam 0.5-1 mg po or iv q4-6 prn. 7. heparin iv weight based. 8. albuterol nebulizer q6h prn. 9. warfarin 4 mg po q hs, restarted on . follow-up plans: patient is scheduled to be transferred to for further workup in the inpatient medicine floor. patient's cardiologist, dr. will follow the patient at . , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified diagnoses: acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified hematoma complicating a procedure chronic obstructive asthma, unspecified injury to bladder and urethra, without mention of open wound into cavity home accidents cardiotonic glycosides and drugs of similar action causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to