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: s/p arrest major surgical or invasive procedure: intubation history of present illness: yo male nursing home resident with a history of coronary artery disease s/p remote cabg and congestive heart failure was admitted from his nursing home after having been found unresponsive. . patient went to go to the bathroom and started to have "seizures." he fell to the floor and developed loss of consciousness with pursed lip breathing. his first vital signs were 93% o2 sat on nrb and hr 71. per report, his initial rhythm was thought to be a wide complex tachycardia without evidence of pacer spikes. he underwent temporary pacing; however, shortly afterward, he was found to have native spikes. as temporary pacing was discontinued, he had return of his native spikes and regular sinus rhythm. he was intubated and then brought to the ed. upon arrival to the ed, vital signs were temp 96.5, hr 71, bp 164/90, rr 19, and pulse ox 98%. his ed course was complicated by hypotension while on propafol. . review of systems could not be obtained as patient is intubated and sedated. of note, in previous admissions, patient was noted to be dnr/dni. past medical history: 1. coronary artery disease s/p cabg in 2. congestive heart failure 3. peripheral vascular disease 4. atrial fibrillation s/p pacer 5. s/p right cea 6. dyslipidemia 7. spinal stenosis s/p decompressive laminectomy 8. gastritis 9. degenerative joint disease 10. aortic stenosis 11. s/p prostate surgery . cardiac risk factors: dyslipidemia, hypertension cardiac history: cabg, in , anatomy unknown percutaneous coronary intervention: not done pacemaker/icd: pacemaker in place but unclear when this was placed social history: full social and family history could not be obtained in the setting of patient being intubated and sedated. family history: full social and family history could not be obtained in the setting of patient being intubated and sedated. physical exam: gen: elderly male, nad, lying in bed, intubated and sedated. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with flat jvp. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. right elbow ecchymoses and skin tear. 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+ pertinent results: 01:35am urine blood-tr nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 01:35am urine rbc-1 wbc-1 bacteria-few yeast-none epi-1 renal epi- 01:35am urine hyaline-1* 01:35am wbc-4.5 rbc-3.80* hgb-11.7* hct-37.0* mcv-97 mch-30.7 mchc-31.5 rdw-17.1* 01:35am neuts-69.2 lymphs-22.2 monos-4.5 eos-3.4 basos-0.7 01:35am pt-14.9* ptt-29.0 inr(pt)-1.3* 01:35am plt count-147* 01:35am digoxin-0.7* 01:35am calcium-8.3* phosphate-4.4 magnesium-2.0 01:35am ctropnt-0.07* 01:35am ck(cpk)-73 01:35am glucose-160* urea n-36* creat-1.8* sodium-144 potassium-4.9 chloride-110* total co2-23 anion gap-16 02:13am lactate-3.3* 03:31am glucose-127* lactate-1.2 na+-140 k+-3.9 cl--113* 03:31am type-art po2-145* pco2-45 ph-7.26* total co2-21 base xs--6 07:07am type-art po2-187* pco2-47* ph-7.30* total co2-24 base xs--3 brief hospital course: - ecg - - v paced rhythm, afib, ~75 bpm, left axis deviation - ct head - - negative for acute intracranial process - portable cxr - - slight lucency at the left apex most likely represents a skin fold. however, suggest short interval followup. interval improvement of aeration of the left base. persistent right pleural effusion, cardiomegaly, and overhydration. - echocardiogram : the left atrium is dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. overall left ventricular systolic function is severely depressed (lvef= 25-30%). the septum is nearly akinetic and the other basal segments moderately hypokinetic. the apex has relatively preserved function. the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis (area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. significant pulmonic regurgitation is seen. there is no pericardial effusion. impression: mild symmetric lvh with severe septal hypokinesis, moderate hypokinesis of the basal to mid segments and relative preservation of the apical segments. the degree of aortic stenosis is probably severe (velocity falsely low due to reduced systolic function). dilated and hypokinetic right ventricle. mild mitral and moderate tricuspid regurgitation with moderate pulmonary artery systolic hypertension. compared with the prior study (images reviewed) of , direct comparison is difficult as both studies are suboptimal. overall lv systolic function is probably similar. the right ventricle now appears dilated and hypokinetic. the degree of aortic stenosis has increased. hospital course: 1. cardiac arrest: etiology of the cardiac arrest is unclear. differential diagnosis includes arrhythmia, pacemaker malfunction, arrest secondary to an additional medical complication such as sepsis. no clear localizing symptoms from prior to event and no localizing signs on exam. ep was consulted, interrogated his ppm, and found it to be working appropriately. he is a-sensed and v-paced when rate drops below 70bpm. urine and blood cultures were sent and had no growth at time of discharge. head ct was negative for acute process. relatives related that he had had a swollen and red rle for 2 weeks without any intervention at rehab. lenis were obtained and showed no dvt. 2. ? ptx patient's cxr had a questionable ptx after intubation. thoracic surgery was consulted in the ed and recommended a follow-up chest x rays with the idea that if there was in fact development of ptx, would consider either chest tube or pigtail catheter placement. further cxrs showed no evidence of ptx. 3. respiratory failure patient was intubated in the setting of cardiac arrest. patient does not seem to have a clear diagnosis of baseline pulmonary disease however he did have over-hydration on the cxr. after tte showed worsened ef patient was cautiously diuresed given as. was weaned off the vent after only one day and tolerated nasal canula with sats in mid-90s. on discharge he was 98% on ra. 4. congestive heart failure patient had a history of chf, although when presented initally was euvolemic. after receiving fluids he did have increased pulmonary congestion on a cxr and decreased o2 sats so received some diuresis with 20mg iv lasix. he was continued on his beta blocker and digoxin (once digoxin level came back normal). he was re-started on a low dose of his cozaar which he had been on previously. 5. cad patient has a history of of cad s/p cabg. no clear history of chest pain and ecg looked relatively unchanged from prior. he was continued on aspirin, statin, and beta blocker and re-started the acei. the tte showed new wall motion abnormalities of rv consistent with prior ett that showed reversible inferior wall ischemia. in the setting of this it is possible that he did have an acute coronary event, however, with no clear symptoms of chest pain and no ekg changes patient was managed conservatively with beta blockers, asa, statin, ace as above. 6. depression and dementia: he was continued on his home citalopram, aricept, and namenda. he required olanzipine sl at night for icu-delirium. 7. hypothyroidism: he was continued on levothyroxine 8. gerd: he was continued on prilosec 9. atrial fibrillation patient has a history of atrial fibrillation and is s/p ppm placement. unclear if he has been anticoagulated in the past. as above ep was consulted, interrogated the ppm and found afib when patient was not paced. 10. lower extremity swelling: with rv dilation on tte new from prior concern for pah from pe. lenis were ordered and showed no dvt. on further history son reports pt had knee surgery on that leg. possibly has chronic venous stasis from this. 11. severe as: patient had tte showing severe as (valve area 0.7) worse than prior tte dated . this could have been cause of his fall as he could have syncopized. patient was not thought to be a surgical candidate given his multiple other medical problems. 12. cri: patient had creatinines 1.3->2 in omr. with diuresis for respiratory status, creatinine increased to 2.2. encouraged po intake. drugs renally dosed. avoided contrast. #. ppx: ppi, fall precautions, bowel regimen prn.dvt ppx full code->confirmed with family #. communication: patient, son (home), cell medications on admission: 1. aspirin 325mg po daily 2. citalopram 10mg po daily 3. digoxin .125mg po mwf 4. fluticasone 1 spary per nostril 5. folate 1mg po daily 6. levothyroxine 100mcg po daily 7. mvi 1 tab daily 8. prilsoec 40mg po daily 9. aricept 10mg po daily 10. simvastatin 10mg po daily 11. docusate 200mg po bid 12. metoprolol 12.5mg po bid 13. namenda 5mg po bid 14. tylenol 15. senna 2 tabs qhs discharge medications: 1. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 5. donepezil 5 mg tablet sig: two (2) tablet po hs (at bedtime). 6. memantine 5 mg tablet sig: one (1) tablet po bid (). 7. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day). 8. losartan 25 mg tablet sig: one (1) tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 10. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. 11. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day). 12. outpatient lab work please draw inr 2 days after discharge and fax results to rehab physician for dosing of coumadin. 13. aspirin 81 mg tablet sig: one (1) tablet po once a day. 14. prilosec 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 15. outpatient lab work please draw creatinine 1 day after discharge and fax to rehab physician. losartan if creatinine >2.2. 16. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal once a day. 17. simvastatin 10 mg tablet sig: one (1) tablet po once a day. 18. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: atrial fibrillation severe as chf discharge condition: the patient was afebrile and hemodynamically stable prior to discharge. discharge instructions: you were admitted to the hospital after you fell at your rehab facility and were unresponsive. you had to have a tube down your throat to help you breath but this quickly came out and you were breathing well on your own. your pacemaker was checked and is working appropriately. you had an ultrasound of your heart that shows that it is not beating as well as it should and that one of the valves is not opening enough. medication changes: start: warfarin 5mg daily start: cozaar 25mg daily change: aspirin to 81mg daily please come back to the hospital or call your primary care doctor if you have fainting or near fainting, dizziness, light-headedness, shortness of breath, chest pain, jaw pain, arm pain, nausea, abdominal pain, palpitations, blood in your stools or black tarry stools, weight gain more than 3lbs in one day, leg swelling, or any other concerning symptoms. followup instructions: pacemaker check: provider: clinic phone: date/time: 1:30 cardiology: provider: , md phone: date/time: 1:00 primary care: , d. phone: date/time: procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours application of other wound dressing artificial pacemaker rate check diagnoses: acidosis unspecified pleural effusion congestive heart failure, unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status aortic valve disorders other chronic pulmonary heart diseases unspecified fall pulmonary collapse acute respiratory failure hypotension, unspecified cardiac pacemaker in situ alzheimer's disease accidents occurring in residential institution spinal stenosis, unspecified region combined systolic and diastolic heart failure, unspecified tricuspid valve disorders, specified as nonrheumatic open wound of elbow, without mention of complication dementia in conditions classified elsewhere with behavioral disturbance 

Answer: The patient is high likely exposed to