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: codeine / iodine / iv dye, iodine containing contrast media attending: chief complaint: dyspnea, palpitations major surgical or invasive procedure: cardiac ablation for avnrt history of present illness: the patient is a 67 year old female with morbid obesity and no prior cardiac history except recent cardioversion for presumed afib/flutter at osh who was sent to the ed after presenting to her cardiologist for a routine visit in svt. . she initially presented to last tuesday with dyspnea and palpitations. she was thought to be in atrial fibrillation vs flutter and cardioverted the next day. she subsequently flipped in and out of sinus rhythm, with continued dyspnea and lightheadedness over the next few days. she felt somewhat better over the weekend, and was discharged on dronedarone 400 mg po bid and pradaxa 75 mg po bid. she was unable to fill the pradaxa at her pharmacy the next day. . her symptoms returned soon after discharge, with continued dyspnea on exertion and intermitent palpitations. she also described tightness in epigastric area and pain in her left shoulder blade radiating to the head, worse with exertion. earlier today, she presented to her cardiologist, dr , for a routine followup visit. she was found to be in svt at 165 bpm. she was sent to the ed, where ekg at 16:47 showed atrial flutter at 165 bpm, and ekg at 17:10 showed spontaneous conversion to sr at 82 bpm. she was started on heparin iv at 1600 units/hr with 7700 unit bolus and transferred to the ed for possible ep study and ablation. . in the ed, she felt relatively well except for continued dyspnea on exertion. she denied chest pain, near syncope, or syncope. initial vitals were t 96.8, hr 72, bp 99/47, rr 16, and spo2 100% on 2l. ed read of a portable cxr showed possible rul pneumonia. she was was started on ceftriaxone 1000 mg iv and azithromycin 500 mg po. her chem10 was notable for k 3.5 and mg 1.4, and she was given magnesium sulfate 2 grams iv. her coags showed ptt 120.9, and her heparin drip was stopped. she had a negative troponin <0.01 and elevated bnp 2834. a foley catheter was placed. ua showed rbc 20 and wbc 5, but otherwise normal. ekg was sinus rhythm at 69 bpm. . she was admitted to ep for possible ablation in the morning. vitals prior to floor transfer were t 100.3 oral, hr 77, bp 149/50, rr 26, and spo2 100% on 2l nc. on reaching the floor, she complained of continued dyspnea with minimal exertion, left shoulder pain, and headache. she denied any current chest pain. she noted that her lower extremity edema was decreased from baseline. she did report a recent cough with sputum that turned green today. . cardiac review of systems was notable for absence of paroxysmal nocturnal dyspnea, orthopnea, palpitations, or syncope. she denied any nausea, vomiting, abdominal pain, or change in bowel habits. she denied urinary symptoms besides frequency with furosemide. she has a distant history of dvt. she denies any history of stroke, tia, pulmonary embolism, bleeding at the time of surgery, myalgias, black stools or red stools. she denies recent fevers, chills, or rigors. all of the other review of systems were negative. past medical history: # cardiac risk factors: hypertension # atrial flutter (?fibrillation) -- recent diagnosis # hypertension # morbid obesity # sleep apnea -- does not wear her cpap # dvt history -- 12 years ago # bilateral hip and knee replacements # cholecystectomy social history: # home: lives with her husband. # alcohol: rare, few times/year # tobacco: none # drugs: none family history: # father -- cabg in his 80s, hypertension, hyperlipidemia # mother -- # brother -- cabg at age 59 # sister -- multiple sclerosis no family history of early mi, arrhythmia, cardiomyopathy, or diabetes. physical exam: admission physical exam: vs: t 99.0, bp 172/74, hr 83, rr 22, spo2 95% on 1l nc gen: morbidly obese female in nad. oriented x3. mood, affect appropriate. speaking in short sentences heent: ncat. sclera anicteric. perrl, eomi. conjunctiva without pallor or injection. mmm, op clear. neck: supple, full rom. jvp not visibly elevated, limited by body habitus. no cervical lymphadenopathy. cv: rrr with normal s1, s2. no m/r/g. chest: respiration somewhat labored. ctab except for few crackles at right base. no wheezes or rhonchi. abd: normal bowel sounds. soft, obese nt, nd. no organomegaly. ext: chronic le venous stasis changes. le edema 1+ bilaterally. digital cap refill <2 sec. distal pulses intact 2+ radial, 1+ dp, and 1+ pt. skin: stasis dermatitis. no ulcers, rashes, or other lesions noted. neuro: cn ii-xii grossly intact. moving all four limbs. . discharge physical exam: pertinent results: admission labs: glucose-112* urea n-12 creat-0.9 sodium-138 potassium-3.5 chloride-99 total co2-29 anion gap-14 alcium-9.2 phosphate-3.7 magnesium-1.4* pt-16.3* ptt-120.9* inr(pt)-1.4* wbc-5.4 rbc-4.76 hgb-13.7 hct-40.4 mcv-85 mch-28.7 mchc-33.8 rdw-13.2 plt count-164 neuts-71.8* lymphs-17.8* monos-7.9 eos-2.0 basos-0.6 probnp-2834* ctropnt-<0.01 . pertinent labs: trops negative x2 d-dimer negative . discharge labs: . . micro/path: . gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): gram positive rod(s). . imaging/studies: # echo - very limited image quality. the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function appears mildly depressed (lvef= 45 %). the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is no pericardial effusion. . # cxr - impression: right upper lobe pneumonia superimposed on worsening severe bilateral pulmonary edema. . brief hospital course: the patient is a 67 year old female with morbid obesity and no prior cardiac history except recent afib/flutter s/p cardioversion and recent hospitalization who was sent to the ed after presenting to her cardiologist for a routine visit in svt. . ccu course: pt transferred to ccu following attempted ablation procedure in which she became acutely sob whe laying flat prior to procedure. found to be in chf on exam with cxr significant for severe pulmonary edema and rul infiltrate concerning for pneumonia. she was diuresed with iv lasix and put out to 80mg and was started on azithromycin/ceftriaxone. she had two runs of avnrt in the unit which did not respond to adenosine 6mg followed by 12mg but responded to iv dilt 10mg x 1. she rhythm controlled on diltiazem 60mg po qid, further diuresed, and underwent apparently successful ep ablation of arrythmogenic focus. she was started on lisinopril for further bp control, found to be hd stable with a residual o2 requirement of 2-4lnc owing to fluid overload and pneumonia. she was called out to for further workup and management. . # avnrt/fib/flutter: pt was cardioverted for aflutter/afib at osh before transferring here. pt experienced multiple paroxysmal bouts of tachycardia up to the 160s. ekg and telemerty did not show signs of aflutter/afib but were suggestive of avnrt. metoprolol was given for rate control but was not effective. she was then switched to diltiazem for rate control which seemed to control her svt until her procedure. she underwent ablation and was in nsr after the procedure. she had no further episodes of atrial fibrillation/flutter during this admission, however due to her new chf her chads2 score is now 2, so she was discharged on coumadin. she also was discharged on rate control with dilt. she will follow up as an outpatient for coumadin checks. . # rul pneumonia: cxr in ed showed rul pna. pna could have been a contributing factor to her dyspnea. we treated for cap with a 5 day course of azithromycin and a 7 day course of ceftriaxone. pt was afebrile for most of the hospitalization and labs never showed leukocytosis. sputum culture grew gpc in pairs and clusters as well as gpr. hospital acquired pna was a concern due to her recent hospitalization, however pt improved on cap abx so no changes to regimen were made. will need repeat cxr 6 weeks from now. . # systolic congestive heart failure: pt presented with a history suggestive of chf. echo on showed ef 45%. pt also had elevated bnp 2834. etiology unclear, however pt reports sx since and depending on how often she has been in svt in this 2 month period that could produce a cardiomyopathy. previous to first ablation attempt pt went into severe pulmonary edema when she was laid flat. she was given lasix, morphine, nitropaste, and cpap and subsequently transferred to ccu because of continued respiratory distress and svt. over the course of her hospitalization, she was diuresed aggressively with good response in o2 requirement and work of breathing. discharged on po lasix, started lisinopril. will need outpatient echo in weeks to evaluate whether chf has improved. . active diagnoses: avnrt, acute chf, pna . chronic diagnoses: htn, osa medications on admission: dronedarone 400 mg po bid -- recently started pradaxa 75 mg po bid -- recently prescribed but not taken furosemide 20 mg po bid magnesium oxide 400 mg po daily fluticasone 220 mcg inhaler 2 puffs albuterol inhaler 2 puffs q6h prn sob or wheeze discharge medications: 1. cefpodoxime 200 mg tablet sig: two (2) tablet po twice a day for 1 days. disp:*4 tablet(s)* refills:*0* 2. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 3. diltiazem hcl 120 mg capsule, extended release sig: two (2) capsule, extended release po daily (daily). disp:*60 capsule, extended release(s)* refills:*2* 4. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. warfarin 2.5 mg tablet sig: three (3) tablet po once daily at 4 pm. disp:*90 tablet(s)* refills:*2* 6. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: one (1) inhalation every six (6) hours as needed for shortness of breath or wheezing. 7. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) inhalation every six (6) hours as needed for shortness of breath or wheezing. 8. furosemide 20 mg tablet sig: two (2) tablet po once a day. disp:*60 tablet(s)* refills:*2* 9. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po once a day. discharge disposition: home with service facility: vna of greater discharge diagnosis: atrioventricular nodal reentry tachycardia (avnrt), now ablated congestive heart failure pneumonia atrial fibrillation/flutter discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you at . you were admitted for an electrophysiology procedure to ablate an area of your heart to stop it from going into an abnormal rhythm. during your stay, we found that your heart was mildly weakened, causing fluid to build up in your body and especially your lungs. you were sent to the cardiac icu for concern of your breathing status, which was treated with medicine to remove water from your body. you ended up having the electrophysiology procedure, that seemed successful. you had a rhythm called atrioventricular nodal reentry tachycardia, which is treated with this ep procedure. you also had an abnormal rhythm called atrial fibrillation and atrial flutter at the transferring hospital; because of this rhythm, you need to be anticoagulated with a medication called coumadin. you also had a pneumonia in your right lung during this admission. you were treated with iv antibiotics, with good response. you will need one more day of antibiotics when you are discharged. please make the following changes to your medications: please start: lasix 40mg by mouth once per day lisinopril 10mg by mouth once per day coumadin 7.5mg by mouth once per day cefpodoxime 400mg by mouth twice per day (for only one day) diltiazem xl 240mg by mouth once per day please stop: dronedarone pradaxa magnesium oxide lasix 20mg twice per day (we changed your dose) otherwise please take all your medications as prescribed. your dry weight is approximately 335 pounds. please weigh yourself daily. if you gain more than 3 pounds in a day, please call your doctor for further management. followup instructions: name: , location: health care group address: ste 4b, , phone: *please call your primary care physician and book follow up appointment within 1-2 weeks. you will need to schedule a repeat chest xray in 6 weeks to evaluate your pneumonia. name: , md address: , , phone: *please call your cardiologist to book a follow up appointment of your hospitalization within 2 weeks. you will need an echocardiogram in weeks to evaluate your heart. department: cardiac services when: friday at 1 pm with: , md building: sc clinical ctr campus: east best parking: garage md procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation atrial flutter other specified cardiac dysrhythmias morbid obesity chronic obstructive asthma, unspecified acute systolic heart failure knee joint replacement hip joint replacement body mass index 70 and over, adult 

Answer: The patient is high likely exposed to