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: bradycardia, asystole major surgical or invasive procedure: cardiopulmonary resucitation intubation temporary pacing wire history of present illness: 78y f cantonese-speaking only with h/o afib on , cad s/p cabgx2 , and diastolic chf lvef >55% presents with abdominal pain in ed. while in ed, patient became bradycardic to the 50s and continued to the 30s when she then went into asystole. patient coded by ed team intermittently for 20 minutes. intubated. cardiology fellow and ep fellow called- placed temporary pacing line. patient's rhythm and pulse returned- then transferred to the ccu for further monitoring/evaluation. . upon transfer to floor, patient was intubated on mechanical ventilation. hr in 80s and sbp of 109/53. non-responsive. again seen and evaluated by ep fellow and cardiology fellow as well as by ccu team. . unable to obtain review of systems given patient is sedated. past medical history: atrial fibrillation chf cad s/p cabg (2vd, svg -> om1/pda) s/p mitral valve repair s/p cholecystectomy s/p ercp for cbd stone removal social history: never smoked, no alcohol use, no illicit drug use. she lives at home alone. during the day she spends time with family, who provide meals for her, at night she is by herself. family history: mother- colon ca brother- liver ca copd physical exam: vs: t= 96.3 bp= 140/70 hr= 90s rr= 12 o2 sat= 100% ra general: lying in bed, nad, a and o x 3 heent: ncat. perrl. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with no elevated jvd cardiac: irregularly irregular s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: cta bilat 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: dp/pt 2+/1+ left: dp/pt 2+/1+ pertinent results: cxr : findings: in comparison with the study of , the right ij catheter has been removed. little change in the appearance of the heart and lungs with enlargement of the cardiac silhouette and blunting of the costophrenic angles bilaterally. no definite pulmonary vascular congestion at this time. . tte : the left atrium is moderately dilated. the right atrium is moderately dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 60-70%). right ventricular chamber size and free wall motion are normal. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior report (images unavailable for review) of 25 vnov ember v2008, probably no major change. . ct chest/abd/pelvis : impression: 1. no pulmonary embolism. 2. mild aneurysmal dilatation of the ascending aorta without evidence of dissection or intramural hematoma. 3. diffuse ground-glass opacities and septal thickening within the lungs with bilateral pleural effusions, likely on the basis of pulmonary edema/fluid overload. there is also cardiomegaly. 4. stable intrahepatic biliary ductal dilatation and air as well as common bile duct dilatation. 5. mesenteric stranding and fluid in a peripancreatic region around the pancreatic head extending into the porta hepatis and anterior perirenal fascia. these findings may relate to pancreatitis, please clinically correlate with patient's laboratory values. 6. poor renal cortical enhancement identified on arterial phase imaging, which is symmetric. given patient's history of recent pea arrest, atn is highly considered. 7. featureless appearance of the entire large bowel with intramural fat deposition and absence of skip lesions. no pericolonic inflammatory changes are noted. these findings may be related to burnt out/chronic ulcerative colitis, as opposed to a more acute process. 8. ascites. labs at discharge wbc rbc hgb hct mcv mch mchc rdw plt ct 6.9 4.25 11.9* 36.2 85 28.1 33.0 15.0 140 inr 3.1 glucose urean creat na k cl hco3 angap 189* 22* 1.0 138 4.0 103 23 16 . brief hospital course: 78 y/o f with cad presenting with abdominal pain, bradycardia progressing to pea arrest, s/p resuscitation, intubated and on pressors. . # rhythm/pea: has chronic history of a-fib (on anticoagulation). patient became asystolic while in ed in the setting of bradycardia. suspect vagal episode. was coded by ed team, intubated, and had temporary pacer wire placed by cardiology fellow. interestingly, unsure if the event was true asystole, as patient seems to recall the entire event. pulse/pressure returned and patient immediately trasferred to ccu. patient extubated on hospital day 2. in paced rhythm with hr of 90. telemetry without other events, and temporary pacer wire was removed soon thereafter. of note, etiology likely bradycardia/vagal reaction, as ct chest, abdomen, and pelvis not consistent with other etiologies of pea/asystole including trauma, pneumothorax, aortic dissection, pe, aaa, mi, mesenteric ischemia, etc. patient's hr ranged from 90s-110s, while on metoprolol 75 mg tid. patient was discharged on the following regimen for rate control: coreg 25 mg , dilt er 120 mg daily. . #hypotension: unclear etiology, but in the setting of her pea/asystolic/bradycardia event. patient was weaned of pressors fairly rapidly while in the ccu, did well, was soon transferred to floor. pt continued to be normotensive upon discharge. . # abdominal pain - ct abdomen/pelvis without clear etiology for abdominal pain. pain resolved fairly rapidly and may have been related to incomplete obstruction/constipation. . # hypoxia: cxr with ?lll infiltrate, cardiomegaly, coin lesion in rll. in setting of her leukocytosis, empiric flagyl and levofloxacin were started. abx were continued for total of 5 days. . #acute renal failure: baseline creatinine 1.0, was 2.0 on presentation, suspect etiology to be pre-renal insult in setting of her bradycardia/asystolic event. on discharge, cr was 1, at baseline. . #leukocytosis: wbc 20.0. suspected from stress of cardiac arrest, epinephrine administration. unlikely from abdominal catastophy as ct abdomen and pelvis negative for acute process. patient to complete 5 day course of flagyl and levofloxacin. . # coronaries: history of cad s/p cabg in . continued on aspirin, atorvastatin. cardiac enzymes not c/w acs. . # pump: history of htn- patient on carvedilol 25mg po bid and lasix 40mg daily. echo from showing moderately dilated la. the right atrium is moderately dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 60-70%). right ventricular chamber size and free wall motion are normal. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior report (images unavailable for review) of 25 vnov ember v2008, probably no major change. . # anticoagulation- on 2mg daily for chronic a-fib. on discharge inr was 3.1, likely elevated in setting of short course of antibiotics. pt will have close follow up to monitor inr. dose will be held on day of discharge, and 1 mg will be given day after discharge. home regimen prior to admission was warfarin 2 mg daily. the patient is a full code. medications on admission: 1. warfarin 2 mg daily 2. atorvastatin 20 mg tablet daily 3. aspirin 325 mg tablet daily 4. diltiazem hcl 240 mg capsule, sustained release: one (1) capsule, sustained release daily. 5. furosemide 40 mg tablet daily. 6. carvedilol 25mg tablet discharge medications: 1. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 2. warfarin 2 mg tablet : one (1) tablet po once daily at 4 pm: take tab on then start taking full tablet on . 3. carvedilol 12.5 mg tablet : two (2) tablet po bid (2 times a day). 4. diltiazem hcl 120 mg capsule, sustained release : one (1) capsule, sustained release po daily (daily). 5. lasix 40 mg tablet : one (1) tablet po once a day. 6. outpatient lab work please check inr in next 1-2 days call results to dr. at 7. atorvastatin 20 mg tablet : one (1) tablet po once a day. 8. lidoderm 5 %(700 mg/patch) adhesive patch, medicated : one (1) topical once a day for 3 days. disp:*1 0* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnoses: vagal episode, asystole lll pneumonia secondary diagnoses (prior to this hospitalization): 1. cardiac risk factors: diabetes, dyslipidemia, hypertension 2. cardiac history: -cabg: - 2vd, svg-->om1/pda -percutaneous coronary interventions: none -pacing/icd: temporary pacer placed in ed atrial fibrillation chf s/p mitral valve repair 3. other past medical history: s/p cholecystectomy s/p ercp for cbd stone removal discharge condition: stable and improved discharge instructions: you came to the hospital with abdominal pain. while being evaluated in the ed, your heart slowed to a dangerously low rate, and stopped for a short period of time. cpr was performed to help you, and you had a temporary pacemaker placed in the ed. during this time, strong medications and a breathing tube were being used to support you. you were then transferred to the icu for more care. your rapid heart rate was controlled, and you underwent a series of tests which were all normal. you did well, the breathing tube and strong medications were stopped, and you were transferred to the floor. following transfer, your home medications were restarted, and you continued to do well. you were discharged on in good condition. the following changes were made to your medications: diltiazem 120 mg daily (your dose was cut in half) do not take your warfarin today. take your warfarin in the following way: take no warfarin tonight. take 1mg of warfarin tomorrow (). then resume taking your home dose of warfarin (2mg daily) on thursday (). please have your inr checked in the next 1-2 days and fax the results to your so they can continue to help you with your warfarin dosing. please see below for your follow up appointments. please call your pcp 911 if you develop chest pain, shortness of breath, dizziness/lightheadedness, fevers, chills, abdominal pain, or any other concerning medical symptoms. followup instructions: please visit dr. office, your cardiologist, tomorrow between 9 and 2:30 to pick up your heart monitor. your follow up appointments: md: specialty: family practice/ pcp date and time: tuesday, :30am location: , phone number: dr. , your cardiologist, will see you at at 3 p.m. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube insertion of temporary transvenous pacemaker system diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status constipation, unspecified other and unspecified hyperlipidemia heart valve replaced by other means hypotension, unspecified pneumonitis due to inhalation of food or vomitus cardiac arrest long-term (current) use of anticoagulants other ascites hypoxemia chronic diastolic heart failure 

Answer: The patient is high likely exposed to