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: penicillins attending: chief complaint: nausea/vomiting major surgical or invasive procedure: attempted temporary pacing wire placement (unsuccessful) foley catheter history of present illness: 72 year old female with h/o severe ventricular dysfunction (ef 10%) secondary to polysubstance abuse and hiv (dx on , last cd4 359), 2+ mr, on methadone maintenance who presents with nausea, bradycardia, acute on chronic renal failure with potassium of 6.0. patient states she has been fatigued recently but denies shortness of breath, chest pain, orthopnea and leg swelling. on day of presentation to ed, she began vomiting, non-bloody non-bilious. . patient was recently admitted to from /07 with chf exacerbation, swan was placed that admission and she was diuresed. elevated troponin at the time thought secondary to demand. she was started on amiodarone for runs of vtach and continued on digoxin. she states she has been compliant with her medications. . ed: sbp 80's, which is baseline. given insulin, 1amp d50, atropine, calcium gluconate 1g, sodium bicarbonate 50meq for potassium 6.0. given ondansetron. ekg likely junctional brady with retrograde p waves. . on review of symptoms, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. other review of symptoms negative aside from above. . in the ed, the patient was afebrile with sbp in the 80-90s. she had nausea and was noted to have hr in the 30s junctional vs av delay. now being transferred to floor for further mgmt. . on arrival to the ccu, she was feeling tired (hadn't slept all night) but no cp, shortness of breath, dizziness or lh. . on review of symptoms, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. other review of symptoms negative aside from above. . cardiac review of systems is notable for absence of chest pain, shortness of breath, palpitations, syncope or presyncope. past medical history: 1. hiv- diagnosed in , has taken therapy intermittently. stopped taking her pills three months ago because stated she had foamy vomit every time she took them. cd4 274, vl<50 in 2. chf- ef 10% 7/07 followed by dr. 3. hcv- vl >700k in , not a good candidate for interferon therapy or liver biopsy per gi note in 04. 4. mild copd- pfts showed a normal study 5. ivdu--last abuse heroin several days ago, skin popping 6. arthritis 7. chronic pancreatitis 8. ventricular tachycardia social history: has 20 grandchildren, tobacco: cig/day, 40 py heavy etoh in past. states that last used heroin in the past few days (skin popping) and also used cocaine in the last month. family history: nc physical exam: vs: 96.2f hr 30 bp 86/50 rr 16 100%/2ln.c. gen: cachectic female in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple, thin. cv: pmi located in 7th intercostal space, midclavicular line. distant heart sounds, regular rhythm, normal s1, s2. holosystolic murmur at apex. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. crackles at right base, left base clear. abd: soft, nd, mild ttp epigastrium and ruq with hepatomegaly. no abdominal bruits. ext: no le edema bilaterally. skin: multiple well healed lesions from h/o drug abuse pulses: right: 1+ dp left: 1+ dp pertinent results: 7/13/7. cxr. stable severe cardiomegaly. new mild-to-moderate pulmonary edema accompanied by small bilateral new pleural effusion. . digoxin level 3.8 . dig level 2.5 . dig level 2.1 . dig level 1.5 brief hospital course: 72 yo female with severe ventricular dysfunction (ef 10%) secondary to polysubstance abuse and hiv (last cd4 359) who presented with bradycardia secondary to digoxin and amiodarone toxicity. . # rhythm: found to be bradycardic to 30's in ed in setting of digoxin toxicity with amiodarone and hyperkalemia contributing. patient had been started on amiodarone at her last hospitalization due to runs of vtach. pacer pads were placed but she did not require transcutaneous pacing. an isoproterenol drip was started which increased her heart rates to 50's-60's (although initially remained in junctional rhythm). digoxin and amiodarone were held. an attempt was made to place a temporary pacing wire, but this attempt was unsuccessful because of thrombosed veins. the isoprotenenol drip was stopped on . patient will not go home on amiodarone and will go home on digoxin 0.125 mg qod. . # pump: ef 10% on last echo (). she appeared euvolemic on admission so lasix was held. she developed increased shortness of breath and cxr was consistent with pulmonary edema, so patient was diuresed with lasix. a foley catheter was placed to monitor accurate i/os. digoxin and acei were held. acei will be held until she follows up in clinic with dr. . # cad: no evidence of active ischemia during admission. normal perfusion images in . # hiv: last cd4 359 in 04/. patient requested that her therapy be stopped as she felt that this made her nauseated and gave her abdominal discomfort. her pcp was and made aware that the was stopped. her bactrim prophylaxis was continued. she will follow-up with her pcp to discuss further treatment options. # polysubstance abuse: last use mos pta. continued with methadone 90mg. # arf on cri: baseline creatinine 1.3-1.5. now arf on cri; likely secondary to bradycardia and low ef in setting of digoxin toxicity. held lasix and acei initially. creatine continues to trend towards baseline with return of home lasix dose. #) hyperkalemia: likely arf on cri. held acei. avoided calcium in setting of digoxin toxicity. monitored frequent electrolytes. treated with kayxalate as needed. she will have her potassium monitored on at the rehab facility. #) anticoagulation: patient started on coumadin given poor lv function and risk of clot formation. continued coumadin at decreased dose with sub-therapeutic inr. prior to discharge to rehab, coumadin was increased to 5mg daily. her inr will be checked on at rehab and coumadin will be adjusted by dr. . medications on admission: 1. amiodarone 400mg 2. digoxin 0.125 mcg tablet : 0.5 tablet po daily 3. emtricitabine-tenofovir 200-300 mg po daily 4. furosemide 100mg po bid 5. lansoprazole oral disintegrating tab 30 mg po daily 6. lisinopril 20 mg po daily 7. methadone hcl 90 mg po daily 8. sulfameth/trimethoprim ds 1 tab po bid 9. warfarin 2 mg po hs discharge medications: 1. methadone 10 mg tablet : nine (9) tablet po daily (daily). 2. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 3. trimethoprim-sulfamethoxazole 160-800 mg tablet : one (1) tablet po daily (daily). 4. furosemide 20 mg tablet : five (5) tablet po bid (2 times a day). 5. digoxin 125 mcg tablet : one (1) tablet po every other day: start on tuesday, . 6. coumadin 2.5 mg tablet : two (2) tablet po once a day: please have your inr checked on . results faxed to dr. . 7. outpatient lab work please have your pt/ptt/inr as well as a chem 7 (electrolytes, creatinine, bun) checked on wednesday, . fax results to dr. at (. discharge disposition: extended care facility: - discharge diagnosis: digoxin toxicity resulting in bradycardia congestive heart failure coronary artery disease discharge condition: afebrile, comfortable on room air discharge instructions: your foley catheter was removed just prior to discharge to rehab. please perform a voiding trial on the day of admission to rehab. . please stop taking amiodarone and lisinopril. please resume taking digoxin 0.125 mg every other day starting on tuesday, . . please take coumadin at 5 mg daily. your inr will be checked on wednesday, . results will be faxed to dr. office. . please resume the rest of the medications you were on prior to admission, including lasix 100 mg twice per day. please call your primary physician or return to the emergency room should you develop any of the following symptoms: nausea/vomiting, chest pain, difficulty breathing, or any other concerns. followup instructions: please keep your appointment to see dr. on thursday, at 2:30 pm. call if there is a problem with this appointment. you should discuss restarting your hiv medications at this appointment. please see dr. on at 3:30 pm. call if there is a problem with this appointment. procedure: venous cutdown diagnoses: hyperpotassemia mitral valve disorders congestive heart failure, unspecified chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified human immunodeficiency virus [hiv] disease chronic kidney disease, unspecified opioid type dependence, continuous paroxysmal ventricular tachycardia other specified cardiac dysrhythmias surgical or other procedure not carried out because of contraindication cardiotonic glycosides and drugs of similar action causing adverse effects in therapeutic use secondary cardiomyopathy, unspecified 

Answer: The patient is high likely exposed to