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: the patient is a 73 year old male with a recent history of paroxysmal atrial fibrillation and hypercholesterolemia who presented to the emergency department with the chief complaint of syncope. the patient was discharged from with the diagnosis of pulmonary embolism about six months prior to the current admission and was started on warfarin. one month prior to this admission, the patient reports not feeling well with worsening gastric distress. a few weeks prior to admission, he fell down on his back and started taking ibuprofen 1000 mg once a day for pain and vioxx in addition to his aspirin and coumadin regimen. the night prior to admission, he was found by his wife on the bathroom floor in a pool of urine, unresponsive without any body movements, post-ictal state. ems was activated, however, the patient refused to go to the hospital. a similar episode happened at 2 a.m. the same night and at 07:45 on the day of admission, the patient lost consciousness once again when he was trying to sit up. he was then transferred to . the patient reports some nausea and epigastric pressure which is post-prandial. he denies any emesis, melena, diarrhea or constipation. he describes the room spinning with attempts to sit upright. no history of previous episodes was noted. denies incontinence. he does have diaphoresis and weakness with orthostatic changes. in the emergency department, stool guaiac was trace positive. hematocrit was 24.8, with a baseline of 46. gastric lavage was grossly positive for coffee ground material. his inr was found to be 4.4. he was given vitamin k 10 mg subcutaneously, 2.5 liters of normal saline, two units of packed red blood cells and two units of fresh frozen plasma and transferred to the medical intensive care unit for further management. past medical history: 1. hyperthyroid disease status post radioactive iodine ablation, now hypothyroid on levoxyl. 2. history of pulmonary embolism, etiology unknown. it was thought to be induced by frequent flying to . the patient was started on coumadin five months prior to this admission. 3. hypercholesterolemia. well controlled on lipitor. last total cholesterol was 168 in . 4. paroxysmal atrial fibrillation in the setting of pulmonary embolism. past surgical history: 1. only significant for a right inguinal hernia repair. allergies: penicillin. outpatient medications: 1. lipitor 10 mg three times a week. 2. aspirin 81. 3. propranolol 10 mg three times a day. 4. coumadin 6.25 mg once a day. 5. levoxyl 100 meq q. day. 6. ambien p.r.n. 7. vitamins. 8. vioxx times three weeks. social history: the patient quit smoking 20 years ago; ethanol one glass of wine a day. he is a retired elementary school principal and now works in management. family history: significant for mother who has hypertension and stroke at the age of 70. physical examination: temperature was 100.3 f.; heart rate was 115. in general, in no acute distress. alert and oriented times three. heent: extraocular movements are intact. pupils equally round and reactive to light and accommodation bilaterally. oropharynx clear. mucosal membranes are moist. cardiovascular: regular rate and rhythm, normal s1, s2, no murmurs, rubs or gallops. pulmonary clear to auscultation anteriorly. abdomen soft, mildly distended, nontender, positive bowel sounds. extremities with no edema, one to two pulses in all four extremities. laboratory: sodium 141, potassium 4.4, chloride 108, bicarbonate 23, bun 57, creatinine 0.7, glucose 115. white blood cell count 11.0, differential with 76 neutrophils, 2 monos, 21 lymphocytes, and no eosinophils. hematocrit 24.8, platelets 223, inr 2.4, ck 234. ct scan of the head showed no hemorrhage or edema. ekg showed normal sinus rhythm at 90 with normal intervals and st wave inversions and early r wave progression. hospital course: the patient was transferred to medical intensive care unit for further management for acute gi bleed. 1. gastrointestinal bleed: the patient continued to receive blood transfusions on the floor and serial hematocrits with serial inr checks were drawn. as he was receiving his third unit of packed red blood cells, the patient became tachycardic and short of breath. his temperature raised from 98.6 f., to 101.0 f. he was shown to have rigors. the transfusion was stopped and the patient was given tylenol 1 mg with epinephrine, 100 mg of hydrocortisone, 25 mg of benadryl and demerol 15 as well as pepcid. he had emesis times three of 75 cc of coffee ground material. the patient also desaturated to the low 80s and was started on a non-rebreather mask. his saturations improved quickly on 100% non-rebreather mask within 15 to 20 minutes. shortly after his mental status changed; he became disoriented and euphoric and continued to be in this state for two more hours. after that period of time, his mental status gradually improved and he continued to receive his blood transfusions requiring a total of ten units of packed red blood cells and four units of fresh frozen plasma to reach a hematocrit of 30.0, which remained stable for the duration of his stay. on admission, the patient was started on high dose proton pump inhibitors for prophylaxis. on wednesday, , an esophagogastroduodenoscopy was performed and was significant for the following findings: medium hiatal hernia, barrett's esophagus, erosion of the gastroesophageal junction, granularity, erythema and congestion of the antrum in the pre-pyloric region compatible with gastritis. erosions in the antrum and pre-pyloric region, granularity, erythema and congestion of the anterior bulb and posterior bulb compatible with duodenitis. it was recommended by gastroenterology that the patient is to stay off aspirin for at least four to six weeks at discharge to prevent further bleeding. 2. cardiovascular: during transfusion reaction episode, the patient had an episode of tachycardia ranging from 134 to 158, for one to two hours. ekg during this episode was taken and showed sinus tachycardia; however, serial enzymes were significant for ck peaking at 1075, mb peaking at 114 and mb index peaking at 10.8, consistent with myocardial damage. the day following this episode, ekg showed loss of r wave progression in anterior leads and q waves in leads iii and avf consistent with anteroseptal myocardial infarction. the patient's blood pressures remained stable during his stay. he had no episodes of arrhythmia on telemetry. cardiology consultation was obtained. the myocardial infarction was attributed to demand ischemia secondary to acute hematocrit drop exacerbated by tachycardia secondary to blood transfusion reaction. further cardiologic work-up was suggested as an outpatient at four to six weeks post discharge. the patient was started on lopressor, lipitor and lisinopril. 3. after ten units of packed red blood cells and four units of fresh frozen plasma transfusions, the patient's hematocrit remained stable at above 30. his inr decreased to 1.3 at the time of discharge. he required no blood transfusions for four days prior to discharge. 4. history of pulmonary embolism likely secondary to frequent flying. the need for further anti-coagulation was discussed with the patient's attending, dr. , and it was decided not to continue anti-coagulation due to increased risk of gastrointestinal bleeding. the patient remained symptom free during his stay in the hospital, saturating well in room air. 5. endocrine: the patient was restarted on levothyroxine soon after admission. his hemoglobin a1c was sent and it was pending at the time of discharge. 6. single mental status change times two hours during episode of blood transfusion reaction. was most likely due to multiple drugs administered during the episode including demerol. after this episode, the patient's mental status remained clear for the rest of the duration of his stay. 7. prophylaxis: the patient was sent home on proton pump inhibitors. his helicobacter pylori serology was sent and was pending at the time of discharge. condition at discharge: good. disposition: the patient was discharged to home on the following medications. discharge medications: 1. lisinopril 5 mg p.o. q. day. 2. metoprolol 37.5 mg p.o. twice a day. 3. lipitor 10 mg p.o. q. day. 4. pantoprazole 40 mg p.o. q. day. 5. levothyroxine 100 micrograms p.o. q. day. discharge instructions: 1. the patient was to arrange his follow-up with his primary care physician, . 2. to follow-up with his cardiologist, dr. within one to two weeks of discharge. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine other endoscopy of small intestine diagnoses: pure hypercholesterolemia acute myocardial infarction of other anterior wall, initial episode of care atrial fibrillation other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hematemesis postsurgical hypothyroidism 

Answer: The patient is high likely exposed to