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: gi bleed major surgical or invasive procedure: egd history of present illness: this is a 58 year old male with cad, s/p cabg and recent pci () on plavix and asa who presented to osh w/presyncope/cp/weakness/diaphoreis and sob. the patient also reported a history of black tarry stool and lightheadedness for 1 wk with fatigue and doe. at the osh on , in addition to shortness of breath, the patient was also found to have inferolateral st depressions and was then transferred here to . at osh, hct 31 and he received 2l ivf. in the ed, the patient was started on integrillin and heparin boluses as he had mild sscp and continued ekg changes. shortly thereafter, hct was unfortunately down to 25; integrillin and heparin were stopped and the patient was transfused 2u prbcs. guiaic positive stools were appreciated and the and was taken for egd after large black guiaic positive bm in ed. egd showed blood in the fundus, adherent clot to lower third of esophagus, likley evidence of tear. the patient was subsequently intubated for airway protection and a clip was placed at the site of a 2cm m-w tear; 4 epi injections were also applied to area with control of bleeding. he has denied any nsaid use or abd pain. he had, however, recently been started on plavix and full strength asa from a baby asa alone after recent pci with stent placement. a followup egd was performed which showed no bleeding at the site of the clip and m-w tear, but there was erosion in ge junction with active bleeding (which was treated with termal therapy for hemostatic control.). the patient was subsequently extubated. in total, the patient received 9units of prbcs. past medical history: * cabg lima->lad, svg-> am, pda, om1, d1, d2, and ramus. * 3 stents to lad * pci of the svg to omii on * htn * hyperlipidemia * prior imi social history: carpenter, no smoking or etoh use. lives at home with wife. family history: positive for cardiac disease. no history of gi bleeds. physical exam: vitals: t98.7 p70 bp 119/69 r18 sat 100%ra gen:: lying in bed, alert and conversational, no acute distress heent: perrl, mmm, clear op, neck veins not elevated chest: ctab no wheezes, rales or rhonchi cv: rrr no murmurs abd: soft, obese, nt/nd, +bs ext no edema, 2+dp pulses bilaterally neuro: alert and orientedx3, ii-xii intact, full strength 5/5 in all extremities pertinent results: 06:20am blood wbc-10.1 rbc-4.10* hgb-12.0* hct-34.6* mcv-84 mch-29.3 mchc-34.8 rdw-14.8 plt ct-132* 06:16pm blood hct-33.2* 11:59am blood hct-32.8* 03:25pm blood wbc-16.1*# rbc-2.98*# hgb-8.5*# hct-25.3*# mcv-85 mch-28.7 mchc-33.8 rdw-13.8 plt ct-306 06:20am blood plt ct-132* 05:39am blood plt ct-102* 03:25pm blood d-dimer-239 05:39am blood glucose-111* urean-17 creat-0.8 na-142 k-3.7 cl-110* hco3-25 angap-11 03:25pm blood glucose-146* urean-59* creat-0.8 na-137 k-4.3 cl-107 hco3-18* angap-16 05:39am blood calcium-8.0* phos-2.3* mg-2.0 06:08am blood lactate-1.1 ------- egd 1am findings: esophagus: mucosa: an adherent clot with active oozing was noted in the lower third of the esophagus. due to repeated epsidoes of vomitting patient was intubated for airway protection and endoscopy was repeated. the clot was dislodged with a polypectomy snare and revealed a 2cm tear. single endo clip was deployed with successful hemostasis. 4 1 cc.epinephrine 1/ injections were applied for hemostasis with success. stomach: contents: clotted and liquid blood was seen in the fundus. duodenum: normal duodenum. other findings: no blood was noted in duodenum. impression: blood in the fundus adherent clot in the lower third of the esophagus no blood was noted in duodenum. otherwise normal egd to second part of the duodenum recommendations: protonix iv bid keep npo serial hct, transfuse to keep hct greater than 30. ------ egd 9am findings: esophagus: lumen: a small size hiatal hernia was seen. excavated lesions the esophageal mucosa distal to the clip placement (within the hiatal hernia) was abnormal and was noted to be actively oozing. -cap electrocautery was applied for hemostasis successfully. other the previously placed clip was seen in the distal esophagus. there was no bleeding directly associated with this lesion. stomach: contents: bilious fluid was seen in the stomach. duodenum: normal duodenum. impression: 1- bilious fluids in stomach 2- the previously placed clip was seen in the distal esophagus. there was no bleeding directly associated with this lesion. 3- erosion in the gastroesophageal junction with active bleeding (thermal therapy for hemostatic control) 4- small hiatal hernia recommendations: high dose (double dose) ppi serial hct, transfuse as necessary carafate slurry 4x/day when extubated and taking po. icu monitoring for at least another 24 hours given high risk of bleeding ------ chest (portable ap) 2:02 am findings: et tube is seen with the tip approximately 5 cm above the carina. again seen are median sternotomy wires and clips from prior cabg. the pulmonary vasculature is within normal limits. there is scattered atelectasis noted at the left lung base, which obscures the left costophrenic angle. no right-sided pleural effusion is seen. the soft tissue and osseous structures are normal. impression: an et tube is seen with the tip approximately 5 cm above the carina. brief hospital course: * gi/cv: as discussed previously, the patient was found to have a significant tear which was treated with emergent egd and multiple blood transfusions (9 units). documentation of egd and associated interventions are documented above. etiology of the m-w tear was cryptic insofar as the patient denied vomiting, abdominal pain, coughing. etiology of the patient's initial presentation with chest pain and inferolateral st depressions on ekg, on the other hand, was attributed to anemia and consequent demand ischemia. in total, the patient received 9 units of blood and serial hct revealed no evidence of continued bleeding. the patient's diet was advanced and outpatient medications were reinitiated, including aspirin, plavix, statin, betablocker, and ace-i. the patient did not demonstrate any further evidence of bleeding on the floor as seen with serial hcts. at discharge he was able to tolerate a regular house diet. the patient was advised to follow up with his pcp 3 days of discharge to have another hct check and discuss long term screening for another possible episode of bleeding in the future. medications on admission: asa plavix zestril lipitor atenolol hctz vitamin c niacin flax seed oil niacin mvi discharge medications: 1. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 4. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 5. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). 6. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po daily (daily). 7. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours) for 4 weeks: after 4 weeks, take 1 tablet daily. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 8. outpatient lab work check a cbc within 3 days. values should be reported to the patient's pcp. discharge disposition: home discharge diagnosis: gi bleed, - tear discharge condition: good discharge instructions: * take all of your medications. note: you should take protonix 40 mg twice daily for a minimum of 4 weeks. after that time, you may take 40 mg once a day. discuss this change with your gi doctor. * have a cbc checked within 3 days of hospital discharge * make an appointment with your gi doctor within 5 days of hospital discharge * seek medical attention for: black stool, blood per rectum, lightheadedness, dizziness, nausea, vomiting, diarrhea, abdominal pain, chest pain, shortness of breath, or any other concerning symptoms * see your pcp 5-7 days of hospital discharge for a follow up appointment * do not smoke or drink alcohol followup instructions: provider: , m.d. where: phone: date/time: 3:10 provider: , md where: cardiac services phone: date/time: 9:00 provider: , m.d. where: phone: date/time: 10:30 ***make an appointment with your gi doctor within 5 days of discharge from the hospital procedure: endoscopic excision or destruction of lesion or tissue of esophagus endoscopic excision or destruction of lesion or tissue of esophagus transfusion of packed cells diagnoses: unspecified essential hypertension acute posthemorrhagic anemia aortocoronary bypass status percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia gastroesophageal laceration-hemorrhage syndrome other acute and subacute forms of ischemic heart disease, other 

Answer: The patient is high likely exposed to