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 / citrus derived / lactulose attending: chief complaint: chest pain major surgical or invasive procedure: none history of present illness: the pt is a 84 y/o m with pmh of cad (mi and ) transferred from rehab for chest pain starting this am. he notes that the pain started this am but denies any associated sx. he notes that he has not eaten or drank well for some time. upon presentation to the ed, he was noted to have ekg w/twi in v2-v5 in the ed and was hypotensive to 70's/50s in the ed which was responsive to fluid. through the ed resident's discussion with the hcp, the plan was for conservative management of pt's sx. they did not want cardiac catheterization. however, they did feel that if pt's hypotension required pressors or central line, they would be agreeable. thus, he was transferred to the ccu. he was afebrile sating well on ra, his cp resolved w/heparin iv. . currently complains of chest wall pain. denies sob, ha/dizzyness. no cough, fever/chills. + pain in le bl. past medical history: cardiac risk factors: negative for diabetes, dyslipidemia, and hypertension . cardiac history: stemi s/p mid and distal lad placement of 2 bare metal stents anterior stemi in - medically managed h/o lv thrombus - on tte in , completed 3 wk course of lovenox . percutaneous coronary intervention demonstrated: lad had total occulsion proximally. rca no cad, lcx and lmca no cad mid and distal lad placement of 2 bare metal stents . other pmh: - ulcerative colitis - recurrent uti - dysphagia s/p esophageal dilatation - bilateral leg ulcers and skin grafts - h/o c diff social history: lives at senior center. social history is significant for the absence of current tobacco use. there is no history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: vs: t 96.6, bp 85/55, hr 62, rr 27, o2 99% on ra gen: cachectic elderly gentleman, nad heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa, dry mm. no xanthalesma. neck: supple with flat jvp. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: + scoliosis and kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, nt + mild distention. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. rectal: guiac (-) ext: no c/c/e. no femoral bruits. skin: no rashes, + ulcers on le bl, scars, or xanthomas. . pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: medical decision making ekg demonstrated new twi in v3-v5 compared with prior dated . 2d-echocardiogram performed on demonstrated: a moderate sized apical thrombus in lv. the clot is mural and not mobile. lv systolic function appears moderately-to-severely depressed (ejection fraction 30 percent) secondary to akinesis of the anterior septum and anterior free wall, with extensive apical dyskinesis. rv wnl. mild mitral valve prolapse. mild (1+) mr. the left ventricular inflow pattern suggests impaired relaxation. . cxr: no acute intrathoracic pathology is noted however the study is moderately limited due to patient rotation to the right side. 01:23pm blood wbc-3.1* rbc-4.53* hgb-10.8* hct-36.1* mcv-80* mch-23.9* mchc-30.0* rdw-14.6 plt ct-582* 06:05am blood wbc-4.9# rbc-3.73* hgb-8.8* hct-29.4* mcv-79* mch-23.5* mchc-29.8* rdw-15.7* plt ct-507* 01:23pm blood pt-13.1 ptt-31.3 inr(pt)-1.1 07:50pm blood pt-14.7* ptt-93.2* inr(pt)-1.3* 06:05am blood pt-13.7* ptt-67.4* inr(pt)-1.2* 01:23pm blood glucose-87 urean-23* creat-0.7 na-142 k-4.4 cl-104 hco3-31 angap-11 06:05am blood glucose-62* urean-13 creat-0.5 na-143 k-3.8 cl-111* hco3-23 angap-13 01:23pm blood ck(cpk)-32* 07:20pm blood ck(cpk)-28* 03:19am blood alt-13 ast-17 ld(ldh)-175 ck(cpk)-35* alkphos-72 amylase-25 totbili-0.3 01:23pm blood ctropnt-0.15* 07:20pm blood ck-mb-notdone 07:20pm blood ctropnt-0.13* 03:19am blood ck-mb-5 ctropnt-0.14* 03:19am blood albumin-2.7* calcium-7.8* phos-2.2* mg-1.8 brief hospital course: a/p: 84 yo man with pmh of cad (mi and ) admitted with c/o chest pain in the setting of two recent anterior mi s/p pci to lad and recent medical management. . #. cad - pt s/p pci with bms to mid and distal lad and recent anterior stemi which was managed medically. pt is cp free after iv hydration and improved bps. initially with twi in v2-v5, trops at bl 0.14, ck-mbs negative. for medical management of this event (which was not felt to represent recurrent acs given low-grade and flat elevations of troponin alone) he was continued on asa, statin, and plavix initially, though plavix was discontinued during his stay for 4 days in preparation for gtube placement on . this was restarted after his procedure. metoprolol was held as patient was hypotensive and bradycardic to high-40s even while awake. he should follow-up as an outpatient for possible reinitiation of bblocker. . #. pump - tte - ef 30% secondary to akinesis of the anterior septum and anterior free wall, with extensive apical dyskinesis consistent with known cad. his ace-i was held because of relative hypotension. should follow-up as outpatient for possible reinitiation of ace-i. . #. rhythm - h/o atrial fibrillation but in nsr during his stay. bblocker was continued as above. . #. hypotension - hypotension improved with ivfs and was thought to be due to chronic poor po intake and volume depletion. there was no evidence of infection. this likely represented volume depletion as pt has very poor po intake. discussed recent speech and swallow evaluation with speech pathologist at rehab which showed patient aspirated all consistencies (but did best with honey-consistency). risks and benefits of enteral feeding discussed with patient who felt that gastric feeding was the only gastric tube was placed by surgery given patient' . #. leukopenia w/relative lymphocytosis and thrombocytosis - currently improved . #. anemia - near baseline hct of 31 . #. ulcerative colitis - continued outpatient regimen . #. severe malnutrition: aspiration precautions for h/o dysphagia, spoke with rehab where he had s&s which showed aspiration of all liquids. continue honey-thickened liquids, pureed diet. pt. currently favoring g-tube as longer-term solution to poor nutrition an po. spoke with hcp sister as well sa who agree. gi on board for outpatient gtube placement. plavix held in preparation, will need to be restarted after procedure. he was given d51/2ns for calories during his stay and should continue getting that until he can be fed enterally. . #. prophylaxis: heparin sc, ppi, bowel regimen . #. code: dnr/dni . #. communication: sister, , hcp /family attorney: home: (, cell: ( medications on admission: aspirin 325 mg daily clopidogrel 75 mg daily senna 8.6 mg prn bisacodyl 10 daily atorvastatin 80 mg daily omeprazole 40 mg daily mesalamine 250 mg tid digoxin 125 mcg daily metoprolol tartrate 12.5 twice daily ferrous sulfate 325 mg once daily discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. 3. docusate sodium 50 mg/5 ml liquid : one (1) tablespoon po bid (2 times a day). 4. aspirin 81 mg tablet : one (1) tablet po once a day. 5. atorvastatin 80 mg tablet : one (1) tablet po daily (daily). 6. digoxin 125 mcg tablet : one (1) tablet po daily (daily). 7. heparin (porcine) 5,000 unit/ml solution : one (1) injection injection tid (3 times a day). 8. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 9. mesalamine 250 mg capsule, sustained release : one (1) capsule, sustained release po tid (3 times a day). 10. ferrous sulfate 325 mg (65 mg iron) tablet : one (1) tablet po tid (3 times a day). 11. clopidogrel 75 mg tablet : one (1) tablet po daily (daily). 12. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 13. morphine sulfate 1 mg iv q2h:prn breakthrough pain discharge disposition: extended care facility: for the aged - macu discharge diagnosis: failure to thrive severe malnutrition chronic systolic congestive heart failure discharge condition: stable discharge instructions: you were admitted to the hospital with chest pain. this was likely caused by low blood pressures from not eating well. you had a peg tube placed for your feeds. you should take your food and medications through this tube from now on. please continue to take your medications as prescribed. if you develop chest pain, shortness of breath, fever, or any other concerning symptoms please contact a physician . tubefeeding recommendations as below: monitor lytes including phosphorus to adjust. probalance full strength; starting rate: 10 ml/hr; advance rate by 10 ml q8h goal rate: 45 ml/hr residual check: q4h hold feeding for residual >= : 100 ml flush w/ 50 ml water q6h followup instructions: please follow up with your primary care physician and cardiologist in weeks. procedure: enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia old myocardial infarction chronic systolic heart failure ulcerative colitis, unspecified dehydration stricture and stenosis of esophagus nutritional marasmus ulcer of ankle 

Answer: The patient is high likely exposed to