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: levofloxacin attending: chief complaint: melena major surgical or invasive procedure: upper endoscopy with cauterization of bleeding vessel peg tube placement history of present illness: year old anaesthesiologist with history of cabg, esophageal strictures/dismotility, htn, and chf with ef 45% presenting with mahogany stools. the week prior to admission he began to feel a sense of weakness, fatigue, and dizziness. he stopped taking his asa, also had been on advil for sore foot a week prior. he started noticing melanic stools the morning prior to admission. he presented to where his hct was found to be 20 from a baseline of 29. he had no nausea or hematemesis. at the icu his hct went to 22 after 3 units prbcs. he has gotten 3 more units prbcs prior to arrival in the micu for a total of 6 units. he has had 4 bloody bms today. the gi physicians at jordans were hesitant to scope him given his esophageal stricture so he was transfered here for egd. his last colonoscopy was which showed diffuse diverticulosis. currently he has no chest pain, he had some abdominal pain earlier today which has resolved with fentanyl. he has no shortness of breath, no nausea. he does note a 20 lb weight loss over the last few months with no change in diet. he has no edema, no orthopnea, no pnd. past medical history: 1. esophageal dismotility - treated with botox injections, eventually requiring peg placement 5 years ago. 2. esophageal stricture - unable to pass pediatric endoscopy tube without dilation 3. paroxismal atrial fibrillation s/p pacemaker placement for tachy brady syndrome 4. ischemic heart disease s/p cabg ' 5. aortic stenosis 6. mitral regurgitation 7. cri, baseline creatinine 1.6 8. htn 9. chf with ef 45% 10. bladder tumor social history: retired anesthesiologist who worked for 40 years at . currently leading very active life. golfs 3x per week. lives at home with wife. smoking, no etoh family history: parents died in their 80s of heart disease physical exam: vital signs temp 97,7, bp 124/35, p 67 (nsr), rr 16, 100% on 2l nc gen: alert, oriented, cachectic appearing male in nad heent: mm dry, op clear, perrl lungs: clear to auscultation bilaterally, decreased bs at right base cv: holosystolic murmer loud at both rusb and apex abd: concave, thin, non-tender, non-distended, positive bs ext: no edema neuro: intact pertinent results: labs from osh: wbc 5.9, hct 20.5 -> 22.4 (after 3 units), plt 121 pt 12.9, inr 1.2 na 140, k 4.9, bun 110, creat 1.6 (baseline), alb 1.6, bili 0.3 alk phos 36, ast 14, alt 19 . 04:43pm blood wbc-7.8 rbc-3.70* hgb-11.1* hct-31.0* mcv-84 mch-30.0 mchc-35.9* rdw-17.3* plt ct-121* 08:04am blood hct-36.6* 05:22am blood wbc-6.5 rbc-3.68* hgb-10.8* hct-30.1* mcv-82 mch-29.4 mchc-36.0* rdw-17.6* plt ct-90* 07:50pm blood hct-27.8* 03:35pm blood hct-31.2* 09:55pm blood hct-30.6* 05:10am blood wbc-6.1 rbc-3.57* hgb-10.9* hct-30.2* mcv-85 mch-30.4 mchc-36.0* rdw-17.5* plt ct-106*. . echo: the left atrium is elongated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild to moderate regional left ventricular systolic dysfunction with distal septal and apical hypokinesis as well as basal inferior and infero-lateral hypokinesis. no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are moderately thickened. there is moderate aortic valve stenosis. mild (1+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric, directed toward the anterior mitral leaflet. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. . egd report : fresh blood was found in the duodenal bulb and second portion of the duodenum. a clot was seen with active bleeding in the second portion of the duodenum. after 20 cc of 1:10,000 epinephrine was injected in the area with successful hemostasis, what appears like a single cratered ulcer with a visible vessel was seen in the second part of the duodenum. -cap electrocautery was applied for hemostasis successfully. impression: blood in the stomach ulcer in the second part of the duodenum recommendations: protonix 40mg iv bid continue serial hct. avoid nsaids. . egd report : previous single ulcer was found in the duodenum s/p bicap with question of minimal oozing. impression: duodenal ulcer peg placed. brief hospital course: while in micu, patient transfused 4 more units prbcs. gi consulted, underwent egd through peg tube site given esophageal stricture. found to have blood in bulb and 2nd part of duodenum. a clot with active bleeding was also found, hemostasis achieved w/ epi and electrocautery. hct decreased from 37-30.8 throughout the day yesterday, now stable at 30-31. no further episodes of melena. . on transfer to the medicine floor, the patient felt somewhat improved, denied chest pain or shortness of breath, abdominal pain, or light-headedness. his hematocrit was monitored every 6 hours, and he was transfused 1 more unit overnight given that it had decreased from 30 to 27, with an appropriate increase the following day. gi decided to re-scope him to ensure no further bleeding, the previous lesion had some slight ooze, but did not require any intervention. a peg tube was placed without complication. the patient was continued on the ppi , and did not have any further episodes of melena or guaiac positive stool. his hematocrit remained stable. he was provided with ppn given that he was npo, and tube feeds were initiated once his peg was placed. he was provided ivf and free water boluses through the peg tube to help correct his hypernatremia. additionally, he noted to have right foot pain on the day prior to discharge. plain films were obtained, which suggested gout. treatment was discussed, but deferred for now as the patient did not feel that his pain was intolerable, and he felt it was improving. prior to discharge, his ace was also restarted to ensure that his blood pressure would tolerate this. he was evaluated by pt prior to discharge and cleared for a safe discharge home. he was provided a script for protonix, but instructed to substitute prilosec if unable to afford the protonix. he will follow-up with his pcp after discharge, and was reminded to avoid all aspirin and nsaids. medications on admission: aspirin hytrin 10 mg daily quinapril vitamins brewers yeast prune juice medications on transfer: protonix drip terazosin 5 discharge medications: 1. terazosin 5 mg capsule sig: two (2) capsule po hs (at bedtime). 2. quinapril 5 mg tablet sig: two (2) tablet po daily (daily). 3. pantoprazole 40 mg recon soln sig: forty (40) mg intravenous twice a day: administer through peg tube. disp:*qs * refills:*1* discharge disposition: home discharge diagnosis: bleeding duodenal ulcer bleeding duodenal ulcer discharge condition: good discharge instructions: we have started you on a new medication, pantoprazole, to help protect your stomach. please take this medication as instructed. if this medication is too expensive, you may substitute prilosec, which is sold over the counter (same dose, 40mg twice a day). please do not take any aspirin, ibuprofen or other nsaids. . please call your doctor or return to the hospital if you develop fevers, chills, chest pain, shortness of breath, or if you start to have black or bloody stools. followup instructions: please call your pcp for a follow-up appointment within 1 week of discharge. procedure: enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] endoscopic control of gastric or duodenal bleeding transfusion of packed cells diagnoses: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute posthemorrhagic anemia coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cardiac pacemaker in situ hyperosmolality and/or hypernatremia diverticulosis of colon (without mention of hemorrhage) acute duodenal ulcer with hemorrhage, without mention of obstruction dyskinesia of esophagus 

Answer: The patient is high likely exposed to