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: melana, chest pain major surgical or invasive procedure: esophagogastroduodenoscopy history of present illness: 72 year old male with cad s/p cabg, atrial fib on coumadin, s/p vt/vf arrest with biv pacer; chf with ef 15% admitted to the micu () after presenting with cp, sob, abdominal pain, melena, inr of 3, and hct drop from 40 to 37. he was admitted to the micu where he was given ffp and 1u prbcs and ruled out for acs. he was seen by gi, surgery, and cardiology. gi c/s resulted in plan for egd. surgery c/s resulted in inr reversal and serial exams and hcts. cardiology felt the patient's cp was not a cardiac etiology. he was ruled out for mi regardless. his hct was 31 at its lowest but remained stable and, as he was stable overall, he was felt appropriate for transfer to the floor for further work up of his melena. . of note, last , the patient had a similar presentation and egd, c-scope, and capsule endoscopy demonstrated gastritis, barrett's, diverticulosis and grade 1 hemorrhoids were found, without any active bleeding. at time of transfer, the patient endorsed mild abdominal pain and diaphoresis. he denied chest pain. he had not had a bm in 2 days. past medical history: --cad status post cabg with simultaneous aortic aneurysm repair in , history of stenting of the left circumflex artery --s/p vt/vf arrest, s/p icd placement in --ischemic cardiomyopathy with an ed of 20%, s/p biv pacer --chest wall cellulitis over pacer site vs. icd pacer pocket infection --paf --ckd with baseline cr. 1.6-2 --hyperlipidemia --asthma --anxiety --alzheimer's dementia --hypothyroidism --gi bleed of unknown etiology . egd revealed esophagitis, barrett's esophagus, and duodenitis. no ulcers. --diverticulosis --gerd --s/p cholecystectomy social history: patient originally from and moved to the united states in . worked as an off-set printer in , where he continues to live with his wife. father of five children. retired 6 years ago, and since his recent heart problems, says he rarely leaves the house. most of his time is spent in front of the television with his wife handling their affairs at home. no history of smoking, past or present. patient was a heavy drinker until 20 years ago, when he stopped completely after attending aa and encountering marital difficulties. no history of illicit drug use. family history: non-contributory. physical exam: afebrile, 115/69, 75, 18, 99%2l general appearance: pleasant, obese male, mildly diaphoretic lying in bed in no acute distress. eyes / conjunctiva: perrl, eomi, no icterus head, ears, nose, throat: ncat, mmmi, jvd 10cm cardiovascular: paced, looud blowing systolic murmur loudest at lusb with radiation along the left sternal border throughout, large, prolonged and displaced pmi respiratory / chest: cta b/l abdominal: soft, mild guarding, +bs, subumbilical tenderness with mild tenderness in bl lower quadrents, no guarding extremities: pneumoboots in place, dps 1+ bl neurologic: attentive, follows simple commands, a and o times 3, movement and sensation intact in all extremities pertinent results: 03:20pm pt-29.2* ptt-31.4 inr(pt)-3.0* 03:20pm plt count-168 03:20pm neuts-75.5* lymphs-13.8* monos-7.0 eos-3.4 basos-0.4 03:20pm wbc-8.6 rbc-4.30* hgb-12.4* hct-37.0* mcv-86 mch-28.8 mchc-33.5 rdw-14.6 03:20pm digoxin-0.9 03:20pm calcium-9.0 phosphate-3.1 magnesium-2.3 03:20pm ck-mb-4 03:20pm ctropnt-0.01 03:20pm lipase-44 03:20pm alt(sgpt)-20 ast(sgot)-28 ck(cpk)-112 alk phos-89 tot bili-0.2 03:20pm estgfr-using this 03:20pm glucose-72 urea n-23* creat-1.7* sodium-138 potassium-4.5 chloride-101 total co2-32 anion gap-10 03:32pm k+-4.6 03:32pm comments-green top 06:02pm hct-35.6* 06:12pm lactate-0.9 11:30pm hct-31.1* 11:30pm urine hours-random urea n-377 creat-52 sodium-50 11:30pm digoxin-0.8* 11:30pm magnesium-2.0 11:30pm ck-mb-4 ctropnt-0.01 11:30pm ck(cpk)-110 11:30pm glucose-89 urea n-20 creat-1.6* sodium-141 potassium-4.2 chloride-104 total co2-30 anion gap-11 ekg - : ventricular paced rhythm atrial mechanism uncertain - may be paced ot possible ectopic atrial rhythm since previous tracing of , ventricular ectopy absent and p wave morphology appears changed cxr - : single portable upright view of the chest: the cardiomediastinal contour is unchanged, with moderate cardiomegaly. there is no pleural effusion or evidence of focal consolidation. the dual-lead pacing device is unchanged in appearance. osseous structures are unremarkable. impression: no significant change since . no evidence of pneumonia or congestive heart failure. kub - : findings: there is non-specific bowel gas in the abdomen. there are no distended loops of bowel, or concerning air-fluid levels. there is air in the rectum. there is a large amount of feces in the descending colon, suggesting constipation. of note, there is a right hip hemiarthroplasty hardware, without apparent hardware complication. there is a mild lumbar levoscoliosis. there are surgical clips at the right upper quadrant, from prior cholecystectomy. there are wires projected on to the heart, likely pacer wires. impression: no evidence of bowel obstruction. likely constipation. egd - : barrett's exophagitis, gastritis, duodenitis brief hospital course: 72 year old male with cad s/p cabg, atrial fib on coumadin, s/p vt/vf arrest now with biv pacer; chf with ef 15% who presented with what appears to be non-cardiac chest pain, abdominal pain and melena. . # melena/abdominal pain: hct decreased to 31 from bl of 33 on arrival to micu. inr was reversed. serial hematocrits were checked and remained stable despite the patient remaining guiac positive. aspirin and coumadin were held until after egd at which time they were restarted. iv ppi was given until egd. patient was converted to po ppi and instructed to continue as such for six weeks. gi follow up . patient had similar episode in and had an extensive gi workup which was negative. . # chest pain: pain resolved by the time the patient arrived to the floor. cardiology felt the pain was unlikely to be cardiac in nature as cardiac enzymes were negative on arrival to the ed after 5 hours of constant chest pain. pain could be esophageal as patient has history of esophagitis and barretts esophagus. last possibility is aortic chest pain as patient has history of thoracic aortic aneurysm repair, small concern for dissection although unlikely as patient remained stable throughout his hopitalization and his cp resolved. . # cad: patient is s/p cabg. chest pain unlikely to be cardiac. mi ruled out. asa, bb and statin were initially held in setting of possible gib but were restarted prior to discharge. . # chf: patient with history of ischemic cmp with ef 15%. home lasix, aldactone, and toprol were intially held but reintroduced prior to discharge. home digoxin was continued. . # paf: patient s/p biv pacer placement on coumadin. inr was reversed intially but coumadin was restarted prior to discharge. digoxin was continued. . # vf/vt arrest: patient is s/p biv pacer/icd placement. home sotalol, mexiletine were continued. . # asthma: albuterol mdi at home. albuterol nebs were given prn. . # hypothyroidism: home levoxyl was continued. . # ckd: patient with cr of 1.7 on admission with baseline cr 1.5-2. remained stable. . # alzheimer??????s: held home donepezil, celexa initially. restarted prior to discharge. medications on admission: sotalol 80mg lipitor 20mg daily donepezil 5mg daily quetiapine 25mg, 3tabs qam, 1tab noon, 3tabs qhs celexa 60mg daily protonix 40mg daily asa 81mg daily clonazepam 0.5mg tid prn lisinopril 5mg daily digoxin 125mcg, tab daily k-dur daily spironolactone 25mg daily levothyroxin3e 112mcg daily trazodone 25mg qhs mexiletine 150mg tid albuterol mdi 2puf q6hprn fluticasone 110mcg 2puff toprol sl 50mg daily lasix 40mg tid coumadin discharge medications: 1. sotalol 80 mg tablet sig: one (1) tablet po bid (2 times a day). 2. mexiletine 150 mg capsule sig: one (1) capsule po q8h (every 8 hours). 3. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 4. clonazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day). 5. digoxin 125 mcg tablet sig: tablet po daily (daily). 6. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours): take twice per day for a total of 6 weeks. can then resume once per day. disp:*45 tablet, delayed release (e.c.)(s)* refills:*0* 8. warfarin 1 mg tablet sig: 2-3 tablets po once a day: 2 to 3 tablets by mouth once per day or as directed. 9. albuterol 90 mcg/actuation aerosol sig: two (2) puffs inhalation every six (6) hours as needed for shortness of breath or wheezing. 10. lipitor 20 mg tablet sig: one (1) tablet po once a day. 11. celexa 40 mg tablet sig: 1.5 tablets po once a day. 12. donepezil 5 mg tablet sig: one (1) tablet po at bedtime. 13. fluticasone 110 mcg/actuation aerosol sig: two (2) puffs inhalation twice a day. 14. lasix 40 mg tablet sig: one (1) tablet po once a day. 15. lisinopril 5 mg tablet sig: one (1) tablet po once a day. 16. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 17. miralax 100 % powder sig: one (1) packet po once a day. 18. k-dur 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 19. quetiapine 25 mg tablet sig: two (2) tablet po qam. 20. quetiapine 25 mg tablet sig: one (1) tablet po qnoon. 21. quetiapine 25 mg tablet sig: three (3) tablet po at bedtime. 22. spironolactone 25 mg tablet sig: 0.5 tablet po once a day. 23. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po once a day. 24. magnesium oxide 400 mg tablet sig: one (1) tablet po once a day. 25. promethazine 12.5 mg tablet sig: 1-2 tablets po every six (6) hours as needed for nausea. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: upper gastrointestinal bleed barrett's esophagitis gastritis duodenitis discharge condition: fair discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 2l you were admitted to the hospital because you had blood in your stool along with a decrease in your blood count/hematocrit concerning for ongoing bleeding. because you also had chest pain upon presentation, you were also admitted to rule out the possibility that you were experiencing a heart attack. you had an egd performed which showed irritation and inflammation of your esophagus, stomach, and duodenum. this irritation could be the cause of your bloody stool and decrease in blood count. you were given blood replacement products along with high doses of protonix and your blood count remained stable. you should continue to take you protonix twice per day for the next 6 weeks. you have follow up with the gi doctors . you should call your doctor and/or return to the emergency room if you have dark tarry stools or bright red blood in your stool, chest pain, shortness of breath, or any other corncerning symptoms. followup instructions: at 9:30am device clinic (phone:) at 10:00am , np (phone:) at 11:00 , md (phone:) procedure: other endoscopy of small intestine transfusion of packed cells transfusion of other serum diagnoses: esophageal reflux congestive heart failure, unspecified unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status asthma, unspecified type, unspecified chronic kidney disease, unspecified paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia chronic systolic heart failure long-term (current) use of anticoagulants automatic implantable cardiac defibrillator in situ other chest pain alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance duodenitis, without mention of hemorrhage hemorrhage of gastrointestinal tract, unspecified unspecified gastritis and gastroduodenitis, without mention of hemorrhage barrett's esophagus 

Answer: The patient is high likely exposed to