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 -year-old man with a history of peptic ulcer disease, coronary artery disease, status post myocardial infarction in as well as , temporal arteritis, who presented with melenas and chest pain. the patient reported melanotic stools times 5 since 4 p.m. on the day prior to admission. no hematemesis or hematochezia. stools were loose. the patient had a history of melena in . the patient also reported being lightheaded, fatigued with an increase in his ch set discomfort for which he was taking sublingual nitroglycerin with relief. on the a.m. of presentation, the symptoms persisted; the patient contact his pcp who sent him to the . in the ed, the p was found to have a hematocrit of 22.9 decreased from a baseline of 32 to 38. he was given iv protonix, iv fluids, and transfused the first of 2 units of packed red blood cells. gastroenterology was consulted. the patient initially had an ekg with slight inferior changes while the patient was pain free. the patient then had an episode of substernal chest pain in the ed with 3 to changes in v3 to v4. past medical history: significant for upper gastrointestinal bleed in . an esophagogastroduodenoscopy showed an ulcer in the pylorus and chronic gastritis, coronary artery disease, status post myocardial infarction in and , benign prostatic hypertrophy, history of temporal arteritis, pemphigoid, history of anemia, history of small bowel volvulus, status post appendectomies, status post inguinal hernia repair x2, history of colonic polyps, and sigmoid diverticulosis. allergies: the patient has no known drug allergies. medications: the patient was on: 1. celebrex. 2. aspirin. 3. prednisone. 4. atenolol. 5. imdur. 6. nitroglycerin p.r.n. social history: he is a retired physician, . remote tobacco history. social alcohol use, which is infrequent. married with 1 son. family history: noncontributory. physical examination on admission as follows: vital signs: vital signs of 98.9 temperature, blood pressure 128/80, pulse 72, respiratory rate of 13, and oxygen 100% on 3 liters. general: the patient appeared comfortable. heent: examination was unremarkable except for pale conjunctiva, dry mucosa. laboratory data: significant for the hematocrit of 23 as stated above, a potassium of 5.3, a bun 78. initial ck was 107 with an mb of 6 and a troponin of 0.02. inr was 1.0. urinalysis was unremarkable. as stated above, the patient had 2 ekgs and the second of which showed 2 to changes in v3 to v6. chest x-ray showed no acute cardiopulmonary process, so the patient was admitted to the hospital. concise summary of hospital course as follows: gi: the patient was felt to likely have another bleeding ulcer as the etiology of his melanotic stools and anemia. the patient had a history of helicobacter pylori in the past that was treated. the patient was felt to require egd to evaluate for recurrent infection as well as ongoing bleeding. the patient was initially admitted to the icu. gastroenterology was consulted. the patient was taken for egd on , which showed a deep antral ulcer, no acute bleeding. the ulcer was injected. the patient was initially continued on iv b.i.d. protonix. hematocrits were followed and the patient was maintained on 2 peripheral iv's at all times, and aspirin was held. the patient has another episode of melanotic stool. on , he was taken for another egd, at that time which showed the ulcer was not bleeding. as a result, the patient was felt to be stable for discharge to home from a gi perspective with continuation of the b.i.d. protonix. the patient to follow up for a repeat endoscopy in 8 weeks as an outpatient. cardiac: cardiac enzymes had been significant for elevated troponin on admission. cardiology was contact who did not recommend cardiac catheterization or coronary artery bypass graft. the patient initially received heparin and was restarted on aspirin, which was approved by gi as long as the patient had serial hematocrits. the patient was transfused to keep the hematocrit above 30. he was restarted on atenolol. the patient was also on imdur for a longer-acting vasodilator effect. the patient had a couple of episodes of further chest pain during the admission but had no further ekg changes. pulmonary: the patient had some desaturations to 70's and 80's with ambulation without improvement with oxygen with ambulation, but at this time the patient was completely asymptomatic and the patient's oxygen saturation recovered spontaneously to the high 90's on room air with rest. as a result, this was felt to possibly be not reflective of the patient's pulmonary status, but reflective of some peripheral vascular changes with ambulation. the patient was not felt to need inpatient workup and will follow up with pcp as an outpatient. hematology: the patient with acute blood loss anemia, received a total of 4 units of packed red blood cells, had serial hematocrits while on heparin gtt and was transfused to keep the hematocrit above 30. musculoskeletal: the patient was restarted on his prednisone for polymyalgia rheumatica and temporal arteritis. discharge diagnoses: gastric ulcer. gastrointestinal bleed. demand ischemia, elevated troponins, and ekg changes in the setting of acute blood loss anemia. discharge medications: 1. nitroglycerin sublingual. 2. prednisone 5 mg p.o. daily. 3. atenolol 25 mg p.o. q. p.m., 50 mg p.o. q. a.m. 4. protonix 40 p.o. b.i.d. 5. aspirin 325 mg. 6. isosorbide mononitrate. discharge followup: follow up with cardiology on , , at 9:15 a.m. the patient's primary cardiologist is dr. . dr. was not available so the patient followed up with dr. . the patient also followed up with dr. for outpatient endoscopy on at 12:30 p.m. and the patient was suggested to pursue cardiac rehabilitation in 4 to 6 weeks. , procedure: other endoscopy of small intestine endoscopic control of gastric or duodenal bleeding transfusion of packed cells diagnoses: acute gastric ulcer with hemorrhage, without mention of obstruction subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery polymyalgia rheumatica 

Answer: The patient is high likely exposed to