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 51-year-old man who developed epistaxis in the right naris three days prior to presentation on blowing his nose. the patient takes warfarin to maintain anticoagulation after aortic valve replacement secondary to rheumatic heart disease. the patient's neighbor brought him to the hospital where his inr was found 12.2. his nose was packed there. he received two units of fresh frozen plasma and two units of packed red blood cells. on presentation his hematocrit was 28 and it dropped to a nadir of 22. he had an epistaxis balloon placed temporarily, however, he developed dizziness and lightheadedness and had to have it removed. he also reports having had black stools and melena. of note, the patient is a chronic alcohol abuser. his last drink was two to three days prior to presentation. in addition to the blood products stated above, the patient received subcutaneous vitamin k (5 mg on ). past medical history: 1. rheumatic heart disease status post aortic valve replacement on . he has a 23 st. mechanical valve. the procedure was complicated by right eye blindness secondary to embolization perioperatively. 2. cardiac catheterization revealed moderate to severe pulmonary hypertension with dilation of the ascending aorta. 3. congenital absence of the right kidney. 4. left shoulder injury sustained in after a mechanical fall. medications on admission: 1. warfarin 5 to 7.5 mg q. day. the patient states his last inr check was two weeks prior to admission at the outside hospital. 2. metoprolol unknown dose. allergies: no known allergies. family history: his mother died of a myocardial infarction at age 56. social history: the patient is an investment specialist for a bank. he last held a job in . he is a heavy drinker of approximately two quarts per day of rum and coke. he smokes two packs per day of tobacco. he started smoking at age 25. he is divorced and has an 18-year-old daughter and 16-year-old son and a girlfriend. his ex-wife is supportive. in addition to the blood products stated above, the patient was placed on a ciwa scale for ethanol withdrawal. he was transferred to the for further evaluation. physical examination: temperature 97.2, heart rate 93, blood pressure 124/69, oxygen saturation 99%. generally, he is a very pleasant middle-aged man in no acute distress. heent: crusted blood in the right nostril. oropharynx clear and moist. chest clear to auscultation bilaterally. heart regular rate and rhythm. normal s1. loud mechanical s2. there are no murmurs. abdomen soft, non-tender, non-distended. there is no organomegaly. extremities: there is no edema. laboratory evaluation: white blood cell count 5.7, hematocrit 26.9, platelets 107, inr 2.5. chemistry panel is unremarkable. hospital course: initially the patient was admitted to the medical intensive care unit for treatment of his acute lower gastrointestinal bleed and reversal of anticoagulation. his hematocrit remained stable and he was then transferred to the medical floor one day after admission. of note, the patient's inr had a nadir of 0.9 because of the aggressive reversal of anticoagulation received at the outside hospital. he was started on a continuous heparin infusion for the remainder of the hospital course until the inr approached 2.0. it was 1.9 on the day of discharge. the remainder of his hospital course was marked by the absence of any withdrawal symptoms. ciwa scale was discontinued shortly after transfer to the medical floor. metoprolol was continued for his heart disease. on hospital day eight the patient complained of hip pain and was diagnosed with trochanteric bursitis. he underwent injection of the joint with adequate relief. he was discharged with follow up two days after discharge to recheck his inr. discharge diagnoses: 1. lower gastrointestinal bleed secondary to supratherapeutic inr. 2. rheumatic heart disease status post aortic valve replacement on . he has a 23 st. mechanical valve. the procedure was complicated by right eye blindness secondary to embolization perioperatively. 3. cardiac catheterization revealed moderate to severe pulmonary hypertension with dilation of the ascending aorta. 4. congenital absence of the right kidney. 5. left shoulder injury sustained in after a mechanical fall. , m.d. dictated by: medquist36 procedure: injection of steroid diagnoses: abnormal coagulation profile tobacco use disorder unspecified essential hypertension acute posthemorrhagic anemia blood in stool long-term (current) use of anticoagulants other and unspecified alcohol dependence, unspecified epistaxis enthesopathy of hip region 

Answer: The patient is high likely exposed to