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: epinephrine / cephalosporins / omeprazole attending: chief complaint: gi bleed, hypotension major surgical or invasive procedure: endoscopy history of present illness: y/o female with hx af on coumadin, cva, cad s/p cabg, htn, pvd, chf admitted to from rehab following hypotension to 69 systolic, in setting of 1 week history of tarry stools. pt was noted to have an ashen appearance. in preceding weeks she had developed worsening weakness/fatigue particulary on ambulation, decreased appetite, occaisional lightheadedness/dizziness. hct at rehab noted at 25.8, giuac postive stools with referral to ed. no prior hx gi bleeds. ros: no brbpr, f/n/v/chills/chest pain/abdominal pain. at baseline produces ~7 stools/day. past medical history: bowel impaction, requiring manual decompaction, '. atrial fibrillation on coumadin, s/p ppm s/p cva s/p r ica stent cad s/p cabg () hyperlipidemia hypertension chronic kidney disease, baseline 1.2-1.5 systolic heart failure, ef 40% , mild mr, severe tr. hiatal hernia gout diverticulosis hemorrhoids pvd anemia non-small cell lung ca uterine prolapse/pessary social history: lives at life, dnr/ dni, sons actively involved. family history: non contributory physical exam: general: pleasant, frail, pale appearing elderly female in no apparent distress. heent: normocephalic, atraumatic. no scleral icterus. perrla/eomi. mmm. op clear. neck supple. cardiac: irregular rhythm, normal rate. normal s1, s2. systolic ejection murmur. lungs: ctab, good air movement biaterally. no rales or wheezing. abdomen: nabs. soft, tenderness to deep palpation in llq, nd. no hsm extremities: no edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. skin: scattered ecchymoses. neuro: a&ox3. appropriate. cn 2-12 grossly intact. nonfocal neuro exam. rectal: guaiac positive stool, small external hemorrhoids. some pain with rectal exam. pertinent results: 07:05pm wbc-7.8 rbc-3.01* hgb-8.6* hct-28.3* mcv-94 mch-28.7 mchc-30.5* rdw-15.0 07:05pm plt count-273 07:05pm glucose-137* urea n-88* creat-2.0* sodium-142 potassium-5.2* chloride-102 total co2-28 anion gap-17 07:15pm lactate-1.9 11:48pm pt-19.4* ptt-28.0 inr(pt)-1.8* 11:48pm hct-22.6* 11:48pm ck-mb-notdone ctropnt-0.07* 11:48pm alt(sgpt)-33 ast(sgot)-53* ld(ldh)-199 ck(cpk)-57 alk phos-79 tot bili-1.0 brief hospital course: pt continued to have lightheadedness on ambulation on the floor.. triggered on floor for bp to 68 noted at time to be diaphoretic, grey, with abdominal pain and malaise, bp's remaining in 80s with iv fluids, prbcs and trendelenburg with subsequent triage to micu. in the micu, given ffp, vit k with goal inr 1.5. 3units prbc w/ increase in hct to >37. had un trending ce's with evoloving ischemic changes on ekg. discussed with family goals of care, and they along with the patient, decided against cardiac cath and desired anticoagulation since risk of gib was less in their minds compared to risk of stroke from afib. pulmonary edema worsened on auscultation, pt given small dose of lasix, while watching uop. transfered back to macu for patient comfort. . during her micu stay the following problems were managed: gi bleed: received endoscopy revealing gastritis, mild esophagitis, 2 superficial duodenal erosions. pt was started on ppi. colonoscopy was considered however hct improved with clinical improvement thus was not pursued. cardiac ischemia: ce's trended along with ekgs. asa given and coumadin restarted. lasix for pulmonary edema. pt did not want cath. hypotension: thought secondary to gib and hypovolemia. pancultured and abx empiric coverage subsequently discontinued after 48 hours with 3 days. constipation: had prior hx on impaction, with constipation possible cause of abdominal pain. started on bowel regimen of lactulose, mirulax, senna, dulcolace, with subsequent bms. anemia: likely a chronic anemia exacerbated by acute gib. pt started on. renal failure: acute on chronic with contribution from hypotension, with improvement on iv fluids. medications were renally dosed and home doses lasix/acei held. hyperkalemia resolved. medications on admission: aspirin 81mg daily calcium 650mg lasix 20mg daily lisinopril 20mg daily metoprolol sr 50mg daily senokot 8.6mg hs coumadin 1.5mg daily vitamin d 3 1000u daily discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. polyethylene glycol 3350 100 % powder sig: one (1) po daily (daily) as needed for constipation. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 5. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day) as needed for constipation. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. warfarin 1 mg tablet sig: 1.5 tablets po once daily at 4 pm. 8. zofran 4 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. disp:*30 tablet(s)* refills:*0* discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary: upper gastrointestinal bleed secondary: cardiac ischemia discharge condition: stable discharge instructions: you were admitted due to hypotension and melena presumed to be from a bleeding in your stomach or intestine. your blood thinner (coumadin) was stopped. your were given 3 units of packed red blood cells. your heart was stressed by this experience and showed signs of not getting enough oxygen. you declined a cardiac intervention. you indicated that preventing stroke was the most important health objective, even if you were to have another stomach/intestinal bleed. you were restarted on your coumadin. followup instructions: macu with pt/ot. follow up with your pcp regarding your hospital course, especially regarding the on-going cardiac ischemia and your desires for limited intervention. md procedure: other endoscopy of small intestine diagnoses: congestive heart failure, unspecified acute posthemorrhagic anemia acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation personal history of malignant neoplasm of bronchus and lung aortocoronary bypass status peripheral vascular disease, unspecified chronic kidney disease, unspecified systolic heart failure, unspecified diaphragmatic hernia without mention of obstruction or gangrene other and unspecified hyperlipidemia hypotension, unspecified blood in stool long-term (current) use of anticoagulants other constipation cardiac pacemaker in situ personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits hypovolemia delirium due to conditions classified elsewhere barrett's esophagus chronic ischemic heart disease, unspecified 

Answer: The patient is high likely exposed to