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 an 83 year old male with a history of coronary artery disease status post left anterior descending stent requiring lgib, status post history of arteriovenous malformation, colon cancer status post colectomy and ileocolonic anastomosis. he presents with black stools and lightheadedness times three days. the patient presented to his primary care physician, . , with subsequently decreasing hematocrit drop. the patient's hematocrit had reportedly dropped from 37 to 35 to 29.6 within two days. the patient was complaining of minor lightheadedness, however, declined any shortness of breath, chest pain or abdominal pain. the patient was instructed by his primary care physician to go to the emergency room. on arrival, the patient's blood pressure was 115/63, however, decreased to systolic 80s on two episodes. the patient had undergone two transfusions of packed red blood cells, and was reportedly hemodynamically stable. gastrointestinal was consulted and recommended tagged red blood cell scan and subsequent esophagogastroduodenoscopy if the patient became hemodynamically unstable again. past medical history: 1. coronary artery disease. 2. three plus mitral regurgitation and hypertrophic cardiomyopathy seen on echocardiogram on present admission. 3. multiple arteriovenous malformations with 15 year history of recurrent gastrointestinal bleeding. 4. gastroesophageal reflux disease. 5. duke's a colon cancer status post right hemicolectomy in . 6. jejunal lipoma in . 7. status post cholecystectomy ten years ago. 8. prostatectomy. 9. left inguinal hernia repair by dr. in . 10. dyslipidemia. 11. history of hemolysis previously in transfusion. medications on admission: 1. atenolol 100 q. day. 2. celexa 20 q. day. 3. hydrochlorothiazide 12.5 mg twice a day. 4. atorvastatin 10 q. day. 5. prevacid 30 q. day. 6. isordil 10 twice a day. allergies: no known drug allergies. social history: quit smoking 35 years ago; currently married, no alcohol use in greater than ten years. family history: mother with cerebrovascular accident at 67; lung cancer at 87. review of systems: upon review of systems, the patient notes shortness of breath times two days; melena at least once a month. physical examination: temperature 99.0 f.; blood pressure 120/58; pulse 84; respiratory rate 20; weight 74.2 kilograms. in general, the patient is in no apparent distress, alert and oriented times three. heent examination: anicteric. pulmonary examination was clear to auscultation bilaterally with good breath sounds; no evidence of wheezing or crackles. on cardiac examination: demonstrated a holosystolic murmur v/vi, loudest at the apex. regular rate and rhythm, s1 and s2 within normal limits; no gallops or rubs. abdominal examination nontender, nondistended. bowel sounds positive, guaiac positive. no hepatosplenomegaly appreciated. no costovertebral angle tenderness. extremities well perfused with no cyanosis, clubbing or edema. dorsalis pedis two plus bilaterally. skin examination: mucous membranes were moist; normal turgor. no focal abnormalities were evident on neurological examination. hospital course: the patient was admitted and underwent a very complicated hospital course. on , the patient underwent enteroscopy which demonstrated polyps in the stomach body and fundus, blood in the duodenum and proximal jejunum. no angiomas were seen at that time; otherwise enteroscopy was normal. the gastrointestinal tagged red blood cell study on , had demonstrated very small amounts of gastrointestinal bleeding in the left upper quadrant, probably within the small bowel. as the patient's hematocrit stabilized and he was not having any more melanotic stools, he was transferred from the medical intensive care unit to the medicine floor, at which time the team began his care. the patient was maintained on the floor with close monitoring of his hematocrit status. the patient's hematocrit's often hovered between 30 and 31, occasionally dropping down to 29 or 28. when the patient's hematocrit fell to 28, he often became symptomatic complaining of either lightheadedness, substernal chest pain, diaphoresis, or minimal shortness of breath. the first episode of substernal chest pain without radiation, the patient was placed on continuous telemetry and ruled out for myocardial infarction. although the patient's troponin were less than 0.1, they had trended up during that time to 0.01, 0.02 and 0.03, suggesting real demand ischemia. on a separate occasion, the patient became very tachycardic and his heart rate was ranging between the 110s and 120s. he was symptomatic as well, complaining of chest pain with radiation down the left arm, shortness of breath and diaphoresis. at this time, the decision was made to start back beta blocker, first putting him back on metoprolol, 50 mg twice a day. on a separate occasion when the patient's hematocrit was 28.1, he was being evaluated by physical therapy and walked approximately five feet before feeling lightheadedness and extremely diaphoretic. the episodes of drop in hematocrit often coincided with melanotic stools, usually ranging from 150 to 200 cc with no obvious signs of bright red blood but being darkly melanotic. the patient received a total of 12 transfusions previous to medical intensive care unit admission. as well, he underwent several studies with gastroenterology including esophagogastroduodenoscopy and duodenoscopy on , which demonstrated angiectasias in the second part of the duodenum; thermal therapy was applied. as well, there was diverticula in the second part of the duodenum; otherwise showing normal ampulla with clear bile seen from its orifice. the rest of the esophagogastroduodenoscopy to the second part of the duodenum was normal. because of dropping hematocrits and recurrent melanotic stools, the patient also underwent a pill study on which demonstrated some fresh blood and active bleeding from arteriovenous malformations in the proximal small bowel. the decision was made on , to repeat esophagogastroduodenoscopy. impressions of the study demonstrated erythema and nodularity in the antrum compatible with gastritis, angiectasias in the proximal jejunum at 1 meter. thermal therapy was applied. angiectasias in the second part of the duodenum, thermal therapy was applied. blood in the jejunum and otherwise normal esophagogastroduodenoscopy to the jejunum. the patient's hematocrits were relatively stable for the next couple of days with no melanotic stools reported; however on , the patient experienced one melanotic stool around 05:30 a.m. he stated that he felt some reflux and knew that something was wrong because this was an unusual symptom for him. as well, he became very diaphoretic with minimal shortness of breath and felt very lightheaded. according to the night float, the patient was pale with a blood pressure of 80/40, heart rate in the 90s. he denied chest pain and abdominal pain. the patient had two large bore intravenous lines; normal saline was started wide open with improvement in blood pressure to 135/80s. the patient improved mentation. gastrointestinal lavage demonstrated two liters of normal saline with dark red material not fully cleared. the patient was placed on suction. ekg demonstrated t wave inversions and st depressions in v3 through v5, although difficult for comparison because his ekg at baseline is abnormal. cardiac enzymes were drawn at that time. hematocrit was drawn which came back at 27 from 31 the previous night. two units of packed red blood cells were ordered stat. the first unit started at 06:45 a.m. and finished by 07:25 a.m. the second unit beginning at 07:30 a.m. the patient denied any chest pain, shortness of breath, and the decision was made to transfer the patient to the medical intensive care unit where he could be more closely observed. this is the end of the interim dictation. please see addendum for medical intensive care unit course and hospital discharge. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine other endoscopy of small intestine arterial catheterization endoscopic control of gastric or duodenal bleeding arteriography of other intra-abdominal arteries transcatheter embolization for gastric or duodenal bleeding transfusion of packed cells diagnoses: other primary cardiomyopathies coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia acute posthemorrhagic anemia aortic valve disorders percutaneous transluminal coronary angioplasty status angiodysplasia of intestine with hemorrhage benign neoplasm of stomach 

Answer: The patient is high likely exposed to