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: this is a 77 year old caucasian male patient with a history of peripheral vascular disease, carotid artery stenosis, status post a right carotid endarterectomy in , complicated by cerebrovascular accident, and diverticulosis, who was admitted to an outside hospital on , with a several day history of black and bloody stools in addition to a six to twelve month history of lightheadedness and shortness of breath. on admission to the outside hospital, the patient denied chest pain or pressure, jaw or arm pain, paroxysmal nocturnal dyspnea, back pain, abdominal pain or orthopnea. he described shortness of breath as progressive dyspnea on exertion over the last six to twelve months prior to admission. in the outside hospital emergency department, the patient was noted to have a hematocrit of 23.0 with a troponin i of 8.55. he was profoundly orthostatic and was transfused with seven units of packed red blood cells. the patient was admitted to the outside hospital intensive care unit and seen by gastroenterology and cardiology. a diagnostic cardiac catheterization showed severe three vessel coronary artery disease and the patient was transferred to for evaluation. on transfer to , the patient denies chest pain, paroxysmal nocturnal dyspnea, orthopnea, edema, palpitations, syncope, but does report mild chronic shortness of breath and lightheadedness on standing. past medical history: carotid artery stenosis, status post right carotid endarterectomy in . cerebrovascular accident as a complication of his right carotid endarterectomy in , manifested as dysarthria and ataxia. diverticulosis. raynaud's. depression. peripheral vascular disease. duodenal ulcer. status post a fall in , resulting in a broken shoulder, status post a second fall several days later resulting in a broken hip, status post pin placement. allergies: ssris. medications on admission: 1. aspirin 81 mg p.o. once daily. 2. klonopin 0.5 mg twice a day. 3. zyprexa 2.5 mg q.h.s. 4. remeron 30 mg two tablets q.p.m. 5. vitamin e. 6. vitamin c. 7. flomax 0.4 mg. 8. pamelor which is nortriptyline 25 mg four tablets q.p.m. social history: the patient is currently retired and lives with his wife. quit smoking tobacco approximately fifty years ago and quit drinking alcohol fourteen years ago. physical examination: blood pressure is 111/66, heart rate 88, respiratory rate 20, oxygen saturation 97 percent on two liters. in general, a well appearing elderly man, mildly confused in no acute distress. head, eyes, ears, nose and throat examination - the pupils are equal, round and reactive to light and accommodation. extraocular movements are intact. the patient has moist mucous membranes. his oropharynx is clear. neck - jugular venous pressure is estimated at approximately ten centimeters. there are no audible carotid bruits bilaterally. lungs - bibasilar crackles but otherwise clear to auscultation bilaterally. cardiovascular is regular rate and rhythm with multiple ectopic beats, normal s1 and s2, i/vi holosystolic murmur appreciated over the apex. the patient has two plus femoral dorsalis pedis pulses bilaterally and one plus posterior tibial pulses bilaterally. there is no evidence of edema. the abdomen shows normoactive bowel sounds, soft, nontender, nondistended. extremities - no evidence of cyanosis, clubbing or edema. neurologically, the patient is dysarthric. he is alert and oriented times three. his cranial nerves ii through xii are intact aside from dysarthria, hypophonia and a mild left sided facial droop. the patient's motor examination is significant for muscle strength throughout all muscle groups except for five minus out of five strength in the left triceps, left hip flexors with mildly increased tone on the left. sensation is intact to light touch in all four extremities. the patient's deep tendon reflexes are symmetric though mildly decreased on the right. laboratory data: white blood cell count was 12.8, hematocrit 31.2, platelet count 202,000. inr 1.4. sodium 144, potassium 4.5, chloride 107, bicarbonate 25, blood urea nitrogen 31, creatinine 1.1, glucose 92. ck 44, troponin 3.44. alt 24, ast 31, alkaline phosphatase 51, total bilirubin 1.3. hospital course: coronary artery disease - the patient was transferred from an outside hospital with three vessel coronary artery disease as demonstrated on a diagnostic cardiac catheterization performed prior to transfer. the cardiac surgery consult service was consulted for possible coronary artery bypass graft and a preoperative workup was initiated. the patient was continued on aspirin, beta blocker and a statin was added for hypercholesterolemia. the patient had no complaints of chest pain, shortness of breath throughout his hospitalization and his beta blocker and ace inhibitor were titrated up as tolerated by his heart rate and blood pressure. the patient was evaluated with a viability study prior to discharge, the results of which are pending at the time of dictation. congestive heart failure - the patient was evaluated with an echocardiogram on admission which demonstrated an ejection fraction of less than 20 percent, moderately dilated left ventricular cavity with severe global left ventricular hypokinesis. the patient had no signs or symptoms of volume overload on physical examination. he was continued on the beta blocker and ace inhibitor, the doses of which were titrated up as tolerated by his blood pressure and heart rate. the patient required no additional doses of lasix throughout his hospitalization. as noted previously, the patient was evaluated with a viability study prior to discharge, the results of which are pending at the time of dictation. rhythm - the patient was monitored on telemetry throughout his hospitalization. he had occasional episodes of premature ventricular contractions that were asymptomatic. gastrointestinal bleed - the patient was transferred from an outside hospital with a history of melena and hematocrit of 23.0 on initial presentation to the outside hospital. the gastroenterology consult service was consulted and performed an esophagogastroduodenoscopy on , that was significant for patchy superficial erythema in the fundus but an otherwise normal esophagogastroduodenoscopy to the third part of the duodenum. there was no source of bleeding identified. the patient was maintained on pantoprazole 40 mg p.o. twice a day which he will receive for a total of fourteen days after which he will be switched to pantoprazole 40 mg p.o. once daily. given a positive serum h. pylori antibody test, the gastroenterology consult service recommended treatment with metronidazole, amoxicillin and pantoprazole. neurology - the neurology consult service was consulted for preoperative stroke clearance given the patient's history of a cerebrovascular accident. a urine culture, tsh,vitamin b12, folate and rpr were checked and noted to be normal. the patient also had a mri/mra which showed no acute ischemic changes and was only significant for chronic small vessel disease with old lacunar infarcts. at the time of dictation, the neurology consult service has not specifically commented on the patient's stroke risk for a potential upcoming coronary artery bypass graft. psychiatry - the patient was admitted with a history of depression and possible dementia. he was continued on his previous doses of nortriptyline and olanzapine. his klonopin was changed to p.r.n. throughout his hospitalization, the patient was noted to become mildly confused at night consistent with potential sundowning. as noted previously, his neurologic workup was negative. hematology - the patient's inr was noted to be elevated to 1.7 of an unclear etiology. liver function tests were checked and noted to be largely normal. the etiology of the patient's elevated inr is considered potentially related to a poor nutritional state. the patient's albumin was 3.3. he was given a dose of vitamin k. the remainder of the hospital course, his discharge medications, diagnoses and follow-up instructions will be dictated at the time of discharge. , procedure: other endoscopy of small intestine diagnostic ultrasound of heart diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified peripheral vascular disease, unspecified depressive disorder, not elsewhere classified systolic heart failure, unspecified hemorrhage of gastrointestinal tract, unspecified acute myocardial infarction of unspecified site, initial episode of care phlebitis and thrombophlebitis of superficial veins of upper extremities helicobacter pylori [h. pylori] 

Answer: The patient is high likely exposed to