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: penicillins / amiodarone hcl attending: chief complaint: dark stools major surgical or invasive procedure: egd on capsule study history of present illness: mr. is a year-old man with a history of coronary arteryd disease, diabetes, hypertension, ischemic/radiation proctitis and colon cancer who presents with a gib. . two recent admission. the first ( - ) was for a lower gi bleed. a colonoscopy was notable for stigmata of a recent internal hemorrhoid bleed with post radiation proctitis. . then readmitted ( - ), this time with lower extremity edema thought to be secondary to a chf exacerbation. he was diuresed 18 liters of fluid via lasix gtt and diuril with a dry weight of 68.5kg achieved. . since discharge from hospital has been relatively stable, though has been less active (previously could do 30 minutes on the treadmill daily, but now cannot do any). over the last day he reports approximately 10 hours of dark black stools. this has not been associated with any abdominal pains, nausea/vomiting, chest pains, shortness of breath, fevers/chills. he called pcp and was advised to come to ed. . in the ed, initial vitals showed t 97.9, hr 70, bp 122/42, 100% ra. his hematocrit was noted to be 22, down from mid 33 just four days prior. one liter of ns was given and unit of blood was hung. protonix iv was also given. . past medical history: 1. coronary artery disease - cabg () with lima to lad, svg to pda, svg to om3 - cath () with 20% lm, native 3vd and patent lima to lad and svg to om3. occluded svg to the pda. 2. congestive heart failure - echo () with ef 40% (secondary to dyskinesis of the basal inferior and posterior (inferolateral) walls and mild lvh 3. mitral regurgitation (3+) 4. pulmonic regurgitation ("significant") 5. moderate pulmonary artery systolic hypertension 6. diabetes 7. hypertension 8. atrial fibrillation 9. nsvt with dual chamber pacer . ischemic bowel disease in the setting of over diuresis social history: he lives at home with his wife. ex-, quit 40 years ago. family history: non-contributory. physical exam: vitals - t 95.6, bp 118/62, hr 70, 100% on 2 liters. gen - thin man, lying in bed in no distress. able to provide clear history. heent - dry mucous membranes. conjunctival palor. no icterus. no lad. cv - regular. iii/vi systolic murmur best heard at the base. pulm - clear. no wheeze/rales. abd - soft and mildly distended. minimally tender in llq. ext - warm. no edema. neuro - alert and oriented x3. able to provide clear history pertinent results: 11:24am blood wbc-7.5 rbc-2.46*# hgb-7.0*# hct-21.2*# mcv-86 mch-28.7 mchc-33.3 rdw-19.5* plt ct-243 11:24am blood pt-21.5* ptt-37.1* inr(pt)-2.0* 11:24am blood glucose-145* urean-161* creat-2.4* na-133 k-5.5* cl-94* hco3-28 angap-17 11:24am blood alt-38 ast-50* ld(ldh)-382* alkphos-43 totbili-0.7 07:10am blood caltibc-430 vitb12-1410* folate-greater th hapto-34 ferritn-89 trf-331 06:00am blood wbc-6.0 rbc-3.24* hgb-9.7* hct-29.3* mcv-90 mch-30.0 mchc-33.3 rdw-18.7* plt ct-186 06:00am blood pt-14.0* ptt-32.9 inr(pt)-1.2* 06:00am blood glucose-79 urean-30* creat-1.4* na-142 k-4.4 cl-108 hco3-25 angap-13 . ekg: ventricular paced rhythm. compared to the previous tracing of no change. . cxr: findings: in comparison with the study of , there is no interval change. again there is enlargement of the cardiac silhouette without vascular congestion. pacemaker device is again seen in a patient with intact midline sutures and evidence of previous cabg. no acute pneumonia. impression: no interval change brief hospital course: y/o male with mmp including cad, chf with an ef of 40%, dm, h/o colon cancer s/p resection & xrt with recent adm for brbpr found to have internal hemorrhoids & radiation proctitis now presenting with black stools and a drop in hct. . #. gi bleed/anemia: pt presented with report of melena and hct of 21 (baseline 30s)and inr of 2. pt was admitted to the micu, transfused with a total of 6uprbcs over the hospitalization and was given po vitamin k to reverse inr. pt was transferred to the floor once hct was stabilized. given the history of melena, this was thought more likely to be an ugib. however, egd was unrevealing so a small bowel etiology was thought possible. pt underwent a bowel prep and had a capsule study performed on to evaluate the entire gi tract. pt's last melenotic stool was on and last tranfusion on . pt was monitored in house for 3 additional days and hematocrit remained stable off coumadin with an inr of 1.2. after discussion with patient & family, decision was made to stop coumadin given his recurrent gi bleeds and there is no plan for ongoing anti-coagulation. pt was discharged on protonix 40mg . pt will be following up with his pcp on and will follow up with gi if capsule study is positive. . #. cad: pt denied any symptoms throughout admission. there were no events noted on telemetry, ventricular paced rhythm on ekgs. pt was continued on ace-i, asa 81mg & carvedilol 3.125mg . . #. acute on chronic kidney disease: baseline creatinine ranges anywhere from 1.5-2.5 over the last month. bun was noted to be elevated on adm likely due to the gi bleed and it trended down to baseline in house. creatinine stable at baseline of 1.4 and pt was continued on his ace inhibitor. . #. atrial fibrillation: pt with a history of atrial fibrillation and nsvt s/p pacemaker and was paced with a rate in the 70s. all anti-hypertensives were held on admission and carvedilol was added back at a lower dose of 3.125mg . pt was continued on digoxin and asa 81mg. coumadin was held of admission due to gib and after discussion with family/patient, decision was made to stay off anti-coagulation indefinitely due to recurrent gi bleeds. . #. congestive heart failure: pt remained dry to euvolemic throughout admission off any diuretics. he denied sob, lungs were clear on exam and maintained his sats well on ra. sbp remained in the 110s, pt was continued on ace-i, lower dose carevdilol & digoxin. pt was instructed to stop bumex & hctz and pcp was notified, pt may need these restarted in the future. . #. diabetes: pt was switched to glipizide 2.5mg daily in place of glyburide due to baseline impaired renal clearance. medications on admission: 1. aspirin 81 mg daily 2. carvedilol 12.5 mg 3. digoxin 125 mcg one half tablet every other day 4. bumex 1 mg 5. hydrochlorothiazide 25 mg every other day 6. lisinopril 5 mg daily 7. warfarin 3.75 mg daily 8. glyburide 5 mg daily 9. potassium chloride 10 meq daily 10. gabapentin 100 mg tid 11. allopurinol 200mg daily 12. folic acid discharge medications: 1. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 2. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 6. glipizide 2.5 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po daily (daily). disp:*30 tab,sust rel osmotic push 24hr(s)* refills:*2* 7. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 8. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: homecare discharge diagnosis: primary: gi bleed . secondary: coronary artery disease s/p cabg congestive heart failure moderate pulmonary artery systolic hypertension diabetes ii hypertension atrial fibrillation nsvt with dual chamber pacer discharge condition: stable discharge instructions: you were admitted with black tarry stools and had an egd that did not show any evidence of bleeding. you had a capsule study that was essentially normal and also did not show any evidence of bleeding. your blood counts have been stable for the last three days since your inr has come down. after discussion with your family & your doctors, you have decided to stop taking coumadin. . please note the changes that we have made to your medications: 1. decrease allopurinol to 100mg daily 2. stop coumadin 3. decrease carvedilol to 3.125mg twice daily 4. stop bumex for now 5. stop hydrochlorothiazide 6. stop glyburide 7. stop potassium chloride 8. start glipizide xl 2.5mg daily 9. start pantoprazole 40mg twice daily . it is important for you to weigh yourself every morning and if your weight increases by more than 2 lbs, you should restart taking bumex 1mg daily. if you gain more than 5lbs, you should take bumex 1mg twice daily. please call dr. to a follow up appointment sooner if you are restarting the bumex. . if you develop any chest pain, shortness of breath, bright red blood in your stools, dark black stools or any other general worsening of condition, please call your pcp or go directly to the ed. instructions: please keep your follow up appointment with dr. on at 11:15am. . provider: clinic phone: date/time: 3:30 . provider: , m.d. phone: date/time: 4:00 md, procedure: other endoscopy of small intestine transfusion of packed cells other diagnostic procedures on small intestine diagnoses: congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortocoronary bypass status other chronic pulmonary heart diseases paroxysmal ventricular tachycardia chronic systolic heart failure personal history of malignant neoplasm of large intestine cardiac pacemaker in situ hemorrhage of gastrointestinal tract, unspecified 

Answer: The patient is high likely exposed to