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 seventy-five-year-old russian male with a complicated recent admission to who was transferred here from on , for chest pain. the patient had ruled in for myocardial infarction, underwent cardiac catheterization and stenting. post-catheterization, the patient had a cerebrovascular accident, leaving him with a left hemiparesis. prior to discharge, he had developed hematuria while continuing therapy on aspirin, plavix and heparin. while at rehabilitation, the patient was receiving endoscopic gastrostomy tube was not possible at that time due to risk of bleeding on those three medications. the patient's plavix was scheduled to run for thirty days ending on . regarding the patient's complaint of hematuria, the patient had developed this problem immediately prior to his discharge in . the patient does have a history of a bladder mass and transurethral resection of prostate in . in , cytology was done of the bladder which was negative for malignancy. this hematuria was felt to be secondary to foley catheter trauma or recurrent nephrolithiasis or tumor while in the setting of anticoagulation. the patient had to be restrained while at hospital because he had been pulling on the foley catheter which may have led to bleeding. in addition, he had removed his nasogastric tube five to six times. on admission, the patient did also have heme positive stool. past medical history: 1) myocardial infarction in , status post percutaneous transluminal coronary angioplasty and stent to left anterior descending artery and left circumflex in , re-stent of left anterior descending artery in , the patient has ejection fraction of 25%. 2) sick sinus syndrome, status post ddd pacer. 3) benign prostatic hypertrophy, status post transurethral resection of prostate in . 4) hypertension. 5) hypercholesterolemia. 6) pancreatitis. 6) spinal stenosis. 7) colon polyps. 8) nephrolithiasis. allergies: no known drug allergies. medications: enteric coated aspirin 325 mg every day, lipitor 40 mg every day, isosorbide mononitrate 60 mg every day, prevacid 30 mg every day, toprol xl 25 mg every day, plavix 75 mg every day, captopril 6.25 mg three times a day, heparin gtt at 1400 units per hour. social history: the patient was born in , denies any use of tobacco in the past and drinks alcohol socially. physical examination: physical examination on admission, the patient was afebrile at 98.8 f, rectal temperature, heart rate 72, respiratory rate 20, blood pressure 90/50, pulse oximetry 92% on two liters by nasal cannula. in general, the patient was in no acute distress. the patient is russian speaking only. the family is present and able to translate. foley catheter was draining amber colored urine at the time of admission. on head, eyes, ears, nose and throat examination, the patient's right eye is closed, pupil measuring 5 mm to 6 mm. left eye is opened spontaneously, measuring 2 mm to 3 mm and minimal reactive. the patient had a pediatric nasogastric tube in place receiving tube feeds and he had dry oral mucosa. on neck examination, his neck was supple, he had no jugular venous distension, lymphadenopathy or bruits. cardiovascular, the patient had a regular s1 and s2 with a iii/vi systolic murmur. the patient was in a regular rhythm. the patient's lungs were clear to auscultation bilaterally listening anterior and anterolaterally. the patient's abdomen had normal active bowel sounds, it was soft, nontender and nondistended. extremity examination, his upper extremities were in soft restraints. the patient had no cyanosis, clubbing or edema. on neurologic examination, his pupils were noted as above on the head, eyes, ears, nose and throat examination. the patient was uncooperative with testing of cranial nerves, as well as strength. the patient was aphasic, although making some sounds and occasional words to his daughter. laboratory data: white blood cell count 8.3, hematocrit 33.7, platelet count 288,000, baseline hematocrit known to be 47 to 48. sodium was 136, potassium 5.0, chloride 100, bicarbonate 26, blood, urea and nitrogen 19, creatinine 0.9, glucose 98. calcium 8.5, magnesium 2.0, phosphorous 3.9. liver function tests, alt was 33, ast 39, alkaline phosphatase 89, total bilirubin 0.4, albumin 3.1. prothrombin time, international normalized ratio were 11.9 and 1.0 respectively, partial prothrombin time was 21.9. urinalysis showed a large amount of blood, 30 of protein, small leukocytes, was amber in color, was otherwise, negative, greater then 1000 red blood cells, 11 white blood cells, occasional bacteria and no yeast. hospital course: hospital course by problem, 1) cardiovascular, given the patient's ejection fraction of less then 25% and his recent stent last month, the patient was continued on his anticoagulative agents including aspirin, plavix and heparin. the heparin drip was continued rather then starting coumadin immediately given the possibility of the patient receiving a percutaneous endoscopic gastrostomy tube this admission by interventional radiology. initially, on presentation, the patient's blood pressure was somewhat labile and low running in the 90's/50's to 100's/60's. the patient's blood pressure medications including his isosorbide and his ace inhibitor were held initially. after gentle hydration, the patient's blood pressure did correct. we were able to administer those medications again. on , the patient was complaining of chest pain. electrocardiograms were taken every five minutes, following sublingual nitroglycerin administration. the patient's pain was relieved with three sublingual nitroglycerin. there were no electrocardiogram changes seen. cardiac enzymes were checked and the patient ruled out for myocardial infarction with three sets of negative enzymes. there were no other complaints of chest pain following that one episode. the patient's captopril was discontinued and changed to zestril over the course of the admission, otherwise, cardiovascularly, the patient remained very stable. 2) hematuria. the patient had been continued on continuous bladder irrigation through foley catheter. the urine did clear to a very light amber color and the continuous bladder irrigation was turned off for a trial period. urine ran very clear without difficulty without passage of clots most of that day but then began to become bloody again and the irrigation was continued. urology was consulted and felt that inpatient cystoscopy was not necessary, rather planned to follow-up as an outpatient appointment and cystoscopy after discharge. the foley catheter was actually discontinued on . the patient voided without difficulty with minimal hematuria. 3) heme. upon admission, the patient was on aspirin, plavix and heparin with a lower hematocrit then his baseline as hematocrit was followed closely reaching a low point of 31.1 on , the patient received two units of packed red blood cells. at the time of discharge, his hematocrit has been stable at 44.8. at the time of discharge, the patient is still on aspirin and plavix. plavix is to be discontinued on . the patient has been started on coumadin which is not yet therapeutic. 4) gastrointestinal. the patient had been receiving tube feeds via pediatric nasogastric tube on admission. nasogastric tube had been pulled a couple of times and replaced by house staff. interventional radiology was consulted and agreed to place percutaneous endoscopic gastrostomy tube even though the patient was on plavix. heparin was discontinued that morning. the patient underwent percutaneous endoscopic gastrostomy tube placement without complication. following percutaneous endoscopic gastrostomy tube placement, heparin was reinstated and coumadin begun. prior to percutaneous endoscopic gastrostomy tube placement, the patient had undergone speech and swallow study that was failed at the bedside. video swallowing study was done the morning of the percutaneous endoscopic gastrostomy tube which the patient also failed providing for the percutaneous endoscopic gastrostomy tube placement. 5) neurologic. the patient's neurologic examination remained unchanged throughout his admission. the patient's mental status tended to wax and wane with his blood pressure and hematocrit when hemodynamically stable, the patient was alert and responded to questions and was able to have brief conversations with family members who would translate for us. there was no evidence of any new cerebrovascular accident this admission. discharge medications: the patient is discharged on, 1) aspirin 325 mg by mouth per gastrostomy tube. 2) plavix 75 mg per gastrostomy tube every day and on . 3) heparin drip 1000 units per hour with a goal partial prothrombin time of 50 to 70. this is to be discontinued once international normalized ratio is therapeutic. 4) coumadin, the dose is still being titrated. the patient has received two doses of 10 mg upon discharge. 5) lopressor 12.5 mg by mouth twice a day. 6) zestril 5 mg by mouth every day. 7) prevacid 30 mg by mouth every day. 8) isosorbide mononitrate 60 mg every day. 9) morphine sulfate 2 mg subcutaneous every four to six hours as needed for pain at percutaneous endoscopic gastrostomy tube site. 10) tube feeds, the patient is receiving promod with fiber at a goal of 100 cc per hour, residuals being checked every four hours and tube feeds being held for residuals greater then 150 cc. discharge condition: stable. discharge diagnoses: 1) hematuria, while on aspirin, plavix and heparin. 2) status post percutaneous endoscopic gastrostomy tube placement for failed swallowing study. follow-up: the patient is to follow-up with his primary care physician, . md, at . in addition, the patient should follow-up with urology, dr. in one to two weeks following discharge at . discharge status: the patient is discharged to an inpatient rehabilitation or facility until strong enough to return home. khasigiwala, m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube percutaneous [endoscopic] gastrostomy [peg] diagnoses: acidosis pure hypercholesterolemia acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified hypotension, unspecified pneumonitis due to inhalation of food or vomitus late effects of cerebrovascular disease, hemiplegia affecting unspecified side late effects of cerebrovascular disease, aphasia 

Answer: The patient is high likely exposed to