A 45-year-old man comes to the emergency department due to severe dyspnea and chest discomfort that began earlier in the day. The dyspnea has been worsening throughout the day and is present at rest. He reports no inciting trauma. He has no other medical conditions and takes no medications. He has a 20-pack-year smoking history and does not use alcohol or illicit drugs. Temperature is 36.7 C (98 F), blood pressure is 110/60 mm Hg, and pulse is 96/min. Arterial blood gas on room air shows PaO2 of 54 mm Hg and PaCO2 of 26 mm Hg. Which of the following processes is most likely occurring in this patient?
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