Review Question - QID 109832

A 62-year-old woman presents to her primary care physician for problems with her legs. She is easily tired whenever she walks and she experiences pain and swelling in her legs that can be difficult for her to cope with. The patient has a medical history of obesity, hypertension, hyperlipidemia, myocardial infarction, and a 52 pack-year smoking history. She lives at home with her husband who assists her with daily acts of living. She endorses falling recently. Her temperature is 99.5°F (37.5°C), blood pressure is 177/108 mmHg, pulse is 90/min, respirations are 17/min, and oxygen saturation is 95% on room air. Cardiopulmonary exam is notable for mild expiratory wheezes and a murmur along the right sternal border. Inspection of the patient's lower extremities reveals the finding in Figure A. Which of the following is the most likely explanation for this patient's presentation?