Review Question - QID 213745

A 34-year-old man presents to the emergency department with shortness of breath while he was hiking. He also reports that while hiking, he fell and hit his chest wall against a boulder, which he believes worsened his dyspnea. The patient endorses several recent upper respiratory infections that he recovered from without issue. He has chest pain with deep breaths as well. His temperature is 99.0°F (37.2°C), blood pressure is 124/64 mmHg at rest and 107/63 mmHg on inspiration, pulse is 130/min, respirations are 23/min, and oxygen saturation is 90% on room air. Physical exam is notable for an absence of wheezes and very poor air movement bilaterally. Initial laboratory tests including a venous blood gas and liver function tests are only notable for a pCO2 of 67 mmHg. Which of the following is the most likely etiology of this patient's variation in blood pressure?