Review Question - QID 216348

A 67-year-old man is brought to the emergency department with his wife, who reports he is increasingly confused. The patient has had fatigue, fever, malaise, and a cough for the past 48 hours, which has worsened acutely today. He has a past medical history of hypertension and takes lisinopril. His temperature is 103°F (39.4°C), blood pressure is 102/62 mmHg, pulse is 145/min, respirations are 19/min, and oxygen saturation is 90% on room air. Physical exam reveals increased work of breathing. The patient is alert and oriented to self only. A chest radiograph is performed as seen in Figure A. Laboratory testing shows a troponin of 0.09 ng/mL (normal < 0.04 ng/mL). An ECG is performed which demonstrates sinus tachycardia. Which of the following is the most likely etiology of this patient's elevated troponin?