A 65-year-old man comes to the physician because of a 3-month history of productive cough and shortness of breath. He has smoked 2 packs of cigarettes daily for 40 years. Physical examination shows prolonged expiration, a loud P2, JVD, and a point of maximal impulse in the sub-xiphoid space. ECG shows right-axis deviation and right bundle-branch block. Blood pressure is 140/90. Which of the following is the most likely cause of these findings?
Decreased carotid sinus baroreceptor firing
Impaired right-heart filling
Increased pulmonary capillary wedge pressure
Increased pulmonic valvular pressure gradient
Reduced numbers of alveolar capillaries
