A 40-year-old man comes to the physician for a 2-month history of dry cough and shortness of breath. He has no past medical history. Chest x-ray shows cephalization of the pulmonary vessels. Resting echocardiography shows left ventricular ejection fraction of 50%. He has smoked one pack of cigarettes daily for 5 years. Which of the following is the most likely cause of this patient’s pathology?
Decreased diameter of terminal bronchioles
Decreased inhibition of protease
Ectasia with loss of bronchiolar musculature
Increased Reid index
Increased pulmonary capillary hydrostatic pressure
