A 62-year-old man with a history of hypertension and anterior wall myocardial infarction 2 years ago presents to the emergency department with a 3-week history of progressive dyspnea, orthopnea, and bilateral lower extremity edema. His wife reports he has been gaining weight despite decreased appetite. On examination, temperature is 37.2°C, heart rate is 102/min, blood pressure is 148/92 mmHg, respiratory rate is 22/min, and oxygen saturation is 92% on room air. Jugular venous pressure is elevated at 10 cm H₂O, lungs have bibasilar crackles, and a prominent S3 gallop is appreciated. Echocardiography demonstrates a left ventricular ejection fraction of 32% with global hypokinesis and dilated left ventricle. Serum albumin is 3.8 g/dL (normal), and urinalysis shows no proteinuria. Which of the following mechanisms best accounts for the development of his peripheral edema?

1. A)Decreased plasma oncotic pressure from malnutrition and hepatic dysfunction
2. B)Increased capillary hydrostatic pressure secondary to systemic venous congestion and impaired renal perfusionGABARITO
3. C)Lymphatic obstruction from cardiac enlargement compressing mediastinal and peripheral lymphatic vessels
4. D)Increased capillary permeability from acute inflammatory cytokine release triggered by myocardial necrosis
5. E)Renal tubular sodium reabsorption defect causing secondary hyperaldosteronism