A 68-year-old man with COPD and hypertension presents to the emergency department with acute dyspnea, tachycardia, and hypoxemia two days after undergoing open reduction and internal fixation of a hip fracture. Vital signs are: heart rate 122 bpm, blood pressure 92/58 mmHg, respiratory rate 30/min, and oxygen saturation 87% on room air. Physical examination reveals unilateral leg swelling and tenderness in the operative leg. Electrocardiogram shows sinus tachycardia with T-wave inversions in leads V1-V3. Serum troponin I is elevated at 0.09 ng/mL, and D-dimer is markedly elevated at 2.8 μg/mL. Chest radiograph is unremarkable. Which of the following best explains the mechanism of myocardial injury in this patient?

1. A)Demand ischemia from systemic hypoxemia and tachycardia in the setting of pre-existing coronary artery disease
2. B)Acute ST-elevation myocardial infarction of the anterior wall due to left anterior descending artery occlusion
3. C)Right ventricular strain and microinfarction secondary to acute increase in pulmonary vascular resistanceGABARITO
4. D)Myocardial inflammation from surgical trauma-induced systemic inflammatory response syndrome
5. E)Septic thromboembolism with direct myocardial invasion by bacterial pathogens