Q. A 60-year-old Asian male presents to the emergency department with symptoms of cough, fatigue, weakness, difficulty breathing, and leg swelling over the last week. The patient suffered a myocardial infarction 10 days ago and was discharged home 72 hours later. His past medical history is significant for atherosclerosis, which is managed with a statin. The patient is also diabetic and is taking metformin in addition to exercising daily. His blood pressure is 130/85 mmHg and heart rate 110/min. On physical examination, 2+ pedal edema is noted. Cardiac auscultation reveals an audible raspy breathing sound. When asked to take deep breaths during pulmonary auscultation, the patient winces and complains of sharp chest pain. He then begins to cough and leans forward as he holds his chest with his left hand. Which of the following precipitated this patient’s condition?