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    Subjects/Physiology/Ventilation-Perfusion Matching
    Ventilation-Perfusion Matching
    medium
    heart-pulse Physiology

    A 58-year-old man with a 40 pack-year smoking history presents with progressive dyspnea on exertion. Chest X-ray shows hyperinflation and bullae in the upper lung zones. Pulmonary function tests reveal FEV₁ 35% predicted with an elevated residual volume. Arterial blood gas on room air shows pH 7.35, PaCO₂ 52 mmHg, PaO₂ 58 mmHg, HCO₃⁻ 28 mEq/L. Which of the following best explains the mechanism of hypoxemia in this patient?

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