A 40-year-old woman presents to the Emergency Department (ED…

A 40-year-old woman presents to the Emergency Department (ED) with severe muscle pain and fatigue after participating in a marathon race. She reports feeling dizzy and nauseous. Laboratory tests show an elevated lactate level, she is also noted to have an oxygen saturation of 87% on RA. Which of the following best explains the elevated lactate level in this patient?