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56-year-old woman who comes to the emergency department after a sudden episode of hematemesis. Yesterday, she had two bowel movements that were dark, sticky, and foul-smelling. She woke up nauseated and has since vomited twice,with a small amount of bright red blood. She also feels dizzy. Because of knee pain related to skydiving 1 week ago, she started taking five tablets of naproxen (1,100 mg) twice daily. She takes no other medicines and denies any significant past medical history. On physical examination, you find a pale, uncomfortable, but alert patient. She is tachycardic (pulse of 115 bpm) and has a blood pressure drop from 116/72 mm Hg supine to 93/65 mm Hg standing. Her abdomen is flat with hyperactive bowel sounds. You note epigastric tenderness but no rebound or guarding. There is melena on rectal examination. How does blood loss lead to an increase in heart rate?

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