In a patient with suspected heart failure exacerbation, what finding would suggest hypovolemic shock?

In the context of suspected heart failure exacerbation, a finding of high systemic vascular resistance indicates hypovolemic shock because it reflects the body's compensatory mechanism in response to decreased intravascular volume. In hypovolemic shock, the body attempts to maintain perfusion to vital organs by constricting blood vessels, which leads to an increase in systemic vascular resistance. This compensatory response is a direct result of increased sympathetic activity and the release of hormones such as norepinephrine and angiotensin II, which work to maintain blood pressure and redirect blood flow.

On the other hand, elevated pulmonary capillary wedge pressure typically indicates fluid overload rather than hypovolemic conditions, as it represents the pressure within the pulmonary circulation and is related to left atrial pressure. The collapse of the left ventricular wall is more associated with other cardiac conditions rather than directly indicative of hypovolemic shock. High central venous pressure generally reflects volume overload and is not a typical finding in hypovolemic shock, where venous return is often decreased due to the lack of circulating blood volume. Thus, high systemic vascular resistance is the correct finding that aligns with the physiological state of hypovolemic shock in this scenario.