A patient at the end of ECC exhibits HIGH BP and HIGH filling pressures along with LOW stroke volume. What does this condition likely indicate?

The condition described—high blood pressure and high filling pressures coupled with low stroke volume—suggests that the heart is encountering significant resistance to flow. This is typically indicative of high systemic vascular resistance (SVR). When SVR is elevated, the heart must generate more pressure to maintain adequate flow, which can lead to high blood pressure.

However, despite this elevated pressure, the heart is unable to effectively pump a large volume of blood, resulting in a low stroke volume. This situation can occur in states of vasoconstriction or afterload increase, where the blood vessels are constricted, limiting the return of blood to the heart and increasing the workload on the heart itself.

In contrast, conditions like hypovolemia would present with low blood pressure and low filling pressures due to insufficient blood volume. Excessive volume status could lead to high filling pressures, but typically this would also correspond with a higher stroke volume due to the increased preload. The choice of needing to return to extracorporeal circulation does not align with the clinical picture described, as it does not directly address the physiological implications of elevated SVR.

Therefore, the indication of high systemic vascular resistance fits best with the symptoms presented, pointing to the heart working under increased stress to