In septic shock, which hemodynamic change is most characteristic?

• A. Increased systemic vascular resistance due to vasoconstriction
• B. Vasodilation with decreased systemic vascular resistance and hypotension
• C. Increased cardiac output with high afterload
• D. Decreased heart rate with increased stroke volume

Answer: (B)

The main idea here is that septic shock causes distributive shock physiology driven by widespread vasodilation. In sepsis, inflammatory mediators (like nitric oxide) relax blood vessels, lowering systemic vascular resistance and leading to hypotension. Early in septic shock the heart often maintains or even increases its output because the afterload is reduced, so you may see high cardiac output with warm skin and rapid pulse. This makes vasodilation with decreased systemic vascular resistance and hypotension the most characteristic change.

The other patterns don’t fit: vasoconstriction would raise vascular resistance, which isn’t typical in septic shock; high afterload contradicts the low-resistance state caused by vasodilation; and tachycardia with decreased, not increased, stroke volume is not the usual picture in early septic shock.