What is a potential adverse effect related to cardiac conditions, caused by Epinephrine?

Epinephrine is a medication that primarily acts as a sympathomimetic agent, stimulating both alpha and beta-adrenergic receptors. One of the notable adverse effects associated with its use in cardiac conditions is angina. This occurs because epinephrine can increase myocardial oxygen demand due to its potent stimulatory effects on the heart, leading to increased heart rate and contractility. In individuals with pre-existing coronary artery disease or narrowings in the coronary vasculature, this heightened demand can outstrip the supply of oxygen, precipitating angina, which manifests as chest pain or discomfort.

The body's response to epinephrine can be especially concerning in scenarios involving people with compromised cardiac conditions, as the drug can exacerbate existing issues. While severe allergic reactions and hypotension can occur in other contexts related to epinephrine (like anaphylaxis), its role in inducing or worsening angina is directly related to its cardiovascular effects on the heart. Bronchoconstriction, which is the opposite of what epinephrine typically causes (as it is often used to relieve such constriction in conditions like asthma), does not align with its action in this context.