Epinephrine should not be used on patients who:

Epinephrine is a vasoconstrictor that can potentially exacerbate certain cardiovascular conditions. In patients who experience angina daily, the use of epinephrine can increase heart rate and blood pressure due to its sympathomimetic effects, which could lead to further angina or even a myocardial infarction. This is particularly concerning because these patients already have a compromised blood supply to the heart muscle, and any additional cardiac stress can be detrimental.

While other conditions listed, such as having had a myocardial infarction seven months prior or possessing a pacemaker, may also warrant caution, the most immediate concern is with the patient who experiences daily episodes of angina. The recurrent nature of their angina indicates a chronically unstable cardiac condition, making the risks associated with epinephrine particularly significant for that patient group. It is crucial for dental professionals to assess the overall cardiovascular status of their patients and to avoid medications that could precipitate an adverse cardiac event in those with unstable angina.