Why should epinephrine-impregnated retraction cords be avoided?

Epinephrine-impregnated retraction cords are primarily avoided in patients with heart disease due to the vasoconstrictive properties of epinephrine. This substance can raise blood pressure and cause increased heart rate, which can elevate the risk of adverse cardiovascular events in individuals who already have compromised cardiac function. Such patients might be more susceptible to these cardiovascular effects, making the use of epinephrine in dental procedures a potential danger to their health.

In contrast, while there may be considerations for patients with diabetes, pregnant patients, or those with respiratory issues, these groups are not affected by the effects of epinephrine on the cardiovascular system in the same critical way. For example, in diabetic patients, careful management of blood sugar levels is vital, but the specific concern about epinephrine is less pronounced than in patients with existing heart disease. Therefore, focusing on patients with heart disease is key in understanding why epinephrine-impregnated retraction cords should be avoided in their care.