A  
Methylergometrine (an ergot alkaloid) produces potent systemic and coronary vasoconstriction, and numerous reports describe hypertension, coronary vasospasm and even myocardial infarction after its use; therefore it is contraindicated in patients with pre-existing heart disease. Oxytocin and misoprostol are hemodynamically safer, and carboprost’s main caution is bronchospasm in asthma, not cardiac ischemia. [Jang 2023, PMID 37069508; Ribbing 2001, PMID 11765484]