Which condition may lead to increased myocardial oxygen demand?

When considering increased myocardial oxygen demand, heart failure is a significant condition to highlight. In heart failure, the heart's ability to pump blood effectively is compromised, which necessitates the heart to work harder to meet the body’s oxygen and nutrient needs. This increased workload inherently raises myocardial oxygen demand as the myocardial tissue requires an adequate supply of oxygen to sustain its activity, particularly when the heart is ineffective at maintaining adequate circulation.

In heart failure, the load on the heart can be due to factors such as increased preload, increased afterload, or even impaired contractility. As a result, despite the decreased efficiency of the heart, the oxygen requirements for the myocardium may become disproportionate to its supply, fostering a state of myocardial ischemia.

Though reduced blood pressure and decreased heart rate might typically decrease myocardial oxygen demand, they do not apply here. Stable angina, while it represents a state of compromised blood flow to the heart and can present with symptoms related to myocardial oxygen demand, does not inherently increase demand without considering the context of the underlying condition affecting the heart's performance.