When nicotine binds to receptors in the peripheral nervous system, it increases blood pressure, heart rate, cardiac contractility, and gastrointestinal tract activity.
However because calcium is also involved in cardiac myocyte contraction, these agents also reduce contractility of the heart and should not be used in case of systolic heart failures.
So, one of the things is they cause our heart to have decreased contractility, because after a heart attack, you've sustained some damage to your heart muscle, so it can't always contract very well.