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We report a case of 37-year-old male, who was admitted to the Vilnius University hospital Santaros Klinikos emergency department suffering from acute chest pain. ECG and elevated troponin level confirmed ST-elevation myocardial infarction, although coronary angiogram had not shown hemodynamically significant changes in coronary arteries. Patient admitted after using cocaine a day ago. To conclude, myocardial infarction is rare, but serious consequence of cocaine use. Clinicians should considerdoi:10.2478/semcard-2019-0005 fatcat:wtnzzzetlnbqpmp23unf75zovu