E-cigarette usage has been shown to be associated with lung injury. However, there has been limited data of cardiovascular complications in e-cigarette users. We present two patients that developed cardiac complications after recent increased e-cigarette usage-the first with non-ischemic cardiomyopathy after a month of electronic cigarette usage at the highest power setting of 40 Watts, and the second with predominantly non-ischemic cardiomyopathy with underlying single vessel coronary artery disease after a threefold increase in e-cigarette usage for the preceding three months. In addition, to the best of our knowledge, this is the first report of an association between e-cigarette usage and heart failure.