To date, cocaine-induced myocardial infarction (MI) remains an infrequent reason for admission into hospital. However, reports identify rising cocaine usage in the UK. With 7-10% of all patients presenting chest pain having traces of cocaine in their urine, there is an increasing incidence of cardiovascular disease in the under 30s age group. The potential impact on health care resources must cause concern. This report describes the case of a young man admitted to the emergency department after an 18-h cocaine session. With evidence of an anterolateral MI, left heart studies and thrombectomy were undertaken in cardiac catheters. Admission to critical care was required for ongoing respiratory and cardiac support therapies. Although there are many aspects of patient management that can be explored, specific issues to be discussed in this paper include evidence-based treatment options, nursing management of inotrope administration and caring for family and friends.