A 54-year-old woman with a history of essential hypertension, coronary artery disease (CAD), heart failure with reduced ejection fraction (HFrEF), and prior cocaine use presents to the emergency department with chest pain and shortness of breath. Her blood pressure is 164/92 mmHg with a heart rate of 104 beats/min. She has adequate oxygenation on room air, clear lung fields, and clinical euvolemia. An electrocardiogram (ECG) reveals sinus tachycardia with no acute ST-T wave abnormalities. Laboratory testing reveals mildly elevated high-sensitivity troponins, nonelevated NT-proBNP, and a urine toxicology screen positive for cocaine. She has a normal chest X-ray. The hospitalist elects not to resume the patient's home carvedilol and recommends discontinuation on discharge due to current and potential for ongoing cocaine use.