A 28-year-old lady presented to the emergency department after an overdose of methylphenidate. She complained of chest pain and developed an acute coronary syndrome with marked ST segment depression in the electrocardiogram and elevated troponin I level. She was closely monitored in the cardiac care unit and was treated with the standard therapy for acute coronary syndrome. Echocardiogram showed global left ventricle impairment. The follow-up echocardiogram showed that the left ventricular function normalised and the subsequent coronary angiogram was normal. The clinical use, abuse potential, toxicity and overdose treatment of methylphenidate are discussed.
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