Global recreational drug use has reached worrying proportions, to the point of threatening socio-economic stability of the countries.It is estimated that in developed countries one in four people have used recreational drugs at some point in their lives.Therefore, it is common that physicians be confronted with clinical pictures secondary to drug abuse.In addition to its central nervous system effects, these drugs also produce significant cardiovascular changes, responsible for a not negligible related morbidity and mortality.In this article a case of acute myocardial infarction secondary to heroin consumption is exposed, the systemic effects of this drug are reviewed, and the management and the mechanisms underlying this relationship are discussed.