&NA;This article reviews the chemical nature of cocaine, an increasingly abused stimulant. Following a description of the clinical manifestations of drug use, cardiovascular effects as well as routes of administration are described. Clinical complications of acute and chronic cocaine abuse include dysrhythmias, acute myocardial ischemia and infarction, sudden death, myocarditis, and cardiomyopathy. Clinical manifestations and assessment protocols are summarized. Treatment protocols remain focused on symptom presentation at this time, as there is no known antidote for cocaine toxicity or overdose.