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A 19-year-old man presented with central crushing chest pain 20 h after the oral ingestion of a gram of plant food ( panel A ) containing mephedrone, which he legally purchased in a 'headshop'. He denied alcohol or any other drug ingestion during the plant-food ingestion or afterwards. He had no history of prodromal illness. All his vital signs were normal. His urinary drugs screen was negative for cocaine, alcohol, benzodiazepines, amphetamines and opiates. His ECG showed significant ST elevation ( panel A ) and his serum troponin concentration was raised (1.19 μg/l). A cardiac MRI showed high signal on T2-weighted sequences in the lateral myocardial segments consistent with acute myocardial oedema ( panel B ). After intravenous 0.2 mmol/kg gadolinium diethylenetriaminopenta-acetate, late-enhanced sequences showed high signal in the lateral segments in the mid wall consistent with acute...