IS IT A HEART ATTACK ?

A middle-aged female patient comes into the ED with chest pain, a very common chief complaint. She was extremely concerned that it may be her heart and was sure it was a heart attack. I obtained a good history, which sounded like a possible heart attack (acute coronary syndrome vs. infarction). I always ask about alcohol, smoking, and drug use - especially cocaine, meth, etc. She strongly denies all the above. I tell her we will work her up for cardiac chest pain and get the labs cooking. As I'm walking out of the room, she asks, "Doctor, could this be caused by injecting Ritalin, because I do that." Boy, did I feel stupid for not remembering to ask that very important Ritalin injection question they teach you in med school.