When you question him further, he says that he does not use any alcohol or illicit drugs. Although the details are vague, he describes the chest pain as a substernal tightness that is definitely not related to exertion. He appears slightly anxious. He denies illicit drug use. Eye, nose, mouth, extremities, lungs, and liver are normal.
Cocaine use is confirmed.
The patient admits a possible temporal relationship between his cocaine use and his chest pain and expresses concern about long-term health risks.