Cocaine intoxication remains a significant clinical challenge in Latin America due to its high morbidity and the wide spectrum of systemic manifestations it can produce. We report the case of a 39-year-old man with a history of habitual cocaine use who presented to the emergency department after inhaling an unknown amount of cocaine and subsequently developing palpitations, dyspnea, and seizures. On arrival, he was in poor general condition, with acute respiratory failure, severe hypoxemia, and altered mental status, requiring orotracheal intubation and mechanical ventilation. Initial investigations revealed diffuse pulmonary edema, aspiration pneumonia, cerebral edema, hyperlactatemia, and multiorgan injury characterized by type 2 acute myocardial infarction secondary to coronary vasospasm, severe rhabdomyolysis, acute kidney injury (AKIN stage I), and probable ischemic hepatic injury. ...