An 18-year-old obese man with a body mass index of 40, diagnosed with attention-defi cit hyperactivity disorder and treated with methylphenidate (Concerta®) was acutely admitted to hospital with hypoxia and dyspnoea. On investigation signs of liver-, renal-, and heart-failure were found. Noradrenalin infusion was started. Echocardiography showed dilated left ventricle and an ejection fraction (EF) ...