A 38-year-old man of Somali origin was admitted with acute myocardial infarction and hypertension after chewing khat leaves. Cathinone, the most active substance in khat leaves, increases the blood pressure and heart rate by increasing the rate at which catecholamine is released from the nerve endings. Increased risk of acute myocardial infarction has been reported in people who use khat on a regular basis. It is not known if this occurs due to a direct or indirect effect, e.g. as a result of hypertension caused by the use of khat. The chewing of khat leaves is widely prevalent in Yemen and in East-Africa, as well as among people in the Netherlands originating from these areas. In people of Yemeni or East African origin presenting with hypertension or (early-onset) cardiovascular disease specific inquiries should be made about khat use and it should be discouraged.