Early repolarization syndrome (ERS) is a relatively common variant of the normal electrocardiogram. Most patients are asymptomatic. Some patients have autonomic dysfunction with vagal predominance and often feel dizziness, palpitations, easy fatigue, precordial discomfort, stabbing or squeezing pain, sometimes radiating to the left shoulder and arm. The precordial pain is not related to physical stress and cannot be relieved by taking nitroglycerin. The main manifestations are chest pain, chest tightness, palpitations, and ST-segment elevation on the electrocardiogram, resembling variant angina pectoris, hyperacute phase of myocardial infarction, and acute pericarditis, which are easily misdiagnosed as organic heart disease. ERS is a benign congenital cardiac conduction or electrophysiological abnormality, not a sign of organic heart disease, and most patients do not have any symptoms. Some patients have autonomic dysfunction with vagal dominance, often feeling dizziness, palpitations, easy fatigue, precordial discomfort, tingling or squeezing pain, sometimes radiating to the left shoulder and arm. ERS patients have no significant abnormalities on long-term follow-up X-rays, coronary angiograms, echocardiograms, and various laboratory tests. ERS is a benign ECG variant and generally does not require special treatment. In case of combined neurocirculatory abnormalities, symptomatic treatment can be given, including analgesics for chest pain, nitroglycerin preparations in severe cases, and antiarrhythmic drugs in case of arrhythmias. Prognosis: ERS is a normal ECG variant with a good prognosis, and ST-segment elevation can be reduced or returned to normal with age. The ECG features are: (1) J-point elevation, up to 0.1-0.4mV, mostly seen in the anterior chest leads. (2) ST elevation, concave upward type, can be elevated 0.1-0.6mV, individual up to 1mV, mainly in V1-V3 leads. In a few cases, it can be seen in leads II, III and avF, and this ST change is persistent without dynamic evolution. (3) In some patients, the J-point is not clear, but the R-wave descending branch is blunt or similar to the R’ wave (pseudo R’ wave), making the QRS wave group similar to the RSr’ type. (4) The T wave is upright and elevated, with symmetry in both limbs. (5) Most of them are associated with reverse clockwise transposition. There is no effective prevention method for this disorder because it is a normal variant. According to the literature, early repolarization syndrome accounts for about 2% of healthy individuals and seems to be more common in middle-aged and young adults. Its incidence is 18.5% in children, 12.8% in adolescents, 8.2% in adults, and 4.7% in the elderly, with more men than women. This sign needs to be distinguished from acute anterior wall myocardial infarction, acute pericarditis, variant angina, left ventricular hypertrophic strain, myocardial ischemia, and right bundle branch block on the electrocardiogram. Otherwise, it can pose a serious psychiatric threat to the subject. This syndrome has upright T waves, no dynamic evolution, and no pathological Q waves, which are not difficult to identify when combined with clinical symptoms, physical signs, and myocardial enzyme profile assays. The early repolarization syndrome is not a disease and does not require too much attention. If the symptoms are obvious, you can take Betalac 6.25mg 2/day for a short time with some Valium.