Early repolarization ECG is characterized by J point visible in QRS wave, ST segment elevation at J point, elevated ST segment leads with elevated T waves.1, Mostly seen in II, III, AVF inferior wall leads and V3V4 leads, AVR leads are usually not elevated.2, Elevated ST segment, concave side up elevation is different from the arch back up elevation of myocardial infarction, this ECG feature has not changed for several years change, when doing exercise flat, with the increase of heart rate, the elevated ST segment can return to normal, and the elevated T wave can become normal. Early repolarization is a physiological ECG variation that is mostly benign and does not require treatment. The ECG changes of early repolarization resemble the pattern of acute myocardial infarction, so sometimes early repolarization is diagnosed as acute myocardial infarction. Therefore, it is important to pay attention to the ECG features of early repolarization syndrome and acute myocardial infarction for differentiation in clinical practice.