Interpretation of ECG in athletes can be quite challenging as it requires adequate experience to distinguish physiologic changes related to adaptation to training from pathologic findings. ECG interpretation is an important diagnostic tool for high intensity trained athletes. Herein, we present the case of a young high-competitive athlete who presented with a variant ST elevation on 12lead ECG that was initially considered suspicious of myocardial infarction. Diagnostic workup including clinical examination, echocardiogram, 12-lead surface ECG and laboratory tests (troponin and CK-MB) did not confirm the presence of acute coronary syndrome. The patient was monitored for a few hours and was finally discharged with no restrictions regarding training. ECG in the present case resembles Wellen's syndrome pattern which represents a preinfarction stage of CAD with a significant proximal left anterior descending artery (LAD) stenosis that will be followed by ACS of anterior wall if left untreated. However, there were no other findings to support the clinical diagnosis of Wellen's syndrome in our case and the ECG changes were attributed to a physiological adaptation to training. During exercise several ECG adjustments develop as a result of the decreased sympathetic tone and the increased parasympathetic tone combined with the heterogeneity of ventricle repolarization. The preparticipation screening performed by experienced physicians in the field of sports cardiology is crucial in order to recognize physiologic cardiovascular adaptation to exercise and exclude cardiovascular abnormalities.