Patients uncommonly present to urgent care clinics with ischemic cardiac symptoms, but these situations do occur and represent a high risk to both clinician and patient. All clinicians should be aware of any ECG findings which may predict potential cardiac risk. Wellens’ sign is one ECG pattern which, when present, is highly specific for significant coronary heart disease, even in patients whose symptoms have resolved by the time the ECG is performed. This article will present a specific patient case and review the pertinent ECG findings of Wellens’ syndrome.