ECG findings suggestive of STEMI often lead to emergent left heart catheterization (LHC). Occasionally, non-coronary conditions mimic ECG findings of STEMI resulting in increased risk and expenses from emergent transportation and procedures. While the overall incidence is declining over the last decade given advances in guideline directed medical therapy, this still accounts for a substantial amount of ED visits. We report a case of 1:1 atrial flutter in a patient with dextrocardia presenting as STEMI.