Dextrocardia is a relatively rare congenital malposition in which the association with coronary artery disease is at the same frequency as in the general population. Previous reports have shown successful attempts at treating percutaneously patients with dextrocardia and coronary artery disease. We report the case of a patient with dextrocardia and multivessel coronary artery disease. In this case we highlight the use of physiologic measurements with a pressure wire, in order to select the significant coronary lesions to treat.