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The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aorticvalve. Aortic angiogram did not reveal aortic dissection. If you see this, you should Doppler the valve. In the cath lab, the patient’s blood pressure remained low. Circulation.
Flecainide : This is a potentially dangerous Na channel blocker which can cause ventricular dysrhythmias including ventricular fibrillation. It simply does not make physiologic sense to suddenly see an all-negative QRS complex in this most lateral chest lead. She is already anti-coagulated, so that is not an issue.
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