Partial Anomalous Pulmonary Venous Return With Persistent Angina: Simulating Coronary Artery Disease
Bibliographic record
Abstract
Partial anomalous pulmonary venous return (PAPVR) is an uncommon adult congenital heart disease caused by an abnormal return of one or more, but not all, of the pulmonary veins to the right atrium or indirectly through venous connections from the anomalous pulmonary vein. Presentations vary from incidental findings to severe heart failure and diagnosis could easily be missed. We report a case of PAPVR in a 51-year-old male with a history of coronary artery bypass surgery presenting with exertional dyspnea and chest discomfort which were initially interpreted as angina in light of patient’s known coronary disease and prior revascularization. Patient underwent surgical repair with redirection of the pulmonary connection to the left atrium. On follow-up, patient had symptomatic improvement and decrease in pulmonary artery pressures. Diagnosis of PAPVR may be particularly elusive when patient also has a more common diagnosis, such as coronary disease. Unexplained pulmonary hypertension should alert physicians to consider additional differential diagnoses including congenital heart disease despite the patient’s adult age. As evidenced in this patient, successful surgical repair can lead to gratifying results and improved prognosis. J Med Cases. 2015;6(11):485-487 doi: http://dx.doi.org/10.14740/jmc2309w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".