Inordinately Sluggish Coronary Artery Flow in an Angiographically Normal Coronary Artery
Bibliographic record
Abstract
A 53-year-old male smoker, without any significant medical history was admitted via the emergency room to the cardiac care unit due to a single episode of unstable angina lasting for approximately 10 minutes. Over the last one year he admits to symptoms indicative of effort angina of class II according to the Canadian Cardiovascular Society (CCS) classification. He had been submitted to an exercise stress test a year earlier which was characterized as positive based on clinical criteria only. On admission no ischemic ECG changes were noted; chest pain had subsided upon arrival to the emergency room, thus an ECG recording during the episode of chest pain was lacking. Cardiac enzymes were normal. However, due to the typical clinical presentation, prior history of effort angina and report of a positive exercise test in the past, a decision was made to proceed with cardiac catheterization, which was performed the following day. Coronary angiography revealed no significant atherosclerotic lesions, however an impressively sluggish flow was observed in the left anterior descending (LAD) coronary artery (Figure 1). During injection of contrast material into the left coronary artery, the left circumflex (LCx) coronary artery (panel A, left side) fills up quickly, while there is an inordinate delay of flow in the LAD which has only filled half-way (panel A, right side). Only several frames later when the circumflex has started to empty (panel B, left side), has the LAD filled up with the contrast material (panel B, right Images In medIcIne
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| 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".