Bibliographic record
Abstract
Cardiogenic shock is the commonest cause of death after acute myocardial infarction. It occurs in 7% of patients with ST segment elevation myocardial infarction and 3% with non-ST segment elevation myocardial infarction. Cardiogenic shock is a progressive state of hypotension (systolic blood pressure < 90 mm Hg) lasting at least 30 minutes, despite adequate preload and heart rate, which leads to systemic hypoperfusion. It is usually caused by left ventricular systolic dysfunction. A patient requiring drug or mechanical support to maintain a systolic blood pressure over 90 mm Hg can also be considered as manifesting cardiogenic shock. As cardiac output and blood pressure fall, there is an increase in sympathetic tone, with subsequent cardiac and systemic effects—such as altered mental state, cold extremities, peripheral cyanosis, and urine output < 30 ml/hour. ### Cardiac effects In an attempt to maintain cardiac output, the remaining non-ischaemic myocardium becomes hypercontractile, and its oxygen consumption increases. The effectiveness of this response depends on the extent of current and previous left ventricular damage, the severity of coexisting coronary artery disease, and the presence of other cardiac pathology such as valve disease. A 65 year old man with a 3–4 hour history of acute anterior myocardial infarction had cardiogenic shock and acute pulmonary oedema, requiring mechanical ventilation and inotropic support. He underwent emergency angiography (top), which showed a totally occluded proximal left anterior descending artery (arrow). A soft tipped guidewire was passed across the occlusive thrombotic lesion, which was successfully stented (middle). Restoration of brisk antegrade flow down this artery (bottom) followed by insertion of an intra-aortic balloon pump markedly improved blood pressure and organ perfusion. The next day he was extubated and weaned off all inotropic drugs, and the intra-aortic balloon pump was removed Three possible outcomes may occur:
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.002 |
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; both teacher heads agree on what is shown here.
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".