Pregnancy-Related Spontaneous Coronary Artery Dissection
Bibliographic record
Abstract
C ase 1: A 34-year-old gravida 2, para 2 woman was admitted with anterior ST-segment-elevation myocardial infarction 10 days postpartum.Coronary angiography showed left main (LM) dissection with occlusion of the proximal left anterior descending (LAD) artery (Figure 1A), and her ejection fraction was 35%.Bare metal stents were successfully implanted from the LM into the proximal LAD and diagonal arteries.Antegrade extension of dissection into the circumflex was left untreated because her ischemia resolved.However, repeat angiography at 5 months with optical coherence tomography showed in-stent restenosis in the LM, stent-strut malapposition in the proximal LAD (Figure 1B), and residual circumflex dissection, prompting subsequent coronary artery bypass grafting (CABG).Case 2: A 40-year-old woman (gravida 2, para 2) presented with non-ST-segment-elevation myocardial infarction 10 days after elective cesarean section.Coronary angiography showed proximal LAD dissection with an occluded midsegment and collateralization from the right coronary artery (Figure 1C), and her ejection fraction was 40%.After the initial angioplasty, extensive dissections from the proximal to distal LAD and diagonal arteries were noted.She underwent emergency bailout CABG with anastomosis of the left internal mammary artery to the distal LAD and saphenous vein graft to the diagonal artery.Follow-up computed tomography angiography at 3 months demonstrated mild residual stenosis of the proximal LAD with a patent left internal mammary artery, but the saphenous vein graft to the diagonal artery was occluded.Case 3: A 37-year-old woman (gravida 2, para 2) presented with non-ST-segment-elevation myocardial infarction 9 days after an uneventful vaginal delivery at 38 weeks.Her troponin I peaked at 26 μmol/L.Coronary angiography showed proximal LAD dissection with 80% stenosis (Figure 1D), and her ejection fraction was 40%.She was treated conservatively because her chest pain resolved.Repeat angiography at 5 days showed improvement of stenosis to 50% (Figure 1E).Computed tomography angiography at 14 months showed almost complete normalization of the proximal LAD.She was found incidentally to have fibromuscular dysplasia of her external iliac artery (Figure 1F).
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 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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".