Ranolazine as Treatment of Microvascular Coronary Dysfunction in a Woman With Signs and Symptoms of Ischemia but No Obstructive Coronary Artery Disease
Bibliographic record
Abstract
Women often exhibit persistent symptoms, functional disability and a relatively high prevalence of microvascular coronary dysfunction (MCD) with no obstructive coronary artery disease (CAD) when evaluated for signs and symptoms of myocardial ischemia. A 27-year-old woman was referred by her treating cardiologist for symptoms of persistent chest pain for 10 years. Cardiac catheterization showed normal coronary arteries. Given the constellation of persistent chest pain and no obstructive CAD, a diagnosis of MCD was suspected, and she underwent coronary reactivity testing (CRT) with intracoronary infusions of adenosine, acetylcholine and nitroglycerin to test nonendothelial- and endothelial-dependent, micro- and macro-vascular coronary function. CRT results were consistent with a diagnosis of MCD. The patient was started on ranolazine, with significant improvement in symptoms. Cardiac magnetic resonance imaging (CMRI) after 3 months of treatment demonstrated improvement in perfusion compared to baseline. J Med Cases. 2014;5(1):23-25 doi: http://dx.doi.org/10.4021/jmc1522w
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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 | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".