Superior vena cava obstruction due to markedly enlarged right pulmonary artery in Eisenmenger syndrome
Bibliographic record
Abstract
A 24-year-old man, with Down syndrome, partial atrioventricular septal defect, and non-restrictive patent ductus arteriosus, had previously documented dilatation and thrombosis of his right pulmonary artery (RPA) secondary to his Eisenmenger syndrome. His clinical situation had been reasonably stable when he presented with increasing dyspnoea and cough. Chest X-ray (CXR) on admission (Panel B) showed significant increase in the size of the RPA when compared with a film obtained 5 years earlier (Panel A). CT pulmonary angiography (CTPA) was performed on a Siemens Somatom 64 scanner. This revealed massive dilatation of the RPA (Panel C) with extensive thrombus (asterisk) in the RPA. This markedly enlarged RPA impinged on the right main bronchus (Panel D) posteriorly (black arrowhead), as well as on the superior vena cava (SVC) anteriorly (white arrowhead). The SVC was severely compressed, but this compression involved only that portion of the SVC caudal to the insertion of the azygos vein (Panel E). The azygos vein was noted to be dilated, as were the intercostal veins (Panel E). We submit that, unlike previous cases of SVC obstruction by an enlarged RPA, there was no SVC syndrome in this case, because the SVC compromise occurred caudal to the insertion of the azygos vein and the expanding RPA had not yet obstructed the azygos arch. The upper body venous drainage could be accommodated, therefore, through the azygos system.
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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".