Sequential spontaneous severe aortic and mitral regurgitation
Bibliographic record
Abstract
Acute severe valve regurgitation has been described in both aortic and mitral valves.In the aortic valve, regurgitation is most commonly a result of infection, aortic dissection, aortic aneurysms or trauma, whereas for the mitral valve, acute regurgitation is generally a result of infection, chordal rupture or ischemia.Rheumatologic disorders affecting cardiac valves, although rare, have been reported to cause both spontaneous aortic and mitral insufficiency.This report, however, is a rare case describing sequential inflammatory damage to both valves in the same patient, requiring two surgical sessions 13 months apart.A 58 year old female patient was referred for aortic valve replacement.She was admitted with an episode of acute onset dyspnea associated with chest discomfort.Echocardiography revealed severe aortic regurgitation with a prolapsing non-coronary cusp (NCC).Left ventricular function was moderately impaired, and the left ventricle was mildly dilated.Coronary angiography showed normal coronary anatomy.She had a history of chronic obstructive pulmonary disease, peripheral vascular disease, smoking and polymyalgia rheumatica for which she was treated with steroids.She had no clinical or serological evidence of rheumatoid arthritis.She was operated on an urgent basis, and she underwent an AVR using a mechanical valve prosthesis.The most striking intraoperative finding was the complete prolapse of
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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 | 0.001 | 0.011 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.017 | 0.013 |
| Insufficient payload (model declined to judge) | 0.004 | 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; 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".