ST-Elevation Myocardial Infarction in an Adolescent
Bibliographic record
Abstract
Myocardial infarction (MI) in the elderly is often due to atherosclerotic accumulation, while an MI in younger patients is often due to embolic events. An embolic MI is rare, accounting for 2.9% of all MIs, but has a higher risk of morbidity and mortality. The most common causes of embolic MI are infective endocarditis, atrial fibrillation, valvular heart disease, prosthetic heart valve, and mural thrombus. We present a unique case study of an ST-elevation MI (STEMI) in an adolescent, with none of the aforementioned risk factors. Our case reports a 17-year-old Caucasian male who presented to the emergency department with substernal chest pain that started while he was watching television. The pain was severe, and radiated down his left arm and up his left neck. Social history and family history were unremarkable. Vitals were within normal limits. The telemetry did not demonstrate any abnormalities. An electrocardiogram (EKG) was performed, as a rule-out, and surprisingly demonstrated an STEMI in the anterior leads with focal ST-segment depressions in the inferior leads. Cardiac catheterization was performed that demonstrated 100% stenosis in the middle to distal left anterior descending (LAD) artery. A stent was unable to be placed due to the small caliber of the occluded vessel, and medical management was started. Transesophageal echocardiogram (TEE) later demonstrated a patent foramen ovale (PFO). J Med Cases. 2016;7(12):519-521 doi: https://doi.org/10.14740/jmc2650w
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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 | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".