Acute Limb Ischemia in a Previously Undiagnosed Case of Mid-Ventricular Non-Obstructive Hypertrophic Cardiomyopathy
Bibliographic record
Abstract
Mid-ventricular hypertrophic cardiomyopathy (HCM) is rare and when associated with an apical aneurysm has a high risk of thrombus formation and embolization. We report a case of a 70-year-old man with peripheral vascular disease who presented with acute progressive right leg pain. Peripheral angiography showed complete thrombotic occlusion of his right superficial femoral artery. Thrombolysis was successfully performed using alteplase. His post-procedure angiography which was obtained the next day showed complete revascularization with no residual stenosis. His echocardiogram showed an ill-defined mass in the left ventricular apex. The absence of residual atheroma on peripheral angiography suggested a primary embolic event. We obtained cardiac MRI which showed mid-ventricular HCM complicated by an apical aneurysm and small thrombus. Left ventricular apical aneurysm occurs commonly in mid-ventricular HCM and is associated with a worse prognosis. Cardiac magnetic resonance imaging (MRI) is superior to echocardiography in identifying left ventricular apical aneurysms and apical thrombi. J Med Cases. 2017;8(10):322-325 doi: https://doi.org/10.14740/jmc2915w
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 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 | 0.001 |
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".