Giant Calcified Left Ventricular Aneurysm with Calcified Thrombus Following Remote Myocardial Infarction
Bibliographic record
Abstract
In this case study, we provide angiographic and computed tomography images demonstrating a large cal-cified left ventricular (LV) aneurysm and associated calcified thrombus—unique, and now rare, sequelae of ST-elevation myocardial infarction (MI) that are rarely seen in the era of percutaneous coronary intervention (PCI). We discuss here the epidemiology, natural history, workup, and recommended management for LV aneurysms and thrombi with reference to clinical guidelines. Our patient’s calcified LV aneurysm and thrombus were discovered at the time of cardiac catheterization undertaken for a 2-month history of stable angina. He suffered an anterior MI 17 years ago and took aspirin only. He remained asymptomatic until presentation. Angiography also demonstrated severe triple-vessel coronary artery disease including left anterior descending artery occlusion. Our patient underwent stenting of the left circumflex and first diagonal and staged PCI to the right coronary artery, which led to functionally complete revascularization. RésuméDans cette étude de cas, nous présentons des images angiographiques et des coupes tomographiques d’un gros anévrisme calcifié du ventricule gauche (VG) et d’un thrombus calcifié qui y est associé – des séquelles uniques, mais maintenant rares, de l’infarctus du myocarde (IM) avec susdécalage du segment ST qui sont rarement constatées à l’ère de l’intervention coronarienne percutanée (ICP). Nous nous penchons sur l’épidémiologie, l’histoire naturelle, le processus d’évaluation et la prise en charge recommandée des anévrismes et des thrombus du VG en nous appuyant sur les lignes directrices cliniques. L’anévrisme et le thrombus calcifiés du VG de notre patient ont été découverts lors d’un cathétérisme cardiaque effectué pour une angine de poitrine stable depuis deux mois. Il a déjà subi un IM il y a 17 ans et ne prend que des aspirines. Il est demeuré asymptomatique jusqu’à la consultation. L’angiographie montre également la présence d’une coronaropathie tritronculaire grave, dont une occlusion de l’artère descendante antérieure gauche. Notre patient a subi une implantation d’endoprothèses dans l’artère auriculoventriculaire et la première branche diagonale et une ICP différée de l’artère coronaire droite, ce qui a mené à une revascularisation complète fonctionnelle.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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 teacher head, 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".