Abstract 10426: An Interesting Presentation of Angina Due to Left Posterolateral to Right Posterolateral Coronary Artery Fistula
Bibliographic record
Abstract
Background: Arterial-to-arterial fistula between right posterolateral and left posterolateral coronary arteries is rare and available literature on it is scarce. Case Presentation: A 60-year-old male with type 2 diabetes mellitus and dyslipidemia presented with shortness of breath and chest tightness. Given his symptoms and poor functional status, myocardial perfusion imaging with regadenoson was performed. The myocardial perfusion imaging study was abnormal with evidence of ischemia in the inferoseptal myocardium. The patient proceeded to the cardiac catheterization lab for selective right and left coronary angiography. Contrast injection revealed non-obstructive coronaries; however, an arterial-to-arterial fistula between the right posterolateral (RPL) branch and left posterolateral (LPL) branch was present (Figure 1A and 1B). Further characterization of the fistula showed the presence of left-to-right and right-to-left filling, indicating a LPL to RPL coronary artery fistula (CAF). The patient was managed conservatively with aspirin, statin, and anti-anginal therapy. Conclusion: There remains a need for diagnostic and therapeutic guidelines to address CAF. Conservative treatment is an option for small CAFs and serves as a potential alternative to catheter-based and surgical closure.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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 | 0.000 |
| 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".