ATTR Cardiac Amyloidosis in a Patient With Pulmonary Sarcoidosis
Bibliographic record
Abstract
BACKGROUND: Amyloid transthyretin (ATTR) cardiac amyloidosis is a progressive cardiomyopathy characterized by misfolded transthyretin deposition, resulting in ventricular stiffening which may cause cardiac dysfunction. CASE SUMMARY: An 86-year-old man with history of pulmonary sarcoidosis presented with progressive dyspnea and emesis. An electrocardiogram demonstrated complete heart block and he underwent permanent pacemaker implantation. While initially suspicious for cardiac sarcoidosis, cardiac magnetic resonance imaging and pyrophosphate scan were consistent with ATTR amyloidosis, which was treated with tafamidis. DISCUSSION: Sarcoidosis has rarely been found to mimic cardiac amyloidosis in cases of equivocal testing. Pyrophosphate myocardial imaging has been shown to have high sensitivity in the diagnosis of cardiac amyloidosis and may aid in distinguishing pathologies. TAKE-HOME MESSAGES: While cardiac sarcoidosis should be suspected in patients with known extra-cardiac sarcoidosis who develop cardiac dysfunction or conduction disease, other infiltrative conditions, including amyloidosis, must also be considered. Multimodality imaging has an important role in diagnosis of cardiac amyloidosis.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".