Refractory Coronary Vasospasms in a Patient With Eosinophilic Granulomatosis With Polyangiitis
Bibliographic record
Abstract
BACKGROUND: Coronary vasospasms refractory to calcium channel blockers and nitrates may be secondary to a systemic process. Although rare, eosinophilic granulomatosis with polyangiitis (EGPA) can cause coronary vasospasms. CASE SUMMARY: A 33-year-old woman presented with recurrent chest pain leading to multiple episodes of cardiac arrest. Rising eosinophilia and coronary intimal thickening were noted, and cardiac magnetic resonance imaging showed scarring. Owing to the high index of suspicion for EGPA, she was started on steroid therapy and cyclophosphamide. With this treatment, she had no further episodes of cardiac symptoms. DISCUSSION: Cardiac involvement in EGPA is rare and carries a poor prognosis. The most common cardiac manifestations are congestive heart failure, pericarditis, myocarditis, and arrhythmias. TAKE-HOME MESSAGES: EGPA should be considered in the differential diagnosis for patients with refractory coronary vasospasms and eosinophilia >10%. EGPA cannot be ruled out solely based on the absence of antineutrophil cytoplasmic antibodies, particularly in patients with cardiac involvement.
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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 | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 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".