Cardiogenic Shock Patient Found to Have Cardiac Amyloidosis and Concurrent Multiple Myeloma
Bibliographic record
Abstract
BACKGROUND: Cardiac amyloidosis is an under-recognized cause of heart failure. CASE SUMMARY: A 61-year-old man presented with acute decompensated heart failure and cardiogenic shock requiring peripheral venoarterial extracorporeal membrane oxygenation support. Endomyocardial biopsy revealed a diagnosis of light-chain cardiac amyloidosis. Work-up for incidentally noted hypercalcemia also revealed a rare diagnosis of concurrent multiple myeloma. Unfortunately, the patient clinically deteriorated with limited treatment options and ultimately died in hospital. DISCUSSION: We discuss this case in relation to the complexities of recognizing and making a diagnosis of cardiac amyloidosis as well as the atypical presentation with cardiogenic shock and concurrent multiple myeloma. TAKE-HOME MESSAGES: A broad differential diagnosis is required in patients with heart failure and worsening cardiogenic shock, including under-recognized etiologies such as cardiac amyloidosis. Though rare, cardiac amyloidosis can co-occur with multiple myeloma, and making the diagnosis early is important to inform available treatment options.
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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) | 0.000 | 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".