Man coughs up part of lung while being treated for heart failure


The photo was released in late November as part of the New England Journal of Medicine's Images in Clinical Medicine series.

The patient reportedly had a medical history including "heart failure with an ejection fraction of 20 per cent, bioprosthetic aortic-valve replacement for bicuspid aortic stenosis, endovascular stenting of an aortic aneurysm, and placement of a permanent pacemaker for complete heart block".

He had been hooked up to a ventricular assist device - used to help circulate blood around the body - and administered anti-coagulation therapy (blood thinners).

Georg Wieselthaler, a transplant and pulmonary surgeon at the University of California at San Francisco told the Atlantic: "We were astonished".

A 36-year-old man was admitted to the ICU with an acute exacerbation of chronic #heartfailure.

The clot shows the three segmental branches in the upper lobe (white arrows), two segmental branches of the middle lobe (black arrows) and five segmental branches of the lower lobe (blue arrows), the NEJM said.

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During the week of his hospitalization the man's cough reportedly progressed to coughing up blood and phlegm.

His trachea was then intubated, with the flexible bronchoscopy revealing a small amount of blood in the basilar branches of the right lower lobe of his lungs.

Doctors working at the hospital said the man instantly felt better after coughing up the clot but the size of it suggested the 36-year-old's condition was severe. But blood is less sticky and sturdy than these other substances, meaning that a cast made of blood is less likely to hold together when coughed up, the Atlantic reported.

More specifically it's a six-inch-wide, unbroken cast of the right bronchial tree, part of the tubular network that distributes air to the lungs.

Sadly, a week after the man coughed up the clot, he died due to complications from heart failure despite being fitted out with the ventricular assistance device.