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Man coughs up a part of his lung after being hospitalised

08 December 2018

Doctors were surprised by the blood clot cast.

The 36-year old man was being treated for a serious heart condition, according to a new report of the case, published November 29 in The New England Journal of Medicine.

Doctors were treating him with oxygen tanks when he had the coughing fit.

After previously coughing up other, smaller blood clots, the man let out a big one, and up came this folded-over clot in the exact shape of his right bronchial tree, one of the primary parts of the lung.

However, anticoagulants can cause problems if a breach occurs in the blood-vessel network, which happened in this extraordinary case; blood broke out of the patient's pulmonary network into his lower right lung.

"We were astonished", Dr. Georg Wieselthaler, a heart and lung surgeon at the University of California, San Francisco (UCSF), who treated the patient, told the Atlantic.

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Wieselthaler called the occurrence "very, very, very rare". And, during a rather extreme hack, he coughed up "an intact cast of the right bronchial tree".

Reports say the man had a rare ejection fraction deficiency (which relates to how much blood is pumped with each contraction), which meant his organ was operating at around 50 percent less than the normal rate.

The patient later died from heart failure complications.

Doctors aren't quite sure how the clot stayed intact while being coughed up, but Dr Wieselthaler suspects it could be due to the patient's higher level of fibringen in his blood, which acts like a glue.

You might think twice about the phrase "cough up a lung" after reading this.

Wieselthaler's colleague, Dr. Gavitt Woodard, a clinical fellow at UCSF, told the Atlantic that one reason they chose to publish the image was to show the "beautiful anatomy of the human body".

Man coughs up a part of his lung after being hospitalised