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

A 36-year-old man was admitted to the intensive care unit with an acute exacerbation of chronic heart failure. His medical history included heart failure with an ejection fraction of 20% bioprosthetic aortic-valve replacement for bicuspid aortic stenosis

Measuring six inched in length, the clot maps out a near-perfect map of the right bronchial system of the lung.

"A 36-year-old man was admitted to the ICU with an acute exacerbation of chronic heart failure".

On Monday, the New England Journal of Medicine tweeted a startling picture as part of its "Images in Clinical Medicine" photo series, which features photos of medical anomalies.

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).

A man who went into the hospital with heart problems ended up literally coughing up a lung. "We were astonished", Wieselthaler told The Atlantic.

"You have high turbulence inside the pumps, and that can cause clots to form inside", Dr Georg Wieselthaler said.

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While you can't actually cough up a whole human lung (you'll probably be slightly relieved to hear), as they're too large to fit through the trachea, you can apparently cough so violently that parts of your lung pop through the spaces between ribs.

It's less rare for patients to cough up bronchial "casts" made of other substances, such as lymph or mucus.

Dr Wieselthaler carefully spread out the coughed-up clot, realising it was the ideal shape. "It's a curiosity you can't imagine-I mean, this is very, very, very rare". The fact the clot came out intact and not in pieces is even more unusual.

Fibrinogen is a type of protein in the blood that works to glue platelets together.

After coughing up the bronchial tree, doctors immediately intubated him and performed a bronchoscopy, but he later died from heart failure complications ('volume overload and poor cardiac output'), despite the placement of the ventricular assist device.

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.

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