Man coughs up 'perfect' blood clot

Nora Nguyen
December 8, 2018

Doctors speculated the clot stayed intact due to a higher-than-usual concentration of a particular protein component of blood plasma, caused by the man's infection, which could have made the blood in his airways unusually rubbery.

The mysterious, cherry-red cast resembled a piece of coral, and an image of it has gone viral after appearing in The New England Journal of Medicine.

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

Georg Wieselthaler, a transplant and pulmonary surgeon at UCSF, told the Atlantic his team was easily able to identify the origin of the clot, it was so detailed.

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

According to doctors, the clot was a near ideal cast of the man's right bronchial tree.

"It's a curiosity you can't imagine".

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.

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"We were astonished", Wieselthaler said.

Bronchial tree clots (called casts) are actually relativelycommon but only in extremely rare cases do they emerge in such pristine condition.

Sadly, the patient died a week later from complications of heart failure.

The woman suffered from asthma, and and after two weeks of particularly harsh coughing, herniating her lung so it slipped through her ribs.

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And in the midst of one coughing fit he hawked up a bronchial tree - a series of tubes that distribute air to the lungs.

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