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A 36-year-old man died from chronic heart failure, a week after coughing up a blood clot that had the shape of a part of his lung.
The unidentified man was admitted to the intensive care unit of the University of California San Francisco Medical Center, as per a New England Journal of Medicine article on Nov. 29.
His medical history included heart failure, endovascular stenting of an aortic aneurysm and a placement of a permanent pacemaker for complete heart block, among others.
During his hospitalization, the man started to cough up phlegm and blood, and at one point it had the shape of the “intact cast of the right bronchial tree.”
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. After he was extubated two days later, he had no further signs of coughing up blood.
Image: Screenshot from www.nejm.org
However, he died a week later from complications of heart failure—volume overload and poor cardiac output—the article said.
The University of California at San Francisco transplant and pulmonary surgeon Georg Wieselthaler said he and his team were “astonished” when they saw the bronchial tree-shaped blood clot. “It’s a curiosity you can’t imagine—I mean, this is very, very, very rare,” he said in a The Atlantic report.
Meanwhile, Wieselthaler’s fellow in the thoracic-surgery department, Gavitt Woodard, took the photo of the clot. He suggested that its size may be the reason why the patient coughed it up. “[B]ecause it was so large, he was able to generate enough force from an entire right side of his thorax to push this up and out,” she said in the report. Katrina Hallare /ra
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