If someone showed you the above picture without context, you would probably think it was an intact blood vessel. Reader,…
If someone showed you the above picture without context, you would probably think it was an intact blood vessel. Reader, it is not. It is a perfect casting of branching airways in the right lung of a man who dies of heart failure, formed from coagulated blood that had accumulated there.
Human doctors were absolutely gobsmacked by what they published in the New England Journal of Medicine .
Let’s first get a thing ready. It’s not part of his lung, as some news headlines claim. It is not possible to cough up a lung (although you can cough so hard, lungs herniate through your ribs. It’s not fun, so try to avoid it).
The fact is that bronchial plugs – called casting ̵
1; are not uncommon at all. Several blood clots have been reported in recent years – coughed by a 57-year-old woman with lupus 2010, a 25-year-old pregnant woman in 2005 and an 80-year-old man in 2015.
And if you move on to the medical image section’s social network Figure 1 and look for “bronchial casting”, you will see a variety of molds made of coagulated blood or from mucus that accumulate in the lungs in some medical conditions.
What makes this casting so exciting is not that it happened at all, but it’s absolutely huge – and the patient coughed it in one piece without breaking.
“We were surprised, “said Dr. Georg Wieselthaler, the man The Atlantic . “It’s a curiosity you can not imagine – I mean this is very, very rare.”
The patient, an anonymous 36-year-old man, coughed up as he was treated for acute end-stage heart failure in the ICU after a long history of heart failure.
His doctor joined his heart into a device to help pump blood around the body. However, as these devices can also cause blood clots, they must give him a continuous infusion of an anticoagulant called heparin to try to prevent this from occurring.
In addition to coagulation, an essential part of the body’s self-repair system is working to keep blood vessels from developing small tears that will lead to internal bleeding – or if they occur in the blood vessels that carry blood around the lungs from leaking into the airways and accumulate where.
Unfortunately, this is what happened to the patient. During the week after his doctor completed the Impella unit and the treatment with heparin he started coughing smaller blood clots, culminating in an extreme fit of cough during which he assumed a huge mass.
When the doctor developed, they saw a casting so perfect that they could clearly identify it as human’s correct bronchial tree.
They think that what kept it together could have been a protein called fibrinogen, which is crucial to the coagulation process. Although the patient was on anticoagulants, his infection caused an elevated level of fibrinogen in his blood – it could have kept clotting together as he coughed it up.
Unfortunately, although he felt better after the coagulum was out of his lungs, and did not cough any additional blood clots, his heart’s condition was too difficult. He died just over a week later from complications of heart failure.
The case was reported in the New England Journal of Medicine .