Incredible Blood Clot Coughed Up Intact Stumps Doctors

Laverne Higgins
December 8, 2018

This kind of clot isn't unheard of in patients, but what was unusual was how intact it was.

The 36-year-old man was admitted to the intensive care unit at University of California, San Francisco with symptoms of chronic heart failure, and during the next week, had coughed up small amounts of blood and had breathing problems.

Last week, a hospitalized California man coughed up an intact cast of part of his right lung, a colossal blood clot almost six inches wide.

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).

After the patient coughed up the bronchial tree, he was immediately intubated and doctors performed a bronchoscopy.

The patient had a violent coughing fit in hospital a week after surgery to fit him with a pacemaker in case his heart became blocked.

While doctors still aren't 100 per cent sure how the clot stayed completely intact on its way up the man's throat, Dr Wieselthaler suspected it was because the man had more fibrinogen in his blood.

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

"You have high turbulence inside the pumps, and that can cause clots to form inside", Wieselthalers told The Atlantic.

"We were astonished", he said.

The clot shows the three segmental branches in the upper lobe (white arrows), two segmental branches of the middle lobe (black arrows) and five segmental branches of the lower lobe (blue arrows), the NEJM said.

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

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

A 40-year-old woman with asthma presented with a 2-day history of pleuritic pain of acute onset in the right side of the chest.

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