Monday , January 18 2021

One patient tapped this huge blood clot that perfectly reproduces the airways of his lungs



A huge blood clot, squeezed out of a patient, replicates the airways of his lungs

NEJM

A person undergoing treatment for heart failure has suppressed a huge, intact blood clot that forms perfect castings from the air passages of his lungs.

The completeness of the cloth, after it unfolds on a blue medical cloth, stuns the doctors; they could trace the three branches of the upper lobe of the lung, the two branches in the middle lobe and the five branches of the segment at the bottom.

Spanning from about 15 cm to 17 centimeters, it is such a perfect airway that they know exactly where the spot has occurred, the right bronchial tree of the patient's lung.

Although it is called a tree, it is more like roots. Imagine pulling a sturdy dandelion when suddenly the whole complex root system slips out of the ground without breaking the bits.

Instead of the doctors who pull the red bleeding from the lungs of the patient, the man unexpectedly discarded it, as doctors later noted, "During an extreme cough."

The strange excerpt from a medical anomaly spurred two of his doctors at San Francisco University, Gavit Woodard, a chest surgeon, and George Wahlealeer, the cardiohist surgical boss, to write a note on the case published this week in the New England Journal of Medicine.

The response of the public is a mixture of amazement and horror.

Different media reports have distorted the science of it, portraying it as a patient, literally a coughing lung, a common expression of what it feels like to cough a lot.

"The person coughs part of the lungs while healing for heart failure," says a Fox News headline by not noticing or noticing that it's a shedding of the inside of the lung – like pouring concrete into mold and then removing mold , only with blood, not with concrete – was coming out of his mouth, not his lungs.

Daily Mail Online even capitalizes on their misconception in the title: "The man, 36, coughs part of his LUNG," he says.

The complex echo is the place where the blood leaks into the airways of the lungs of the patient and hardens, which is called medical coagulation. Strengthening blood provokes an intense cough to clear them. And clear them.

However, any relief from the productive cough did not last. The patient is already dying of heart failure. Despite his intervention, he died nine days after the clot was thrown away.

Doctors do not identify the patient by name but say they are a 36-year-old man treated in an intensive care unit suffering from chronic heart failure.

He had significant interference, including replacement of aortic valve, aortic aneurysm stent, and a permanent pacemaker implanted for a complete heart block.

The unusual clot is probably explained by the next interference.

Physicians have put in their hearts an impartial Impella aid device through an artery that is a heart pump that temporarily supports the patient by moving the blood through the heart to the other organs in the body. According to the manufacturer's website, this is a treatment intended for "patients without possibility".

Blood clots are a known side effect of the pump.

"It is possible to develop blood clots that can pass through the blood vessels and block the flow of blood to other organs, including lungs, that make breathing difficult," the Impella website says.

To reduce clotting, doctors use a blood thinner called heparin.

Next week, the patient had periodic coughing, haggling of small amounts of blood or blood-stained mucus, doctors write in his published note.

He had more and more breathing problems and needed extra oxygen to make it easier.

"During extreme coughing, the patient spontaneously experienced the intact throat of the right bronchial tree," the doctors wrote.

Tubes and a band used to examine the patient's airways were placed on his throat. Two days later the tubes were pulled out and he had no more bleeding cough, the doctors wrote.

A week later, however, the patient died from complications of heart failure.

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