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But it's actually a blood clot, coughed up intact by a patient suffering from heart failure.

The New England Journal of Medicine shares some of the most awesome imagery from the often weird and wonderful field of medicine, but sometimes the content can be simultaneously disgusting and yet mesmerizing.

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 November 29.

During an extreme bout of coughing, the patient spontaneously expectorated an intact cast of the right bronchial tree.

Georg Wieselthaler, a surgeon at the hospital, told The Atlantic that doctors were "astonished" by what they witnessed.

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

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"An Impella ventricular assist device was placed for management of acute heart failure, and a continuous heparin infusion was initiated for systemic anticoagulation".

During one of the coughing fits, the man eventually coughed up a bronchial tree, which is a series of tubes that distribute air from the windpipe to the lungs.

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

However, anticoagulants can cause problems if a breach occurs in the blood-vessel network, which happened in this extraordinary case; blood broke out of the patient's pulmonary network into his lower right lung. But blood is less sticky and sturdy than these other substances, meaning that a cast made of blood is less likely to hold together when coughed up, the Atlantic reported.

One week after extubation, he died from complications of heart failure (volume overload and poor cardiac output) despite placement of the ventricular assist device.

In 2005, a heavily pregnant woman coughed up a similar but smaller bronchial tree clot.


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