While being treated in hospital, he started coughing up blood and mucus, which apparently increased the strain on his lungs, and doctors had started treating him with oxygen tanks. His medical history included heart failure with an ejection fraction of 20%, bioprosthetic aortic-valve replacement for bicuspid aortic stenosis, endovascular stenting of an aortic aneurysm, and placement of a permanent pacemaker for complete heart block.
The unidentified 36-year-old man found himself in the intensive care unit at the University of California San Francisco (UCSF) Medical Center late last month for chronic heart failure. But because these machines can also increase the risk of blood clots, he was prescribed a blood-thinner medication.
"During an extreme bout of coughing, the patient spontaneously expectorated an intact cast of the right bronchial tree", the journal explained.
According to a case report from the New England Journal of Medicine published on November 29, during a particularly violent coughing spell, the man coughed up his right bronchial tree - all intact.
"You have high turbulence inside the pumps, and that can cause clots to form inside", Wieselthalers told The Atlantic.
"We were astonished", Dr Wieselthaler said.
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But one man in California shocked his doctors when he coughed up an unusual-looking blood clot: It was in the shape of his lung.
Even though the man had no further episodes of coughing up blood, he unfortunately died a week later from complications of heart failure.
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.
Wieselthaler called the occurrence "very, very, very rare".
The 25-year-old mum went on to recover fully and delivered a healthy, full-term baby soon after.