Saturday , October 23 2021

A Heart Failure Patient Coughs These Blood Clots Actually Formed Like Pulmonary Passage


An almost perfect cast of a coughed right bronchial tree by a patient with internal bleeding due to anticoagulants administered during heart failure treatment.
Photo by Gavitt A. Woodard, M.D. and Georg M. Wieselthaler, M.D. (New England Medical Journal)

As the Atlantic newspaper reported on Thursday, although the coral resembles a root system or some other kind of growth, the photograph above shows a blood clot that is six inches wide in the near-perfect form of the right bronchial tree of a human lung. . What is even more disturbing is the discovery that he was not taken by medical personnel but was coughed by a patient suffering from heart failure.

The photo was released at the end of November as part of the New England Medical Journal's Clinical Medical Series series. The doctors in San Francisco, Gavitt A. Woodard and Georg M. Wieselthaler, wrote at the University of California that they came from a 36-year-old male patient who had long been suffering from chronic heart failure. The patient was reported to have a medical history such as oğu heart failure with an ejection fraction of 20%, bioprosthetic aortic-valve replacement for bicuspid aortic stenosis, endovascular stenting of the aortic aneurysm and permanent pacemaker implantation for the complete heart block Hast. The patient was admitted to the intensive care unit of the hospital, where they connected her to a pump designed to ensure blood circulation throughout her body:

An Impella ventricular support device was inserted for the treatment of acute heart failure and a continuous heparin infusion was initiated for systemic anticoagulation. The following week, the patient had small volume episodes of hemoptysis, increased respiratory distress, and increased use of oxygen (up to 20 liters through a high-flow nasal cannula). During the extreme coughing episode, the patient spontaneously exposed a solid cast of the right bronchial tree.

The patient was then extubated and the doctor wrote that kardiy she did not experience any more episodes of hemoptysis, yerleştiril but after a week, she died of complications of the heart failure (volume overload and poor cardiac output) despite the placement of the ventricular assist device.

According to the Atlantic, Wieselthaler said that with the risk of uncontrolled internal bleeding, the use of the pump requires anticoagulants to ı make blood thinner and prevent clots kullanım. In this case, Wieselthaler appeared in the journal that the blood leaving the heart to store fresh oxygen in the circulatory system appeared to have accumulated in the coagulated right bronchial tree and then removed in a murmur by the patient:

After Wieselthaler and his team carefully assembled and put together this bundle, they found that the architecture of the airlines was so perfectly preserved that they could only describe it as the correct bronchial tree based on the number of branches and their alignment.

Wieselthaler added that there is a high concentration of fibrinogen, a protein in a blood plasma that assists in the formation of clots, making it possible for clots to remain intact rather than distorted. The patient had an infection that both increased heart failure and caused accumulation of fibrinogen in the blood, which resulted in a more rubbery clot and explained to the Atlantic.

Woodard also added to the journal that the size of the clot might have contributed to its launch, as the patient could aks produce enough power from a full portion of the thorax to push it up and out Wood. Iz (Gizmodo has reached Woodard to clear some ongoing questions and we will update this article if we come back.)

Even though it may seem a bit rubbery to deal with someone's medical misfortune, most doctors may not even have the chance to see something like that. Although there were other conditions that could result in bronchial beats, including infections and asthma diseases or lymphatic flow disorders, which could lead to mucus or lymph fluid formation, respectively, Wieselthaler was sure that the magnitude of this was almost unequal.

. We were surprised, W Wieselthaler said of the Atlantic. Merak A curiosity you can't imagine – So, this is very, very rare. “

[New England Journal of Medicine via the Atlantic]
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