It isn’t every day that a blood clot goes viral. Not viral in a virus-sense, but viral in getting many, many likes and shares on social media. But that’s what happened with a picture of a blood clot that appeared in the New England Journal and the following Tweet:
A 36-year-old man was admitted to the ICU with an acute exacerbation of chronic #heartfailure. After a ventricular assist device was placed & anticoagulation therapy initiated, hemoptysis developed, and he expectorated a cast of the right bronchial tree. https://t.co/QfqeqwWzXt pic.twitter.com/nXW201rjCT
— NEJM (@NEJM) December 3, 2018
Yes, this whole tree-like blood clot emerged from a 36-year-old patient in one piece. The patient had received blood thinners after having a mechanical heart pump placed in his body. Unfortunately, this resulted in his bleeding into his lung airways and a clot forming inside his right bronchial tree. An “extreme” coughing fit, which may have been an understatement, then brought the entire clot pictured in the Tweet out through his mouth.
What’s striking about this picture is not just how such a large object emerged from his mouth but how the clot so accurately represented the shape of the patient’s the right bronchial tree, the set of airways that branch off the trachea and lead to the three lobes of the right lung. Just read how Gavitt A. Woodard, M.D. and Georg M. Wieselthaler, M.D. from the University of California, San Francisco, described the picture in the Tweet above, “The right bronchial tree consists of three segmental branches in the upper lobe (blue arrows), two segmental branches in the middle lobe (white arrows), and five segmental branches in the lower lobe (black arrows).”
The following illustration gives you a sense of where this right bronchial tree sits:
This picture shows the human respiratory system. (Image: Getty)Getty
Needless to say, if you cough up a blood clot that looks like your bronchial tree, see a doctor immediately. Bleeding that much into your lungs or airways is a life-threatening condition, and unfortunately, the man did not survive. Your lungs have many blood vessels coursing through them because that’s where the red blood cells pick up oxygen and discard carbon dioxide. Therefore, some bleeding could quickly become uh-oh bleeding and result in severe blood loss and even suffocation.
Even much smaller amounts of hemoptysis (the medical term for coughing up blood) can be a sign of serious conditions such as lung cancer, pulmonary embolism, tuberculosis, lupus, or a malformation of blood vessels. Never ignore hemoptysis and don’t “like” it. Tell your doctor instead.