​Man Dies After Coughing Up Lung's Bronchial Tree

A man has died after coughing up part of his lung, according to a report in the New England Journal of Medicine.

The 36-year-old had been admitted to hospital with heart failure, but died during his first week of treatment.

According to the NEJM, he had had a pacemaker fitted due to history of poor cardiovascular health.

The unnamed patient was being treated at the intensive care unit at the University of California San Francisco Medical Centre, which was where reports say he started coughing violently.

Diagram of the lungs. Credit: Wikimedia Commons
Diagram of the lungs. Credit: Wikimedia Commons

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.

He sadly died a week later.

Reports say the man had a rare ejection fraction deficiency (which relates to how much blood is pumped with each contraction), which meant his organ was operating at around 50 percent less than the normal rate.

"His medical history included heart failure with an ejection fraction of 20 percent, 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 NEJM report says.

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

The man coughed up the right bronchial tree. Credit: NEJM
The man coughed up the right bronchial tree. Credit: NEJM

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.

After coughing up the bronchial tree, doctors immediately intubated him and performed a bronchoscopy, but he later died from heart failure complications ('volume overload and poor cardiac output'), despite the placement of the ventricular assist device.

While you can't actually cough up a whole human lung (you'll probably be slightly relieved to hear), as they're too large to fit through the trachea, you can apparently cough so violently that parts of your lung pop through the spaces between ribs.

It is also possible to cough up parts of the lung - as proven by this case, in which the man coughed up the right bronchial tree, which consists of three segmental branches in the upper lobe (as shown by the blue arrows above), two segmental branches in the middle lobe (as shown by the white arrows) and five segmental branches in the lower lobe (as shown by the black arrows).

Featured Image Credit: Google Maps

Jess Hardiman

Jess Hardiman is a journalist who graduated from Manchester University with a BA in Film Studies, English Language and Literature, and has previously worked for Time Out and The Skinny among others.

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