Phrase that will stick with me for quite a while from tonight's Twitter perusal: "expectorated a cast of the right bronchial tree." Thanks for sharing, doc.
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://nej.md/2PZu29T pic.twitter.com/nXW201rjCT
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Horror movies are made of these
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I'm going to think about it every time I have a cough.
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I'm RIGHT there WITH ya sister! Holy cats. Can't wait to drop this on my medical laboratory science wife.pic.twitter.com/WzjRmyVlW8
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That is one CRAZY story. I was sure that had been an autopsy finding
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It says he coughed it up
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I know, that’s what’s so crazy about it. I saw the photo before I read the story. But thanks!
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Someone coughed up a smaller cast with a happier outcome (she survived)https://academic.oup.com/ejcts/article/28/3/490/466208 …
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I wonder what that experience is like for the patient
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If I coughed up a model of any part of my bronchial tree I’d probably have a heart attack on the spot lol
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The closest I can imagine, based on my own experience, was expelling what felt like a cast of my sinus a few days after open-heart surgery. Not quite the same, I realize, but still a memorable moment in my recovery.
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Yeah but the coughing though. I mean I can't even imagine. I mean it had to be agonizing in the first place actually dislodging this thing from its mooring. Then additionally your airway is at least partially occluded, plus the gagging. I mean it must be terrifying and agonizing.
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Beyond the obvious incredulous nature of this case, the term ‘cast’ was not something ready on the tip of my tongue. Many questions that would make this an incredible interdisciplinary and IPE teaching case. A literature look pointed me to a similar case of expectoration in 1926.pic.twitter.com/OaIpLOkyQK
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"The incredulous nature of this case" presumably means that the patient exclaimed "Christ Almighty, did I just cough that up???"
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Thank you- I have been looking at my word choice... would prefer ‘extraordinary’ after some reflection- but the personalized way- even better! Incredibly extraordinary and I’m incredulous...still
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I like this one from an asthma pt but yours is a nice colourpic.twitter.com/wglV6LHkOr
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Better out than in.
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