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IMAGE PUZZLE – QUESTION

https://doi.org/10.1007/s12471-018-1115-3 Neth Heart J (2018) 26:361

Cough up your lungs

L. A. J. Rammeloo

1

· N. A. Blom

2 Published online: 17 April 2018

© The Author(s) 2018

Question

After a frightening coughing episode, a 5-year-old boy with a congenital heart condition expectorated what is shown in the image sent by his father (Fig. 1). He had no fever or signs of chest infection. What is your diagnosis?

Answer

You will find the answer elsewhere in this issue.

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://

creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

 L. A. J. Rammeloo l.rammeloo@vumc.nl

1 Department of Paediatric Cardiology, VU University Medical Center, Amsterdam, The Netherlands

2 Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands

Fig. 1 A picture sent by the father showing a expectorated product with a 5 C Cent coin (20 mm) as a size reference

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