Published in: Open Access 01-06-2018 | Image Puzzle – Question Cough up your lungs Authors: L. A. J. Rammeloo, N. A. Blom Published in: Netherlands Heart Journal | Issue 6/2018 Login to get access ExcerptAfter 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? Fig. 1 A picture sent by the father showing a expectorated product with a 5 € Cent coin (20 mm) as a size reference × …