Shot through the heart, is death instantaneous?

Factual Questions
1

I was watching a crime show the other night and a rapist/murderer committed suicide when the cops caught him by shooting himself in the heart while sitting in the front seat of his car. In the reenactment he fell over instantly and when a photo from the actual scene was shown he was slumped over in the same position, as though he didn’t live any time at all after being shot. And I recall seeing videos from time to time where several people are shot simultaneously by a firing squad and they all go limp immediately with no thrashing around or other apparent signs of consciousness or pain, though often an officer will walk along afterward shooting each one in the head to make sure.

So I got to wondering, do people really black out and/or die instantly when they’re shot through the heart? It seems to me that even though the heart has stopped beating, there should still be enough oxygen in the brain to keep the victim conscious for a good minute or two, with brain death not occurring for another eight to ten minutes or so.

So does anyone have any factual knowledge as to what happens when someone is shot through the heart?

2

Well, it sure gives love a bad name.

Seriously, I’ve heard people say that “cardiac arrest” is meaningless as a cause of death, because everyone dies of cardiac arrest. Meaning, the heart is the last organ to stop working. So I would imagine if the heart is the first to stop, death would result either immediately, or in a very few seconds.

3

The brain has about 4 minutes of oxygen, so no, a heart shot isn’t instant death*. In fact, depending where the heart is injured, it’s remotely possible to survive. That would only be if sophicated medical care was immediately at hand.

*I have sad personal knowledge of this. My grandfather shot himself in the heart. I was the first to reach him. He was able to say my name before he died.

4

There’s anecdotal evidence that being beheaded allows for a few moments of consciousness. If you were shot through the heart (or anywhere in the chest) with a very high powered assault rifle, hydrostatic shock turns all your organs to mush. In that respect perhaps the effect of the shot would be something like instant death, or inability to move. As usual though, Hollywood has given us a completely unrealistic perception of death. Dying is never pretty, and is virtually always a painful and somewhat drawn out affair.

5

I nursed a guy who, attempting suicide, shot himself in the heart with a .22 rifle. The bullet lodged in the heart muscle and was only removed sometime later. He survived the whole experience only to quickly die from the undiagnosed cancer that he was suffering from.

Here is another shot in the heart story.

6

From what I’ve read, if the heart completely stops you have maybe 5 to 10 seconds of consciousness, not a minute or two. I forget who it was, but on some famous last words site I read about a man (I think a doctor) who was dying and was checking his pulse. He was conscious long enough to say “it stopped” and then died.

There isn’t just one way to get shot through the heart though. You could get shot by a very large round which may or may not completely obliterate the heart, but one way or another what remains of the heart can no longer effectively pump blood. In this case, if you had a really big hole, the sudden drop in blood pressure could easily cause you to lose consciousness pretty much immediately, much like standing up too quickly can sometimes do the same thing. You wouldn’t be brain dead, but you wouldn’t be conscious either.

You could also get shot through the heart and have the heart continue beating (which I see on preview that don’t ask has already provided a good example of). Maybe your blood pressure would be reduced a bit and you would certainly bleed to death without medical treatment, but some folks have gotten to the hospital in time and have survived a bullet or knife through the heart. It may not be the most likely outcome but it happens.

So you could lose consciousness instantly, or never, or pretty much anywhere in between.

I’ve read a lot of those stories. In fact, I heard something about it on a TV show and thought no way, then jumped on the internet to do some research and that was how I found the Straight Dope way back when. A lot of the stories are exaggerations or complete fabrications written long after the fact. Cecil has one such story in one of his columns. I’m not sure I believe it, but I know better than to argue with Cecil.

7

Well, Trace Adkins was “accidentally” shot through the heart by his second wife. He didn’t press charges. He later became a fairly large country star and has 3 children with his 3rd wife, so I don’t believe it was instantly fatal.

8

This all makes sense. The murderer who shot himself through the heart used a .357 Magnum and the firing squad victims were shot with rifles at close range. I suppose that in the case of these deaths, hydrostatic shock or huge holes resulting in a rapid loss of blood pressure resulted in almost immediate loss of consciousness.

Ten seconds would be a pretty excruciating amount of time to spend conscious with the knowledge and pain involved in knowing that your heart has just been blown to bits, but it’s still less so than a minute or two.

Thanks everyone for your answers, and especially you picunurse. I’m sorry I brought to mind a sad memory and I appreciate very much your willingness to explain what you learned through it anyway.

If anyone else would like to answer, please do so. I may away for the rest of the night though so thanks in advance if you do.

9

Big Mig had a resting heart rate of 28 beats per minute. That means that his heart stopped for a little over two seconds every time it beat. I don’t know if he’s that fit anymore.

So I’d guess that it would be longer than a couple seconds before you lose consciousness.

10

In a firing squad scenario, a shot through the heart with a centerfire rifle would probably cut right through the spine, severing the spinal cord. This might account for the instant slump.

The brain, however, would not instantly cease functioning.

11

Dunno, the only time small-game animals literally drop dead when I shoot them with airguns or arrows is when shot through the heart or straight through the neck, severing the spine. A multitude of other 100% lethal hits leave the target thrashing about for a second or two before expiring.

12

Possibly relevant is the clinical observation that people who experience cardiac syncope (i.e. sudden loss of consciousness due to an abnormal rhythm of the heart) drop instantly. Witnesses will note that the person collapsed in mid-sentence, with no premonitory signs that something was about to happen. Not even for a second. Generally, those who survive such an episode have absolutely no recollection of any sense that they were about to go down.

So, while death (brain death) may take several minutes, loss of consciousness would seem to be immediate when the heart stops.

13

As noted, cardiac injuries are survivable on lucky occasions, so I think your question is more about how instantaneously loss of consciousness and death occur with a sudden loss of perfusion.

In the ED, this is a common occurrence from abnormal rhythms. Perhaps the most common controlled situation is the administration of adenosine, which we give to control certain very rapid heart rhythms. We inject a large bolus into a large arm vein. It takes a few seconds to travel to the heart and then the heart stops beating completely, allowing it to reset. Normally we’ll only see a complete pause (asystole) of at most a few seconds. For those few seconds the patients usually describe a strange sensation, summarized by the phrase “a feeling of impending doom.” It’s not painful, but apparently nerve-wracking.

If asystole or other non-perfusing rhythm (ventricular fibrillation, e.g.) persists more than two or three seconds–at most, five seconds, I’d say–the patient becomes absolutely unconscious, and almost instantaneously. We still have a few minutes to resuscitate them before brain damage occurs. Every ED physician has seen cases where we keep resuscitating a patient’s rhythm long enough to perfuse them and wake them up, followed by a bad rhythm requiring a countershock–sometimes quite a few times. The complaints we get from patients are when the rhythm partially perfuses them (but is still dangerous enough to need a countershock) because they don’t like getting shocked while awake. When the rhythm is completely non-perfusing, they are out like a light instantaneously and don’t complain until they wake up again (a countershock is a little like a horse kick, apparently).

In summary, with a complete loss of cardiac perfusion, you have two or three seconds of normal sensorium followed by a rapid (another two or three seconds at most) total loss of consciousness.

14

I asked my son this very question, since an ancestor of ours was killed near Kabul in Afghanistan, shot through the heart leading a cavalry charge over 130 years ago. My son is an Army surgeon and has served in Iraq and Afghanistan. He replied that with a high powered rifle, hydrostatic shock travels up the great vessels from the heart to the brain and smashes and pulps by massive bruising and death is instantaneousness. A lighter calibre weapon eg. .22 will cause much less of a shock wave. Therefore a firing squad is much faster than lethal injection, but of course messier to clean up.

15

Hydrostatic waves aside, if you tried squeezing your carotid arteries right now, how long before you black out? Don’t be like Vaugn Bodé. Keep your harness well greased.

Now that I mention that, I recall once almost fainting after leaping up off a friends couch. It was 3AM, I’d been asleep laying down. In getting up to use the bathroom, rather than rising normally, I pushed off in one violent motion to standing posture and ran up the staircase to their upper floor. (When nobody is watching, there’s no real need adopt human behavior.) After about three seconds total elapsed time I experienced the typical tunnel vision and roaring noise. Oops. Blood pressure drop! Probably the blood flow to my brain slowed instantly as I stood up, and it took ~3sec before I started losing consciousness.

16

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17

In my psych nursing days I had a patient who shot himself in the heart with a .22 rifle. The bullet lodged in his heart muscle and originally his medical team intended to leave it there, but it was interfering with the electrical signals to his ventricles so it was removed. He seemed to be making a recovery from the shooting and the surgery but ended up dying from cancer of the liver.

18

How much misinformation and speculation can we squeeze into a single GQ thread?

Firstly, there is good research done on the subject of what constitutes an incapacitating shot done by the FBI. It is available online if you want to spend your time looking for it. There are numerous first hand accounts of people shot through the heart who continued to run and fight for several seconds afterwards.

We have literally dozens of examples of people shot through the heart by firing squad who lived for minutes, in one case almost half an hour, afterwards. That these people were shot through the heart can’t be denied because it was confirmed by autopsy. Many of these firing squad subjects either retained or regained consciousness after being shot through the heart. In the British Army, one of the more unpleasant tasks of the officer in charge of the squad was to remain with the body for a minute after the execution. If the person was still alive they were required to deliver the coup de grace with a handgun round to the brain. The pain often caused the person to pass out but they would occasionally regain consciousness fairly rapidly. People breathing and moving after being shot was a normal occurrence and one reason why it was harder to find officer to volunteer for firing squads than enlisted men.

So there is no disputing that being shot through the heart isn’t instantaneously fatal a large proportion of the time.

According to the CIA there are only two ways to instantly take somebody down with a bullet: a hit to the central nervous system or breaking the major leg bones. That is it. Any other wound at all, including heart shots, leaves the target with a very good chance of moving towards you and firing.

Secondly, the concept of hydrostatic shock is still being debated, but most ballistics experts don’t believe it exists to any appreciable degree. The idea of rifle rounds turning organs to mush through hydrostatic shock is simply not true, or at least no evidence of it has ever been found in the real world.

Even if we accept that hydrostatic shock exists, the idea of hydrostatic shock travelling though the blood vessels to the brain and causing brain damage is simply ridiculous. Firstly it would require a round that struck but did not penetrate the ventricle. If it penetrated then any pressure would be dispersed out through the holes, just like the famous strobe photo of an apple being shot. Secondly it would require that the shot hit just as the ventricle was beginning to contract. A hit at any other time would have no fluid to displace. Even if those two highly improbable events did occur, the brain doesn’t have a dedicated blood vessel from the heart. Any pressure increase would be distributed across the entire body, not transmitted ot the brain. The pressure compensation mechanisms that prevent the brain from experiencing excess pressure would easily cope with the tiny fraction of extra pressure that this miracle shot could produce.

250 milliseconds if done correctly. Which has absolutely nothing to do with the subject at hand. Pressure on the carotid sinus causes loss of consciousness though a nervous reflex designed to protect the brain form pressure fluctuation. It occurs regardless of how much or how little blood the brain is actually getting. As such it has absolutely no relevance to this thread.

19

Dr. Vincent DiMiao, in his book Gunshot Wounds, documents a case where a man was shot in the heart at a range of 3-4 ft with a 12ga shotgun firing #7.5 birdshot. The guy’s heart was shredded, but he turned and ran 65 feet before collapsing. If anything is going to stop you in your tracks, you would hope that would be on the list.

Anecdotally, I was at a wound ballistics seminar, and I heard a police officer relate the tale of a suspect who was holding a shotgun on two people. The police sniper fired a .223 bullet that pierced the man’s heart. He was still able to fire the shotgun at one person, rack the slide, and was preparing to fire again when the sniper put a second shot into his head.

20

Shot an small animal in the heart and it pretty much doesn’t move.
Place one shot in the brain and it will flop and bounce for quite a while. Kinda disconcerting when it is a human.

Also, TV does not show the usual bladder and bowl release.
TV does not usually show the live babies spilling from a gut shot mother to be.

One thing you can count on, it will not be as you expect it to be. Takes a while to get callous about it.

YMMV