Shot to the Heart



We've all seen it before. The patient is going into shock, he's losing consciousness! His heart's stopped, and the paddles aren't working. He's not going to make it! Only one thing left to do. Shot to the heart, stat! His heart's beating; he's stabilizing. Crisis averted!

Shot to the Heart is when an injection of adrenaline is administered directly into a patient's heart, usually by a forceful stab. This can be done for a number of reasons, usually to restart a stopped heart or to restore or maintain consciousness. If the injured person is particularly Badass or determined, he may even do it to himself so he can stay conscious long enough to save the day.

The trope was made popular by 1994's Pulp Fiction, when hitman Vincent Vega does it to save the life of Mia Wallace, who has OD'd on heroin and also happens to be his boss's wife. Today it's right up there with a tracheotomy when you need some drama, but in reality, this is a very bad idea and a good way to kill your patient. While epinephrine (adrenaline) is used to treat several ailments from anaphylactic shock to cardiac arrest, no doctor since about 1990 would ever treat a patient by stabbing them in the heart with a giant needle. In the past, an intra-cardiac injection was used very sparingly, but only by trained medical personnel, only if the heart was completely stopped and only if every other option was exhausted. In a modern hospital, if you need a drug to get to the heart quickly, it goes into a vein, with chest compressions used to move the blood in the event of cardiac arrest.

In spite of this, it remains a popular trope, especially in medical dramas and grittier action films, though subversions and lampshade hangings are starting to show up in comedic works.

A subtrope of Artistic License Medicine. See also Instant Drama Just Add Tracheotomy and Magical Defibrillator for similar use of emergency medical procedures for drama.

Anime and Manga

 * While no needle of drugs is involved, a scene very much in the spirit of this trope that is actually more or less medically accurate occurs in the very first chapter of Saijou No Meii. The title character and a friend are out on a fishing boat when the other boy trips and strikes his chest on the prow. Minutes later he's complaining of severe chest pains and collapses on the floor. A quick cellphone call to Saijou's doctor friend has the boy diagnosed with traumatic cardiac tamponade, and a sudden storm blowing in means that the doctor can't make it to them in time, leaving it up to Saijou to take the nearest sharp object and try to pierce his chest to relieve the pressure without stabbing to far and skewering his heart.

Film

 * As shown in the page image, in Pulp Fiction, Vincent does this to Mia, since they don't want a drug lord's wife going to the hospital with an OD. In reality, she almost certainly would have died unless 911 was called. The epinephrine may have restarted her stopped heart, but it would do nothing about the heroin still in her system, she'd probably be tachycardic from the epi, and she'd probably also get an infection from the unsterilized needle in her chest. Not to mention the primary cause of death in a heroin overdose is respiratory failure; the heart only stops when the brain dies due to the lack of oxygen.
 * In The Rock, Nicolas Cage does the self-administered version to counter the effects of poison gas. At least he uses the right drug. Rather than epinephrine, he injects atropine, which along with pralidoxime and possibly diazepam is the correct treatment. Just not directly to the heart.
 * In Get Him to The Greek, Russell Brand injects Jonah Hill's heart with an adrenaline shot. Well, Brand's character tries to do a heart injection, anyway. Being high at the time, he winds up putting the injection somewhere in Jonah Hill's shoulder.
 * In Sherlock Holmes: A Game of Shadows, Holmes invents an epi-pen.
 * Variant: In Breaking Dawn, Edward in an attempt to.
 * After basically falling comatose, Nancy is woken up this way in A Nightmare On Elm Street 2010.
 * Angela kills a police officer this way (the syringe was just filled with air) in Sleepaway Camp III: Teenage Wasteland.

Live Action TV

 * Done twice in the Firefly episode, "Out Of Gas." Simon administers one to Zoe after she's injured in an explosion, and later Mal does it to himself to stay conscious after he is gut-shot.
 * Possibly justified in that Serenity wouldn't have had great medical supplies on hand before the heist in Ariel. Simon may well have exhausted all of his options. As for Mal, he never would have received any sort of medical training beyond basic field medicine so he would have just been copying Simon.
 * Clark does this to Lana in one episode of Smallville.
 * On The Big Bang Theory, Sheldon tries to prank Howard with an Electric Joy Buzzer, but Howard appears to collapse from a heart attack and is instructed to stab a syringe of adrenaline straight through his heart. Of course, it all turns out to be a counter-prank.
 * In the first season finale of Nikita, It was the only way to set her free...
 * Doc Robbins does this in one CSI episode, where a guy revives on his table.
 * Happens in the Stargate SG 1 episode "Avatar," in which Teal'c gets trapped in a virtual reality training program that shocks him every time he dies to increase the realism. The doctor monitoring him has to administer an adrenaline shot when his heart stops after dying for the umpteenth time.
 * House, numerous times.
 * Parodied in Time Gentlemen Please, with a scythe instead of a syringe, and a strong spanish beer for adrenaline.

Music

 * The song "Kickstart My Heart" by Motley Crue was supposedly inspired by Nikki Sixx being revived by an adrenaline shot to the heart after almost dying of a heroin overdose.

Video Games

 * At one point in Modern Warfare 3 you need to press X to do this to Soap.
 * Battlefield Bad Company forgoes the usual Regenerating Health for an auto-injector that refills Marlowe's health when he stabs himself straight in the chest with it. The auto-injector always refills his health to full and replenishes itself after a relatively short time, making it a wonder why medical technology continues to exist in the Bad Company universe.
 * Battlefield: Bad Company 2: Vietnam, instead of giving you a Magical Defibrillator, gives you a mystery syringe full of chemicals capable of reverting cardiac arrest. Given that it's a game, a shot to the big toe is just as effective as a shot to the heart.

Real Life

 * People with beesting allergies generally keep an emergency beesting kit with an epinephrine autoinjector, but it is administered to the thigh or buttock, definitely not into the heart.