This question was posed to me by my Biology teacher:

Consider a hypothetical emergency situation of a person shot by a bullet in the heart. The bullet goes into the body and comes out from it, causing a total of two "holes" in the heart, one each in the "dorsal" as well as "ventral" side of the heart. Blood starts coming out.

Now in an ordinary situation, if the blood continues to flow out, the person will die. But there is a twist, the person has been given an infinite supply of blood from some sort of medical equipment. (Nothing like this actually exists in real life, but you might consider this a "conceptual Biology textbook problem".) The person's heart beats at a normal rate of ~72/second.

Now here is the question :

Considering, the "infinite" supply of blood available, will the person survive?

Will the heart develop some sort of clot or something similar to prevent further leakage of blood, as it forms due the cuts on arms or legs? Is some medical assistance required besides the "infinite" supply of blood?

NOTE : You might make the following assumptions ---

  1. There is no doctor/surgeon to help. Just you and your faithful "machine".

  2. The blood provided by the "machine" is 100% compatible with the blood group of the person.

  3. The "machine" is connected in such a way that after the complete loss of the "original" blood of the person, now the blood provided by "machine" runs in the arteries of the person.

  4. The veins and arteries of the person are 100% OK. The only part affected is the heart "perforated" by the bullet.

  • $\begingroup$ At some point there will be clotting, but if it is fast enough is probably influenced by the size of the bullet holes and the coagulation factors in the infinite blood. $\endgroup$
    – skymningen
    Jan 25 '17 at 10:33
  • $\begingroup$ There are at least three other points to consider. First, you need to make sure the blood is sufficiently loaded with dioxigen and nutrients. Second, the blood pressure must be monitored. Third, your machine has to pump the blood, and not only supply it, since a heart with two holes probably won't do it properly. $\endgroup$
    – Flo
    Jan 25 '17 at 14:10
  • $\begingroup$ Where is this leaked blood going? Is it filling the thorax to interfer with physiological respiration? I say dead. And how does "Life Blood" compare to regular blood? $\endgroup$
    – bpedit
    Jan 25 '17 at 18:03
  • 1
    $\begingroup$ What about the pneumothorax from the GSW? $\endgroup$
    – kmm
    Jan 25 '17 at 22:06
  • $\begingroup$ @kmm - Hemothorax would be a much greater problem. $\endgroup$ Jan 26 '17 at 23:51

The person cannot survive for long, in spite of the infinite supply of blood.

In real life

There is no blood delivery system that can add blood to the vascular system as fast as it would be lost by two bullet holes in the heart. But I guess that's covered by your conditions.

As mentioned in comments, where would the blood go? Despite a thoracic entry and exit wound, blood volume inside the thorax would not squirt out of those holes fast enough to prevent a life-threatening accumulation of blood which would interfere with expansion of the lungs, so unoxygenated blood = death.


I suspect this is what your teacher was hoping would be the answer. Blood - like most things - will follow the path of least resistance. Which has a higher resistance, the aorta and arteries (if it hit both the right and left ventricles, the pulmonary vasculature as well) supplying life-sustaining blood to vital organs, or two holes? Theoretically, there would be little resistance against blood flow through the holes, so no flow into vasculature means death.

Regarding clotting, nope. Rate of blood flow would preclude a functional clot.

In real life, even with surgeons at the ready, this is a deadly scenario. One hole: doable (depending on the caliber of the bullet); plenty of people have survived this event. Two holes, it would take particular circumstances and would basically be a miracle.

  • $\begingroup$ So does it mean a person shot at point blank range has negligible chances of survival unless something miraculous happens... ???? Also please tell in as few words as possible whether a person can survive a bullet shot in "real life" and my "theoretical question", as your answer seems very ambiguous to me...... $\endgroup$
    – user29365
    Jan 26 '17 at 9:20
  • $\begingroup$ @QUANTUM - I'm sorry the answer is ambiguous to you, but I'm not sure I can be any clearer. It was your scenario, not this new comment, that I answered. Two holes in the ventrical(s) is not a survivable injury unless they are very small and a trauma team is able to operate immediately. $\endgroup$ Jan 26 '17 at 15:13

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