Weird Ironman (movie) question

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Darius Alucard

Sr Member
...unless you're John Connor, then you CAN have a heart transplant performed, outside, in the middle of the desert, with no anti-rejection medication, from an incompatible cyborg donor, and you will live.


:lol

Nobody is ever gonna let McG or the writers live that one down!
 

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Shade

Well-Known Member
It was never meant to be looked at scientifically as blewis17 so rightly put, its pure fantasy and couldn't happen in the BEST of circumstances. There might be one way you could actually have one installed IN YOU and it would require extreme surgery which would result in the metal tube being glued to the remains of the sternum and severed ribs with your lungs and heart carefully shifted to allow the tube to sit in the center of your chest. Even then, it would do NOTHING and in all reality, your chest would probably never fully recover from surgery making you impaired for the rest of your natural life. Great way to die eh? That's why it's called SCIENCE FICTION
 

Wes R

Legendary Member
And people thought it was improbable back in the 60s that he had to wear that life support vest/plate under his clothes as his pacemaker lol. That actually has less issues than this when you think about it.
 

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RobI

Well-Known Member
RPF PREMIUM MEMBER
Tony's chest must be the Tardis or something, to have that much room in there!

So true. This has bugged me since I first saw that scene.

Lest we all forget the 1/2" or so end of the 'pipe' sticking out of his chest. Couldn't he had ground that down just a bit?
 

pengbuzz

Well-Known Member
Yeah, I wondered about all this as well. But it was keeping me up nights so I said the heck with it and switched to Captain America instead...
 

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CaptainPanda3

New Member
In real life coronary artery bypass surgery the most common method of accessing the heart is with a median sternotomy. This is when they cut vertically through the center of the sternum and then use a spreader to open up the chest cavity. In normal cases the sternum will heal enough to not cause pain within a couple of months, and within a year return to full strength.

However this depends on the strength of the person's immune system. In some cases either an inability of the body to properly heal the sternum or other cases an infection of the bones in the sternum itself at the site of incision will create the need for a full sternum removal. The rib cage is anchored to your spine, not your sternum. What the sternum is in the body for is to provide a rigid support for chest muscles, breathing and any type of physical exertion, without that very strong bone in the center of the chest the rib cage moves more, and organs can also shift. A common complaint of people who have had a sternum removal the feeling of their heart moving around in their chest - because it actually is. While it doesn't affect the ability of the heart to function - it moving around - at least not under strain.

The point I am making is that people can live relatively normal lives without a sternum, now physical exertion of almost any kind will become a problem - something as simple as pushing a hand lawn mower could cause rib damage. I said the heart would not function abnormally if it moved around and that is true at a resting heart beat, any heavy cardiovascular activity could cause problems with the heart beat.

****************

Okay so now that I've established that I can get to what this has to do with Iron Man. So Tony is brought to the cave and is injured from the explosion, he has an erratic heart-beat and is unconscious. Yinsen assumes that the reason his pulse is not normal is because he is in shock from the shrapnel. He starts removing the shrapnel and but Tony goes into cardiac arrest. Yinsen does not have any modern medical equipment at his disposal such as a defibrillator. He tries to use regular CPR to revive Tony but is unable to with brain death imminent he does the only thing he can do - he splits open Tony's chest with a saw and some pliers, and pumps his heart with his bare hands. Once it starts beating a bit he shocks it with the car battery to return normal rhythm. While he now has Tony's chest open he is able to see that there is shrapnel in his heart.

blewis17 says that any shrapnel would have to go into Tony's lungs to reach the heart, and that the only way his heart could be damaged is by first damaging the pericardium and then the atria or ventricles. Some basic human anatomy here.

BLW_Human_Anatomy.jpg

The heart is located pretty much dead-center of the chest, and slightly to the left. It is NOT behind the lungs, it is between them. If it was behind the lungs CPR would not work to restart the heart. So no, Tony's lungs DO NOT need to be damaged at all for his heart to be hit by shrapnel.

The pericardium filling with blood or being damaged is also not the only option. The pericardium only protects the atria, ventricles and the roots of the great vessels. However the superior vena cava and ascending aorta are very much exposed. See this picture.

800px-Slide5wwww.JPG

Its very possible for shrapnel to have damaged this part of Tony's heart.

Now back to Yinsen in the cave. Again due to his lack of advanced medical equipment he does not have the ability to surgically remove the shrapnel from Tony's damaged superior vena cava or ascending aorta. Again given the frantic and makeshift nature that a medical procedure like heart surgery in a cave can cause Yinsen is forced to improvise. What he comes up with is likely the only option he had - if he cannot remove the shrapnel he can at least use a magnet to stop it from moving further into Tony's heart or bloodstream. He removes Tony's sternum and installs the magnetic/metal cylinder. Tony's heart is moved up and back and the wounds sewn up. There is more room above and behind the heart than you may think, its possible, albeit highly unlikely that it could still function if moved out of normal position to make room for the cylinder.

The fact is that Tony could not have survived that type of medical trauma without blood infusions and proper antibiotics and pain medication for recovery. However everything else about the situation is not that far fetched and can clearly be rooted in medical fact. Its a comic book character in a comic book movie, there cannot be a reasonable explanation for everything. Is there a chance he could survive open chest surgery in a cave with no antibiotics and no pain killers? Yes, a one in a billion chance maybe, but nothing more than that. Some thing we just have to take at face value. But I think my post explains as best as is possible just how - in theory at least, an electromagnet through his sternum could have saved his life.
 

dascoyne

Master Member
In real life coronary artery bypass surgery the most common method of accessing the heart is with a median sternotomy. This is when they cut vertically through the center of the sternum and then use a spreader to open up the chest cavity. In normal cases the sternum will heal enough to not cause pain within a couple of months, and within a year return to full strength.

However this depends on the strength of the person's immune system. In some cases either an inability of the body to properly heal the sternum or other cases an infection of the bones in the sternum itself at the site of incision will create the need for a full sternum removal. The rib cage is anchored to your spine, not your sternum. What the sternum is in the body for is to provide a rigid support for chest muscles, breathing and any type of physical exertion, without that very strong bone in the center of the chest the rib cage moves more, and organs can also shift. A common complaint of people who have had a sternum removal the feeling of their heart moving around in their chest - because it actually is. While it doesn't affect the ability of the heart to function - it moving around - at least not under strain.

The point I am making is that people can live relatively normal lives without a sternum, now physical exertion of almost any kind will become a problem - something as simple as pushing a hand lawn mower could cause rib damage. I said the heart would not function abnormally if it moved around and that is true at a resting heart beat, any heavy cardiovascular activity could cause problems with the heart beat.

****************

Okay so now that I've established that I can get to what this has to do with Iron Man. So Tony is brought to the cave and is injured from the explosion, he has an erratic heart-beat and is unconscious. Yinsen assumes that the reason his pulse is not normal is because he is in shock from the shrapnel. He starts removing the shrapnel and but Tony goes into cardiac arrest. Yinsen does not have any modern medical equipment at his disposal such as a defibrillator. He tries to use regular CPR to revive Tony but is unable to with brain death imminent he does the only thing he can do - he splits open Tony's chest with a saw and some pliers, and pumps his heart with his bare hands. Once it starts beating a bit he shocks it with the car battery to return normal rhythm. While he now has Tony's chest open he is able to see that there is shrapnel in his heart.

blewis17 says that any shrapnel would have to go into Tony's lungs to reach the heart, and that the only way his heart could be damaged is by first damaging the pericardium and then the atria or ventricles. Some basic human anatomy here.

View attachment 243529

The heart is located pretty much dead-center of the chest, and slightly to the left. It is NOT behind the lungs, it is between them. If it was behind the lungs CPR would not work to restart the heart. So no, Tony's lungs DO NOT need to be damaged at all for his heart to be hit by shrapnel.

The pericardium filling with blood or being damaged is also not the only option. The pericardium only protects the atria, ventricles and the roots of the great vessels. However the superior vena cava and ascending aorta are very much exposed. See this picture.

View attachment 243530

Its very possible for shrapnel to have damaged this part of Tony's heart.

Now back to Yinsen in the cave. Again due to his lack of advanced medical equipment he does not have the ability to surgically remove the shrapnel from Tony's damaged superior vena cava or ascending aorta. Again given the frantic and makeshift nature that a medical procedure like heart surgery in a cave can cause Yinsen is forced to improvise. What he comes up with is likely the only option he had - if he cannot remove the shrapnel he can at least use a magnet to stop it from moving further into Tony's heart or bloodstream. He removes Tony's sternum and installs the magnetic/metal cylinder. Tony's heart is moved up and back and the wounds sewn up. There is more room above and behind the heart than you may think, its possible, albeit highly unlikely that it could still function if moved out of normal position to make room for the cylinder.

The fact is that Tony could not have survived that type of medical trauma without blood infusions and proper antibiotics and pain medication for recovery. However everything else about the situation is not that far fetched and can clearly be rooted in medical fact. Its a comic book character in a comic book movie, there cannot be a reasonable explanation for everything. Is there a chance he could survive open chest surgery in a cave with no antibiotics and no pain killers? Yes, a one in a billion chance maybe, but nothing more than that. Some thing we just have to take at face value. But I think my post explains as best as is possible just how - in theory at least, an electromagnet through his sternum could have saved his life.
I was going to post about partial and total sternal resection may be required in instances of sternal osteomyleitis (e.g. as a complication of surgical sternotomy) or for metastatic disease, but your explanation is quite thorough.
 
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