Conspiracy Theory Heart Attacks

Heart AttackIn previous blogs (here and here) I’ve discussed how to construct a murder plot using a drug or medical device that could mimic a heart attack that would be virtually undetectable as a murder—the so-called perfect murder weapon!

But there is yet another equally clever drug (two actually) that can create lethal cardiac events while remaining delightfully elusive to the medical examiner.

Calcium Gluconate is a very useful drug to counteract the effects ofIVBag hyperkalemia (too much potassium in the body) that can produce heart arrhythmias. Calcium gluconate is available as a sterile solution that’s given intravenously. It’s also used to counteract an overdose of Epson Salts (magnesium sulfate).

Too much injected calcium gluconate, however, initiates lethal electrolytic imbalances that disrupt the normal levels of sodium, potassium and chloride in the body’s cells. These electrolyte imbalances interfere with and slow the heart to dangerously low levels, eventually creating a heart attack. It should be noted that a lethal dose of calcium gluconate can only be achieved with the injectable form since an oral dose is absorbed much too slowly.

sweatingThe initial symptoms of a toxic dose of calcium gluconate include skin redness or flushing, a sensation of warmth or heat with a possible rash, sweating, nausea and vomiting, a tingling sensation, and an irregular and slow heartbeat.

The impatient murderer might even add a second injection—potassium phosphate. By doing so, the calcium and phosphate in these solutions will interact and form an insoluble bond that creates what’s known as an aggregate anaphylaxis—severe hypertension and right ventricular heart failure. A hint to the murder mystery writer: When calcium gluconate and potassium phosphate solutions are mixed together, they form an insoluble precipitant. Therefore, they must be injected separately to prevent precipitate formation until they’re in the victim’s bloodstream.

When I was a clinical pharmacist, I formulated and prepared intravenousTPN solutions feeding solutions for patients who could not tolerate oral nutrition. I had to make sure that the calcium gluconate and potassium phosphate solutions remained separated by mixing in the calcium gluconate solution as one of the FIRST ingredients and adding the potassium phosphate solution as one of the LAST ingredients so that each was dilute enough in the total mixture so as not to interact and form an insoluble complex that would harm my patients.

Thoughts? Comments? I’d love to hear them!

About James J. Murray, Fiction Writer

With experience in both pharmaceutical manufacturing and clinical patient management, medications and their impact on one’s quality of life have been my expertise. My secret passion of murder and mayhem, however, is a whole other matter. I’ve always loved reading murder mysteries and thrillers, and longed to weave such tales of my own. Drawing on my clinical expertise as a pharmacist and my infatuation with the lethal effects of drugs, my tales of murder, mayhem and medicine will have you looking over your shoulder and suspicious of anything in your medicine cabinet.
This entry was posted in A How To Blog on Murder Plot Ideas, A How To Blog on Murder Weapons, About James J. Murray, About Medications/Pharmacy, About Murder, About Writing, Aggregate Anaphylaxis, Blog Writers, Blogging, Bloodless Death Scene Writing, Calcium Gluconate and Heart Attacks, Calcium Gluconate and Murder, Chemical Poisons, Chemicals Used For Murder, Designer Drug Deaths, Designing Murder Plots, Dramatic Murder Weapons, Drugs Used to Murder, Electrolyte Imbalances and Heart Attacks, How to Choose a Murder Weapon for a Plot Idea, How To Write A BloodLess Murder Scene, Ideas for Murder Scenes, Instruments of Death, James J. Murray Blog, Killing Off Characters in Writing, Lethal Agents and Murder, Lethal Chemicals in Murder Mysteries, Murder Mayhem and Medicine, Murder Weapons Discussed, New Blog, New Methods of Murder, New Methods To Kill Characters in Your Novel, Pharmacy/Pharmaceuticals, Plotting Murder Scenes, Prescription For Murder Blog, The Art of Storytelling, the perfect murder weapon, The Science of Murder, Tools of Murder, Unique Murder Plots, Unique Murder Weapons, Ways to Murder, Writing Death Scenes and tagged , , , , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.

8 Responses to Conspiracy Theory Heart Attacks

  1. sciencethriller says:

    I swear you are starting to scare me…

  2. Dan Van Oss says:

    Thanks for this post! I’m working on a thriller where I need to kill off the bad guy without leaving a trace. I’m thinking of a fictional scenario where the victim is (unknown to him) given a steady dose of one chemical for a week or so, then given a second “catalyst” chemical at the time that the good guy wants him to die, causing an untraceable heart attack. (Just typing that sounds creepy.)

    • Lol – That’s what happens sometimes when we authors start to develop our plot outlines. Sometimes I scare my wife when I tell her about an idea. Your murder plot sounds very interesting and the best of luck as it evolves. Thanks for your comments and all the best in your writing.

  3. Rob Innes says:

    Ok…so save me here before I get too far into a plot that I then have to drastically change.

    You’re saying there’s absolutely no way that either of these ‘heart attack causing’ drugs could be unknowingly orally administered so as to cause an untraceable cardiac arrest? It absolutely HAS to be injected?
    I don’t suppose you’re a follower of the suspension of disbelief activity? :/

    • Hi Rob:
      Sorry to send bad news to you, but it’s next to impossible for someone to ingest so much calcium gluconate to be fatal. Fortunately for all of us, our digestive systems tend to prevent absorption of overdose quantities of elements like calcium and potassium. That’s why I always speak of injecting these substances – to bypass the digestive system. And the calcium-phosphate aggregate happens when both a calcium (like calcium gluconate) solution mixes with a phosphate (like potassium phosphate) solution.
      Oral doses might possibly cause some readers to question the validity of your plot. I always try to think of fiction writing as a “believable lie” – that you must start with a truth and expand on the known facts.
      Thanks for reading my blogs and for your question.
      All the best in creating the perfect murder plot.

  4. The issue also works in reverse. A heart attack can cause metabolic artifacts that cross-react with cyanide reagents, indicating a cyanide poisoning when none actually existed. I know of six deaths including three wrongful convictions that were wrongly assigned as cyanide poisonings, but which were simple false positives caused by heart attack.

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