February 2026
When Trauma Triggers Death in Patients with Pre-Existing Heart Disease
February is American Heart Month, which makes it an appropriate time to revisit a recurring issue in personal injury cases: how pre-existing heart disease is often treated as a stopping point rather than the start of a proper causation analysis.
We recently consulted on a case involving a high-impact auto collision. The client sustained severe traumatic injuries, including multiple rib fractures, leg fractures, and a partially amputated foot. He was airlifted to the hospital and died shortly after arrival in the emergency department.
The county coroner attributed the death to heart failure secondary to severe coronary artery disease, describing the automobile accident as a “possible contributory factor.” That language is common, and it is often where insurers attempt to discount the role of trauma.
From a medical standpoint, this framing is incomplete.
Severe trauma produces an intense physiologic stress response, including a surge of catecholamines (organic compounds, specifically monoamine neurotransmitters and hormones, that play a critical role in the body’s acute "fight-or-flight" stress response). In patients with advanced coronary artery disease, this response can acutely narrow already compromised vessels while increasing myocardial oxygen demand. The result can be sudden cardiac failure that would not have occurred at that time but for the traumatic event.
In this context, heart disease represents vulnerability, not inevitability. The trauma serves as the precipitating event.
This mechanism is well supported in the medical literature, which consistently shows higher mortality rates following major trauma in patients with pre-existing cardiac disease, particularly when multiple cardiac risk factors are present. These deaths are temporally and biologically linked to the traumatic injury rather than occurring independently of it.
As we summarized in our analysis:
Stating that a patient died of heart failure due to coronary artery disease on the day of a massive auto accident is like stating someone died of “lack of oxygen” without mentioning they drowned.
The heart disease was the “water” (the vulnerability), but the auto accident was the “drowning” (the precipitating event).
When a client has underlying heart disease, the key medical question is not whether the disease existed, but whether the trauma triggered the fatal event. That distinction is easiest to establish when it is addressed early, before the medical record collapses causation into a single diagnosis.
This situation is another example of how we can assist you with all the medical issues in your cases and occasionally find previously undiagnosed medical damages.
Let’s Talk About Your Case
Whether you need:
✅ A quick medical read
✅ A focused opinion letter
✅ Or full case strategy support
I’m happy to talk through how we can help.
— Dr. Darshika Goswami, MD
Pacific Northwest MD Legal Consulting
📧 info@pnwmdlegal.com
📞 (503)‑308‑9186