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Optional Rule Systems / Called Shots / Called Shot Effects

Heart

Source Ultimate Combat pg. 196
A called shot to the heart represents an attempt at a killing blow. If the hit isn’t either a critical hit or a debilitating blow, the attempt fails and is just a normal hit. A called shot to the heart can be used for any small, likely fatal location on a creature, such as the only weakness on an unimaginably ancient red dragon. Called shots to the heart are challenging (–10 penalty).

Called Shot: A called shot to the heart is just a normal hit with no extra effect.

Critical Called Shot: A critical hit to the heart pierces the organ, causing exhaustion and 1d4 points of Constitution bleed damage. A successful Fortitude save reduces this to fatigue and 1 point of Constitution bleed damage. In either case, stopping the bleeding requires either regeneration (spell or special ability), magic healing that heals as many points of damage (from one or more sources) as the original blow dealt, or a successful DC 20 heal check that takes 1d4 rounds to complete.

A critical hit to the heart against a vampire made with a piercing weapon composed entirely of wood leaves the vampire impaled through the heart by the weapon if it fails its Fortitude save, with effects as described in its Monster entry.

Debilitating Blow: A debilitating blow to the heart destroys it, instantly killing any creature that relies on its heart to survive. Creatures that succeed at a Fortitude save suffer exhaustion and take 1d6 points of Constitution damage and 1d4 points of Constitution bleed damage, as do creatures that can survive without a heart.

A debilitating blow to the heart against a vampire made with a piercing weapon made entirely of wood affects the vampire as a critical hit to the heart; for example, it still receives a Fortitude save to avoid the consequences.