What Was Justice Scalia’s ‘Shoulder Injury’?

News reports of Supreme Court Justice Antonin Scalia’s death have mentioned that he experienced a “shoulder injury” last week, for which he visited his doctor and had an MRI.

Presidio County Judge Cinderela Guevara, who concluded that Scalia had died of natural causes–without examining him–told WFAA that she had spoken with his personal physician to satisfy any lingering doubts about the reason he died at the Cibolo Creek Ranch Saturday.

“When [the physician] explained [Scalia] had just visited on Wednesday and Thursday and [the doctor] had done an MRI, then I felt comfortable what I knew was going on with him physically,” Guevara said.

The judge said Scalia went to his doctor for a shoulder injury last week, but also suffered from several chronic ailments.

If Scalia had a typical “shoulder injury,” he would be unlikely to have been able to go on a quail hunting trip, in Texas or anywhere. Quail hunting typically involves the use of a shotgun–which, as anyone who has fired one knows, can deliver a nasty shoulder kick. It is possible, then, that Scalia’s shoulder “injury” was not an injury at all, but severe pain–one of the early signs of coronary heart disease, and a possible early warning of a heart attack.

The Department of Health and Human Services warns:

A common symptom of coronary heart disease (CHD) is angina. Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn’t get enough oxygen-rich blood.

Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest.

We do not know whether that was a medically appropriate diagnosis for Scalia, whether his doctor made such a diagnosis, whether further tests were suggested, or whether Scalia chose to decline further tests until his return.

Further details will likely emerge over time. It may be difficult, however, to determine with certainty what took place, given the lingering confusion surrounding Scalia’s passing, and his family’s desire for privacy and dignity.