It's never enough to kill someone by tearing out their heart. You always, always have to hold it up in front of their eyes as the life goes out of them. Bonus points if the victim doesn't actually die until the heart is destroyed somehow.
While the heart is the most common organ by far, this can be done with almost anything that it will clearly mean certain death to remove.
For bonus points feel free to insert it into the orifice of your choice.note The mouth is popular. Or simply beat them with it.
This trope often turns up among the Mayincatec. For extra creepy factor, add a Beat Still, My Heart effect.
Unmarked spoilers. It's a death trope.
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Anime and Manga
Revy from Black Lagoon threatens to show kid hostage Garcia "the colour of his breakfast" after he throws food at her.
Happens to most of the main cast in Captain Harlock: Endless Odyssey (though they didn't actually lose their hearts, the Big Bad was trying to trick them into making them think it had happened so it could possess their bodies.)
Young assassin Killua from Hunter × Hunter tears a gruesome serial killer's heart out with his bare hand, without spilling any blood for good measure. Somehow, the man doesn't die until Killua has crushed the (still beating) heart in his hand.
This is one of the better examples of "living until the heart is destroyed". Depending on the reader, it's either Narm, nightmarish, or hilarious when said serial killer turns to Killua, motioning in terror to his heart, and basically says, "Hey! Give it back!", before he watches the assassin crush it.
In One Piece we now have Trafalgar Law using his powers to remove the heart of - of all people - Smoker. Yes, that Smoker - the badass that series protagonist Luffy never managed to defeat in a one-on-one. He had his heart taken from him by Law shortly after they started fighting in the form of cube type object with his heart inside flying from his body, leaving a square shaped hole in his chest. Law, annoyed by Smoker's questioning, then coldly quipped to him "I don't have to tell you anything..." before he slumps to the ground, presumably defeated.
This ability allows Law to take the target's heart without killing him, and Smoker eventually gained his back. Presumably this ability was what allowed Law to acquire the one hundred hearts that he sent to the World Government to gain a position among the Seven Warlords of the Sea.
Later on, Nui does this to herself to show Ryuko that like her, she was also infused with Life Fibers at birth.
A Batman villain named Midnight had this as his actually a her gimmick. Everyone in Gotham seemed to be Made of Plasticine in that issue, because he could remove people's hearts just by poking them with his pointed cane. The sheer impossibility of this, coupled with Midnight's Large Ham nature, made him far too Narmy to take seriously.
Near the end of Emperor Joker, The Joker, as a Reality Warper, rips out Superman's heart. Superman survives for minutes, apparently either because of his super-durability or thanks to Joker using his omnipotence for keeping him alive. Supes actually hugged the sun to his chest (he and the Joker were enlarged at the time) to counteract this.
Spider-Man, like many other heroes in Marvel's Mys-Tech Wars miniseries, is killed when he is overpowered by invading demons and his heart is ripped out.
In the Homestuck fanfic "A Wound For Two", Vriska rips out Karkat's heart. Incredibly, he still lives long enough to kiss her (and, it's implied, to be saved through cyber-prostethics).
In the infamously gory My Little Pony: Friendship Is Magic fanfic, "Cupcakes", Pinkie Pie does this to Rainbow Dash's entrails while cheerfully cracking jokes. The fact that the jokes are entirely in-character makes it that much creepier.
The Pony POV Series has this as one of the only ways the Dark World mane cast can actually die, due to having Complete Immortality and their hearts replaced with the Elements of Chaos, the other being destroying their Element (easier said than done). Ironically, the only two its actually happened to ended up surviving. Angry Pie ends up doing it to Twilight, leaving her to die afterwards, but Twilight finds a replacement. Rainbow Dash later inverts this by tearing her own out and showing it to Rarity to shock her out of her self delusion, but puts it back.
It's pretty much routine in any snuff fiction that involves decapitation for the victim (almost Always Female) to be shown her own headless body before she loses consciousness. Usually while someone is still...making use of it.
Ed O'Neill's character suggests that a man who got fired do it to his boss. The man replies that he'd rather file a grievance with his union.
Wayne does it to Cassandra's father in the sequel during a daydream sequence.
Indiana Jones and the Temple of Doom, where the villain famously pulls a man's heart out, leaving the man somehow still alive for several minutes. Then they lower the man into a fire, causing his heart - which is now some distance away - to also burst into flames. It makes very little sense.
Viktor from Underworld doesn't even realise that Selene's swing had hit until she shows him the blade covered in his blood. He then dies.
In Dumb and Dumber, Jim Carrey's character daydreams about fighting the staff of a restaurant, culminating in him ripping the chef's heart out, putting it inside a doggy bag, closing the bag up, and handing it back to the chef just before he falls over.
In Kenneth Branagh's adaptation of Mary Shelley's Frankenstein, the monster does this to Elizabeth, and holds it up to Victor before diving out a window.
The character Frost in From Dusk Till Dawn rips out the heart of one of the vampires, paired with Beat Still, My Heart, after which, Sex Machine kills the vampire by stabbing the heart with a toothpick.
In Last of the Mohicans, the warrior Magua cuts out the heart of Colonel Munro in the midst of a pitched battle.
The single goriest moment of the first Psycho Cop film has this, but it's not saying much.
In The Chronicles of Riddick, the Lord Marshall does this to a Helion Prime native who refuses to convert. Except instead of his heart, he pulls out his soul.
The Toxic Avenger does this sort of thing with various body parts. However, the first and arguably funniest instance occurs in the first movie, in which he grabs a man's arm and rips it off with such ease that the man has time to break out of a grapple and shout a threat to the titular monster before he even realizes his arm is still in Toxie's hand. As soon as he notices, Toxie smacks him to the ground with the disembodied limb.
Braindead : this happens to a victim when the zombies crash the party.
In the film Hannibal, the title character cuts out parts of Ray Liotta's brain and feeds it to him while still alive.
During the climax of RoboCop 2, Murphy defeats the Robocop-ified Cain by detaching the module containing the villain's brain, then smashing it on the ground. The module is still wired up to Robocop 2's cameras, and Cain's Oh Crap expression can be seen on a video screen, confirming he's watching his own brain being spiked.
Perhaps a combination with Hoist by His Own Petard, in The Incredibles, Mr. Incredible tricks the Omnidroid prototype into ripping its own heart out. (Or at least a particular component that stayed lit up red for several seconds after being ripped out).
Iron Man 1: Obadiah Stane pulls out Tony's artificial "heart", the arc reactor, and then taunts the hero while holding it out in front of him.
In the climax of The Woman the feral woman kills Chris by stabbing her hand into his gut, rifling around with his innards, ripping out his heart, and eating it in front of him just before he dies.
Subverted in Crank: High Voltage. While Chelios does wake up during the operation that installs his artificial heart, and see his original heart being examined, he gets up and clobbers the surgeon before his other parts can be fatally removed.
"I think your innards are cut out and shown to you."
"I don't really know. To see if you recognize them, I suppose."
"What... like, 'Yep, that's my kidneys, yep, that's my breakfast'?"
Roger Zelazny's Creatures of Light and Darkness had a very darkly humorous scene in which the god Horus consults a fortune-teller, specifically a reader of entrails. The entrails belong to the fortune-teller's chief rival, who gives accurate predictions while berating the fortune-teller for messing up. (Classic Line: "Those are my entrails! I will not have them misread by a poseur!")
The Big Bad Darken Rahl practices divination by reading the entrails of living humans. If his prisoners won't talk, he can use this as a last resort to get information from them, but can only get one or two words, like a name or the answer to a yes/no question.
In the Ninth Doctor Adventures novel Only Human, the batshit insane villainess removes one of the Doctor's hearts and shows it to him. This actually isn't a problem for him, as said villainess comes from a future where medical science is ridiculously advanced, to the point where they can separate a head from a body without killing the victim, with the two parts still somehow remaining connected. The Doctor is also drugged up with some pretty trippy stuff to the point that he only registers mild discomfort at this. The scene is still strangely horrific, what with the description of the Doctor feeling his insides being mauled about and feeling that he maybe ought to be upset by this.
Non-fatal example in the My Teacher Is an Alien series: Peter undergoes a voluntary surgery to allow the aliens to study his brain, only to wake up and have them off-handedly show him it in a jar, connected back to his body with wires. He's a bit freaked out, but they put it back in shortly thereafter and he's no worse for the wear.
Sam VS Maryann in the season 2 finale. Transformed into a giant bull with enormous horns, he tricks her into coming closer and dropping her guard. As soon as she's close enough, he rips through her body with his horns, shifting back into a human which changes the horn into his arm. He grasps Maryann's black heart while she is still alive. She utters "Was there no God?" before he finally destroys the heart, turning her into a corpse.
Painkiller Jane: In the TV adaptation they quickly show that a neuro who can walk through walls is no Kitty Prydeexpy by having her use her power to kill needlessly.
In a detention-level in Angel, prisoners have their hearts torn out and shown to them regularly (once a day?) by a torture demon. They recover with no ill-effects and almost no memory of the event except a lingering sense of dread about going into the cellar.
Notably, Spike invokes this trope on Lindseywithout even realizing it, as he holds up a human heart from a pile of them and asks whose it is.
In a 3rd Rock from the Sun episode, Sally asked her boyfriend how he would feel if she were suddenly out of his life. When he said he would be unhappy, she asked if it would be like "someone ripped out your heart and showed it to you", to which he replied "well... not showed it to me."
As noted above, ripping the heart out isn't fatal. Destroying the heart afterward is.
A non-fatal example occurs in the Lexx episode "791". The prisoners on the crashed transport have their hearts removed and their bodies put on life support to make sure they can't escape- and to make matters worse, they're fully conscious when their hearts are removed.
In Heroes the legend of Takezo Kensei features a self-inflicted version of this. Kensei learns his sword skills from a dragon, who returns years later to take Kensei's wife as payment. Instead Kensei cuts out his own heart, hands it to the dragon and tells him, "My love is in here. Take it", before dying.
2 Broke Girls. Mentioned metaphorically when Caroline meets David in the episode And the Broken Hearts. He jokingly says she, "tore his heart out and shook it in front of his face."
The Masters Of Horror episode "Imprint". After Christopher shoots Komono through the head in his madness, she picks out a few pieces of her brain in shock before she dies.
One of the many bizarre things you can do in Exalted with high-powered Supernatural Martial Arts is to inflict "Jigsaw Organ Condition" on a person. This will allow you to pull their heart out and show it to them, without this necessarily doing them any permanent harm.
Flavor text for the Netrunner card "Black Dahlia":
She broke my heart - but at least she showed it to me first.
Warhammer 40,000Black Crusade describes a drug that is made from a space marine's organs while he is made to watch. It is never clarified if making him watch actually does anything to the drug itself.
Roboute Guilliman does this to Kor Phaeron as a truly epicShut Up, Hannibal! in the Horus Heresy novel Know No Fear.
In Mortal Kombat, Kano and his various imitators can rip people's hearts out, while they don't directly hold the hearts in front of their victims, they do hold the hearts up for everyone to see (Including the victim, if that particular game makes him fall backward afterwards). Kobra takes it one step further by shoving the heart into the victim's mouth.
In Mortal Kombat 9, Kano's heart rip fatality actually fits the "Show it to 'em" criteria, as he spins them around, so he faces his opponent's back, and then rams his fist through their back and out their chest, clutching their heart in his hand right in front of their face.
One of the many, many over-the-top finishers available in MadWorld. And it's one of the tamer ones.
In Revenant the player's character repeatedly threatens people with the sight of their own organs.
One of the Stealth kills in Legacy of Kain: Blood Omen 2 involves sneaking up behind an enemy, punching through their back, grabbing their heart and pushing it out through the front of their ribcage, where presumably the victim has a good view of it.
Oh, and here's the scene from the movie adaption. In the adaption, it fits better as he doesn't 'forcibly remove' Illya's eyes first.
During the endgame of Dragon Age: Origins, Oghren caps off a surprisingly touching speech (for him, anyway) to the Warden with "Let us show them our hearts, and then show them theirs!"
In the Team Fortress 2 video "Meet the Medic", the Medic has removed the Heavy's heart in order to connect it to a scientific doodad that, in conjunction with a surge from his medigun, can render the Heavy invulnerable. The Heavy is awake the whole time, being kept alive by the running medigunmounted over the operating table. Too bad the Heavy's heart couldn't handle the power and it blew up. The Medic replaced it with a spare Mega-Baboon's heart with the Heavy none the wiser. The Heavy does wonder if he really should be awake during this procedure.
In Serious Sam 3: BFE, you can do this to Beheaded Rocketeers. And then you can toss it at others for an achievement.
M.U.G.E.N has a modified version of Elque, who rips out his opponent's heart, shows it to them, then crushes it as a special finisher.
In Charlie Murder, at later levels you can choose a skill called, appropriately, "Heart Rip". It can only be done as a Finishing Move on especially weakened enemies. During that ability, your character rips out the enemy's heart, shows it to them, and eats it. A later version of the skill eventually provides healing for eating the heart too.
Tex from Red vs. Blue reportedly once beat a man to death with his own skull.
Tucker: Wait a minute, how do you beat someone to death with their own skull? That doesn't seem physically possible. Church: That's exactly what Jimmy kept screaming. Pvt. Jimmy: [in flashback, being beaten to death with his own skull] This doesn't seem physically possible!
Done for comedy in the episode "Roswell That Ends Well". Apparently, Zoidberg has a LOT of redundant organs, as he is able to provide a running commentary on his autopsy, while the doctors take out at least 5 organs and place them aside.
Doctor: One heart.
Zoidberg: Take, I've got four of them!
Zoidberg: Get ready Fry; I'm going to rip your swim bladder out AND SHOW IT TO YOU!
And during a war reenactment:
Darth Trocious: I shall rip out your heart and show it to you! [taps Scruffy with toy lightsaber] It is done!
Danny: I'm gonna shut you down, I'm teaching you a lesson: Rip out your CPU and show it to you still processing!
A Family Guy episode does this as a throw-away gag/Temple of Doom homage: Stewie, annoyed by Meg's interrupting his pre-meal prayer, rips out her heart, turning her into a chanting zombie.
In the Beavis and Butt-Head episode "Tornado", this is what Beavis thinks tornadoes can do to people.
One episode of Xiaolin Showdown showed Past!Good!Chase Young ripping a heart shaped rock out of a golem in one move. The next shot is from the golem's POV, which blurs and dims as it collapses. The only possible way they got away with that is because it was a rock monster rather than a flesh-and-blood human.
Truth in Television (allegedly): Sir Everard Digby, one of Guy Fawkes' gunpowder plotters, was hanged, and then as the story goes, his heart was torn out by the executioner who cried "Here is the heart of a traitor!" The slightly implausible part of the story is that Digby came back to life just long enough to shout "Thou liest!"
This was done in the old-fashioned British execution method known as drawing and quartering, but instead of the heart they did it with the condemned's intestines and "Privy-Members". And set the aforementioned organs on fire as they did so.
MMA fighter Jarrod Wyattapparently ripped out his training partner's heart (along with tongue and most of his face) because he thought Satan was in him after getting high on "mushroom tea". According to the Daily Mail (so take that as you will), Taylor Powell was still alive when the heart came out, so it might fit under here as well.
The Aztecs did this on a daily basis with their captives. They thrust a dagger under the ribs of the victim, yanked their heart out, and held it up as an offering of blood to their gods.
A prisoner named Henri Languille, condemned to the Guillotine, became part of a scientific experiment. Immediately upon decapitation, Dr. Beaurieux took the head and spoke the prisoner's name until the eyes stopped responding and looking in the doctor's eyes. Because no EEG was attached, nobody knows whether it was a conscious mental or unconscious muscle/nerve response. One might assume the prisoner got a glimpse of his own body in those few seconds between being severed and unconsciousness. Since it takes a few seconds for the brain to run out of oxygen after blood flow is cut off (either literally, as in the case of decapitation, or in the form of the heart stopping), it's at least possible that a severed head would be able to see and recognize its own body in that brief time.
Which is why the Guillotine is now considered by many to be an unnecessarily cruel death, despite having been specifically chosen for the opposite purpose: in a search for a painless execution method, it ends up being mentally painful because it's not physically painful enough. Of course, it could be averted by simply, you know, not lifting the head up for everyone to see.
Occasionally, a heart-transplant patient with sufficient scientific and/or morbid curiosity will request, and perhaps even be granted, the chance to see their original heart after their operation.