Firefighters had to rescue a woman who was knocked out when her horse suffered an apparent heart attack, fell on top of her and died.
The woman, believed to be in her late 50s, was found unconscious with her legs trapped at Stoneywell Farm in Longdon, Staffordshire, on Tuesday.
Firefighters from Rugeley and Lichfield used air bags to lift the horse off.
The woman was taken to Selly Oak Hospital in Birmingham by air ambulance with suspected head injuries.
Staffordshire Ambulance Service spokesman Bob Lee said: "She possibly also has leg and internal injuries because of the nature of the incident.
"The horse is believed to have thrown its rider and for some reason fallen onto her."
Staffordshire Fire and Rescue Service were alerted by the ambulance service at about 1145 GMT.