How Cough CPR Could Endanger Your Life During a Cardiac Emergency

Cardiopulmonary resuscitation (CPR) is a critical lifesaving technique that is widely known and practiced globally to help those experiencing cardiac arrest. However, in recent years, "cough CPR" has become a term of concern. People have been sharing online and through social media that coughing forcefully during a heart attack can potentially prevent the attack or sustain life until professional medical help arrives. This belief, known as "Cough CPR," is dangerous and misleading. This article will address the potential hazards of cough CPR, debunk the myths around it, and provide evidence-based guidance for handling cardiac emergencies.

What is Cough CPR?

Cough CPR is often misunderstood and misrepresented. The premise behind it involves a person experiencing a heart attack or arrhythmia forcibly coughing at regular intervals to maintain blood flow and prevent sudden cardiac arrest. Some online sources suggest that coughing mimics chest compressions, purportedly keeping the heart beating and sustaining circulation until help arrives.

The notion of cough CPR seems logical at first glance, and it is based on the body’s natural reaction to chest pain or irregular heart rhythms. A cough can indeed stimulate a reflex that increases pressure in the chest, which might temporarily stabilize a person’s heart rate or blood pressure. But, herein lies the issue—cough CPR is only applicable in very rare, controlled situations, and its widespread use is not endorsed by medical professionals.

Where Did Cough CPR Come From?

The concept of cough CPR originated from a legitimate medical technique used in clinical settings called the Valsalva maneuver. Cardiologists may instruct patients to cough or bear down forcefully in certain controlled environments, such as during a catheterization procedure or when a patient is undergoing continuous heart monitoring. The purpose of this is to restore normal heart rhythm in patients experiencing certain types of arrhythmias, particularly supraventricular tachycardia (SVT).

In these medical situations, the patient is usually under direct supervision, their heart rhythm is being monitored, and the procedure is performed under very controlled circumstances. The problem arises when people believe that this technique can be applied during a heart attack or cardiac arrest in everyday settings, which is completely inappropriate and potentially dangerous.

The Dangerous Myth of Cough CPR During a heart attack

For starters, a heart attack and a cardiac arrest are two very different conditions, though people often confuse them.

• heart attack (Myocardial Infarction): This occurs when the blood supply to the heart muscle is blocked, usually by a clot or plaque in the coronary artery. It is a circulation problem. Symptoms may include chest pain, discomfort, shortness of breath, and nausea.
• Cardiac Arrest: This is an electrical problem where the heart suddenly stops beating effectively. It can occur due to ventricular fibrillation or other arrhythmias and results in a loss of consciousness and absence of a pulse.

The online myth surrounding cough CPR suggests that a person can keep themselves alive during a heart attack by coughing. This is grossly inaccurate and dangerous because:

1. Cough CPR is not appropriate for heart attacks: A heart attack is not a condition that can be corrected by coughing. The primary treatment for a heart attack is to restore blood flow to the heart, which often requires immediate medical intervention, such as medication or procedures like angioplasty. Encouraging people to delay seeking emergency care while they try to manage their condition with coughing could have fatal consequences.
2. Cough CPR is useless in cardiac arrest: If a person is experiencing a cardiac arrest, they will quickly lose consciousness. A cough requires conscious effort, meaning a person in cardiac arrest cannot perform cough CPR. Even in the moments leading up to cardiac arrest, coughing would not be sufficient to restore the normal heart rhythm.
3. Delay in Emergency Response: Cough CPR creates a dangerous misconception that one can manage a heart attack or impending cardiac arrest on their own. The focus should be on calling emergency services (911 in the U.S., or your local emergency number) and seeking medical assistance as quickly as possible, not on trying to perform a technique that has no proven benefit in such emergencies.
4. Misleading Online Information: Much of the information promoting cough CPR has been propagated through viral email chains and social media posts, lacking credible sources. This information has misled many people into thinking it is a practical and effective technique for cardiac emergencies. However, it has no place in first aid practices, and believing in this misinformation can prevent individuals from seeking the appropriate medical help in time.

What Should Be Done in a Cardiac Emergency?

Understanding the correct steps to take in a cardiac emergency is critical. Let’s break down the appropriate response for both heart attacks and cardiac arrests:

heart attack Response

1. Call for emergency help immediately: This is the single most important step. If you or someone else is experiencing chest pain or other heart attack symptoms, calling an ambulance (911) should be the first response.
2. Take aspirin if recommended: While waiting for medical help, taking aspirin (if available and not contraindicated) can help slow the progression of a clot, as it works to thin the blood. Always ask your doctor ahead of time if this is a good idea in case of an emergency.
3. Stay calm and rest: It’s vital to minimize physical exertion during a heart attack. The person experiencing symptoms should sit down and try to remain calm while awaiting emergency medical services.
4. Follow medical advice: If you’re under medical supervision, follow any instructions your healthcare provider may have given you about what to do if you experience a heart attack.

Cardiac Arrest Response

1. Call 911 immediately: Cardiac arrest is a life-threatening condition, and immediate emergency response is critical.
2. Begin CPR: If the person has no pulse and is unresponsive, initiate chest compressions. This involves pressing down hard and fast on the center of the chest at a rate of about 100-120 compressions per minute. The goal is to manually pump blood through the body to maintain circulation until emergency services arrive or a defibrillator can be used.
3. Use an Automated External Defibrillator (AED): If an AED is available, use it. The device will analyze the heart’s rhythm and, if necessary, deliver a shock to try to restore a normal rhythm.
4. Continue CPR until help arrives: Continue performing chest compressions until emergency personnel take over or the person starts to show signs of life.

The Evidence Against Cough CPR

Several professional organizations have spoken out against cough CPR, warning of its dangers and lack of scientific validity. The American Heart Association (AHA) explicitly states that cough CPR is not useful during a heart attack or cardiac arrest. The organization emphasizes that proper CPR—high-quality chest compressions and, when possible, the use of an AED—is the best course of action when dealing with sudden cardiac arrest.

In a 2010 advisory, the American Heart Association clarified that while cough CPR can be used in a hospital setting under strict medical supervision, it is not applicable to unmonitored, real-life cardiac events outside of that context.

Why the Spread of Misinformation is Dangerous

The spread of misinformation about medical procedures can have serious consequences. In the case of cough CPR, believing in this myth can prevent people from taking lifesaving action during a cardiac event. Social media platforms, emails, and unreliable health blogs often perpetuate myths without verification from medical experts. This is why it is crucial to rely on trusted, verified sources when seeking information about medical emergencies.

If you ever come across someone promoting cough CPR, it’s essential to correct the misinformation and encourage them to seek proper medical guidance. Trusting false techniques like this one can be the difference between life and death.

Conclusion: Stick to Evidence-Based CPR

The dangerous myth of cough CPR underscores the importance of relying on evidence-based medical practices. When someone is experiencing a heart attack or sudden cardiac arrest, quick access to medical intervention and proper CPR techniques are essential. Cough CPR is not a legitimate or safe substitute for these measures and has no place in emergency first aid.

The best course of action in any cardiac emergency is to call 911, administer high-quality chest compressions if necessary, and use an AED if available. These are proven methods that can help save lives, unlike the widely debunked practice of cough CPR.