Misinformation regarding “cough CPR” has been prevalent on social media for quite some time, with many erroneously suggesting that forceful coughing can help during a heart attack. Medical professionals are eager to correct this belief and emphasize that this method is not effective. Dr. Bryn Elissa Mumma, a professor in emergency medicine at UC Davis Health in Sacramento, California, stressed the importance of seeking immediate medical attention when experiencing chest pain or symptoms of a heart attack. “The safest way to reach a hospital in such situations is to call 911,” she advised.
The term “cough CPR” is misleading, as CPR is intended for individuals who are in cardiac arrest—the condition where the heart stops beating. In such a scenario, coughing is not a viable action, nor can it be classified as CPR. Dr. Mumma clarified that “It physiologically does not make sense,” asserting that coughing would not revive a heart that is no longer beating. Understanding the distinctions between a heart attack and cardiac arrest is critical, as they represent different types of emergencies. A heart attack is due to restricted blood flow to the heart, while cardiac arrest is caused by electrical issues resulting in the heart’s sudden stoppage, and a heart attack can frequently be a precursor to cardiac arrest.
When cardiac arrest occurs, the person loses consciousness and may stop breathing or exhibit gasping. Rapid intervention is essential, as failure to treat cardiac arrest within minutes can lead to death. The misconception surrounding cough CPR may stem from a temporary strategy employed for treating sudden irregular heartbeats in monitored environments, such as cardiac catheterization labs. Dr. Manesh Patel, a distinguished professor of medicine at Duke University School of Medicine, explained that during an arrhythmia, medical professionals might direct patients to cough forcefully to maintain cerebral blood flow for a short time until proper treatment is administered. However, this approach is not universally effective and should not substitute for required medical intervention, as per guidance from the American Heart Association.
Dr. Patel noted that some individuals believe coughing can adjust chest pressure and influence the heart’s function. However, he clarified that coughing has not been shown to make such impacts. “If someone has lost a pulse, we know that CPR is the necessary course of action,” Patel emphasized. Dr. Mumma, who played a role in updating the American Heart Association’s advanced life support guidelines in 2023, pointed out that a review of literature during this process found no valid research supporting cough CPR. “Clearly, it’s not something recommended in those guidelines due to the lack of evidence,” she stated.
In cases of cardiac arrest, it is crucial to call 911 immediately and perform hands-only CPR, as advised by Dr. Mumma. She recommends placing the heel of one hand in the center of the victim’s chest at the nipple line, placing the other hand on top, interlocking fingers, and then pressing down hard at a pace between 100 and 120 compressions per minute. Additionally, if an automated external defibrillator (AED) is accessible, it should be used right away. Even without training, bystanders can utilize the AED by following the voice instructions it provides.
Given that a heart attack can potentially lead to cardiac arrest, medical experts underscore the importance of calling 911 when experiencing symptoms like chest pain, jaw pain, shortness of breath, nausea, and sweating. Once help is on the way, it’s advisable to remain still and avoid any strenuous activity. Dr. Mumma mentioned that aspirin could be beneficial for individuals who are not allergic to it, and those with nitroglycerin prescriptions for chest pain should take their medication. However, both experts agree on one critical point: coughing is not necessary.
