Can Coughing Save Your Life in a Heart Attack?

The Doctors Debate

man coughing Photo©Lisa F. Young

Is there such a thing as self-CPR? According to this viral rumor circulating since 1999, you can save your own life during a heart attack... by coughing. This is disputed by experts with mixed opinions.

The Genesis of Cough-CPR

The message below gives the impression that the technique described was endorsed by Rochester General Hospital and Mended Hearts, Inc., a heart attack victims' support group. It was not. Although the text was first published in a Mended Hearts newsletter, the organization has since retracted it. Rochester General Hospital played no part in the creation or dissemination of the message, nor does it endorse its contents.

While "cough CPR" (referred to in some variants as "self-CPR") is a real procedure occasionally used in emergency situations under professional supervision, it  is not, however, taught in standard CPR courses, nor do most medical professionals presently recommend it as a "life-saving" measure for people who experience the most common types of heart attack while alone (note: see update below).

Do Doctors Endorse Cough-CPR?

Some doctors say they're aware of the "cough CPR" technique but would only advise it under very specific circumstances. For example, in certain cases where a patient has abnormal heart rhythms, coughing can help normalize them, according to Dr. Stephen Bohan of Brigham and Women's Hospital in Boston. However, most heart attacks are not of this type. Dr. Bohan says the best course of action for a typical heart attack victim is to immediately take an aspirin (which helps dissolve blood clots) and call 911.

This is a case where a nugget of truth has apparently been misunderstood and misrepresented to the public, though not intentionally. A chapter of Mended Hearts published it without proper research. It was then reprinted by other chapters and eventually found its way into email form.

Darla Bonham, the organization's executive director, issued a statement afterward which read, in part:

I've received email from people all across the country wanting to know if it is a valid medically approved procedure. I contacted a scientist on staff with the American Heart Association Emergency Cardiac Care division, and he was able to track a possible source of the information. The information comes from a professional textbook on emergency cardiac care. This procedure is also known as "cough CPR" and is used in emergency situations by professional staff. The American Heart Association does not recommend that the public use this method in a situation where there is no medical supervision.

As with all medical rumors, the most prudent course of action is to verify the information with your own doctor or other medical professional before acting upon it or sharing it with others.

A Second Opinion on Cough-CPR

 In September 2003, four years after this email rumor began circulating, Polish physician Tadeusz Petelenz presented the results of a study which he said demonstrates that cough CPR can indeed save the lives of some heart attack victims. While not immediately embraced by all the members attending the European Society of Cardiology meeting where Petelenz spoke, the findings were characterized by some as "interesting." At least one heart specialist, Dr. Marten Rosenquist of Sweden, found fault with the study, objecting that Petelenz had presented no evidence that the subjects had actually experienced cardiac arythmias. He called for further research.

Sample Email About Cough-CPR attribute to Rochester General Hospital

Here's a forwarded email text on the topic circulated in 1999:

This one is serious...
Let's say you're driving home (alone of course) after an unusually hard day on the job. Not only was the work load extraordinarily heavy, you also had a disagreement with your boss, and no matter how hard you tried he just wouldn't see your side of the situation. You're really upset and the more you think about it the more uptight you become.
All of a sudden you start experiencing severe pain in your chest that starts to radiate out into your arm and up into your jaw. You are only about five miles from the hospital nearest you home; unfortunately you don't know if you'll be able to make it that far.
What can you do? You've been trained in CPR but the guy that taught the course neglected to tell you how to perform it on yourself.
Since many people are alone when they suffer a heart attack, this article seemed in order. Without help, the person whose heart stops beating properly and who begins to feel faint has only about 10 seconds left before losing consciousness. However, these victims can help themselves by coughing repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without letting up until help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating.
The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a phone and, between breaths, call for help.
Tell as many other people as possible about this, it could save their lives!
From Health Cares, Rochester General Hospital via Chapter 240's newsletter AND THE BEAT GOES ON... (reprint from The Mended Hearts, Inc. publication, Heart Response)

Further reading:

Mended Hearts, Inc. Statement
"Despite a contagious rumor, coughing doesn’t prevent a heart attack."

Doctor: Cough CPR Good for Cardiac Arrest
Associated Press, September 2, 2003