Last week, I discussed how to handle chest discomfort if it’s far away from expert assistance. Several readers of that post and on Facebook advised me that strenuous and repeated coughing might be utilized. Since the notion has been disseminated across the Internet, I decided to investigate whether there was any basis for it, as best as possible.

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The Premise

The basic idea behind so-called cough CPR, according to my research, is that taking a big breath and then a deep cough can raise your blood pressure for a second or two, allowing more blood to flow to the brain. Also, it is claimed that if your heart rhythm is abnormal, a strong cough may return it to normal by doing the same thing as a Valsalva maneuver (trying to change the pressure in your chest to make your body believe your heart should speed up).

The Problems with the Premise

1. There is a better approach to reduce your blood pressure than taking medication.

A heart attack can cause blood pressure to be extremely low. When this happens, your body has a hard time raising enough blood to your brain and other organs. You may lose consciousness, and vital organs may start to fail. So the first thing you should do if you’re having a heart attack is lay down. This cuts down on how much pressure is required to move that lifesaving blood around.

When driving, one of the most frequent cough CPR instructions I come across on the internet is that you begin to feel chest discomfort, perhaps faint. To me, any time I feel dizzy, I should lie down or at the very least bend over so my head is level with my heart. This way, you don’t need as much blood pressure to get blood to your brain.)

When you’re driving, you can’t lay down. What should I do? Some claim that beginning to cough is a good idea.

Here’s what I would do instead: Remove my coat and turn on my emergency lights right away. If I felt it was safe, I would lie down in the car ( unlocked) or on the ground if there was room. Then I’d call 911. If I couldn’t pull over,

Now, if you figured that out was too hard or too hazardous because of heavy traffic, maybe you could cough a few times, but the most important thing is to stop as soon as possible. The same goes for trails or anywhere else. If your head is higher than your heart and you’re feeling dizzy and your heart is racing, you may faint just by keeping it like that. Coughing isn’t a reliable way to keep from fainting; especially if your head is higher than your heart.

2. Coughing has not been proved to reduce arrhythmias (abnormal heart rhythms).

One of the most common reasons for coughing is to avoid or stop harmful heartbeats. And, in fact, dangerous rhythms are major causes of mortality during and after a heart attack. Ventricular tachycardia is one such rhythm. Only part of your heart continues to pump while you suffer from ventricular tachycardia, and your blood pressure typically drops considerably. Ventricular fibrillation is another scenario. There isn’t a pulse or blood pressure when V-tach occurs; there is no circulation at all. It’s the deadliest issue because it happens in the first hours following a heart attack. V-tach can lead to V-fib, or V-fib may occur spontaneously due to V-tach.

Coughing is said to prevent two heart rhythms, V-tach and V-fib, which are the immediate killers. There’s no proof that it helps or prevents V-tach or V-fib, which are the immediate killers. It’s possible that it aids in relieving symptoms of hyperventilation by allowing pressure to build up in the chest cavity before releasing harmful gases from your lungs.

3. Coughing is not CPR.

Coughing during a heart attack has been dubbed “cough CPR” by some websites. However, a cough could never be used to replace cardiopulmonary resuscitation (CPR).

Consider this. CPR is only used on a person who shows no signs of life. How can you cough when you’re essentially dead?

According to the American Heart Association, cough CPR is worthless. They can only conclude that:

It is possible for a conscious, responsive person to cough vigorously and repeatedly to preserve enough blood flow to the brain in order to remain conscious for a few seconds until the arrhythmia is treated during a cardiac arrest. Increased chest pressure occurs as a result of forceful coughs, which maintains blood flow.

But, after the heart has stopped beating, there may be a few seconds before you lose consciousness. So, what if you start coughing while you’re still conscious? I suppose you could try it, but I don’t see how it will keep the blood flowing to your brain long enough to keep you awake.

What’s the Issue With Trying?

The concern I have is that instead of doing the fundamentals (lying down if you feel faint, immediately calling 911 if available, and taking an aspirin if you have one), people are relying on “cough CPR.” Also shout for help—a person who may be able to perform chest compressions or locate an AED if needed—even if you’re out for assistance (which you may or may not want to do; see this post). If you feel faint while walking for help, lie down.

Then, if you wish, cough; but, if I were in your place, I would do it less frequently. However, I feel that repeating hard coughing, again and again, is going to be stressful and unpleasant enough that it will add stress on the heart and perhaps cause further damage. Because there’s no evidence of intensified breathing helping when you cough, it’s one of those situations where you have to decide based on the circumstances.

Photo by Annie Spratt/Unsplash

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