Cough CPR
Encyclopedia
Cough CPR is a fake resuscitation technique described in an email that began circulating around 1999, in which by coughing and deep breathing every 2 seconds a person suffering a cardiac dysrhythmia
immediately before cardiac arrest
can supposedly keep conscious until help arrives (or until the person can get to the nearest hospital). Cough CPR is most likely a lay interpretation of a "Vagal Maneuver". A vagal maneuver is a technique where a person bears down (as if trying to forcefully pass wind) to stimulate the vagus nerve. This is helpful in cases when a person experiences a dysrhythmia such as Supraventricular Tachycardia (SVT). The vagal nerve stimulation sometimes can slow down the rapid heart rate and convert SVT back to a normal sinus rhythm.
Although the vagal maneuver is in fact taught to doctors, nurses and paramedics, this widely-circulated email confuses the difference between a "heart attack
" and a "cardiac arrest
" and cardiac dysrhythmia. Cough CPR is supposedly intended only for imminent cardiac arrest, yet it would be impossible for anyone to know if cardiac arrest was imminent. Neither the American Heart Association
nor the American Red Cross
endorses cough CPR during a heart attack..
This confusion appears to revolve primarily over the public's failure to discriminate between a heart attack
and cardiac arrest
and cardiac dysrhythmias. A heart attack occurs when an occlusion (e.g. blood clot) of an artery in the heart slowly causes tissue to die. This can result in chest pain and discomfort, and requires immediate medical attention to resolve the occlusion by emergency surgery or cardiac clot-busting drugs
. A cardiac dysrhythmia is primarily an electrical problem within the heart, and is sometimes treated with electrolytes, vagal maneuver, or electrical cardioversion. Many dysrhythmias may herald an impending heart attack.
"Cardiac arrest" occurs when the heart stops beating, usually due to a heart attack, other prior medical condition or disturbance of the heart's electrical system. "Cough CPR" is intended not for a heart attack, but rather, imminent cardiac arrest. The author of the email attests that coughing can increase blood pressure
to the brain, preventing the person from fully arresting, though there is no scientific evidence that increased blood to the brain prevents cardiac arrest. Most people cannot identify when they are about to go into cardiac arrest even if they are monitored by an electrocardiogram
at a hospital. The American Heart Association does not recommend Cough CPR even when a patient is monitored by an electrocardiogram with imminent signs of cardiac arrest.
Many experts are deeply concerned that people experiencing a heart attack may attempt to perform Cough CPR before attempting to call for emergency medical assistance first. The action of coughing itself may worsen myocardial ischemia
and infarction
(i.e. worsen a heart attack) due to the breath holding individuals experience while trying to cough, preventing the inhalation of oxygen.
Cardiac dysrhythmia
Cardiac dysrhythmia is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heart beat may be too fast or too slow, and may be regular or irregular.Some arrhythmias are life-threatening medical emergencies that can result in cardiac...
immediately before cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
can supposedly keep conscious until help arrives (or until the person can get to the nearest hospital). Cough CPR is most likely a lay interpretation of a "Vagal Maneuver". A vagal maneuver is a technique where a person bears down (as if trying to forcefully pass wind) to stimulate the vagus nerve. This is helpful in cases when a person experiences a dysrhythmia such as Supraventricular Tachycardia (SVT). The vagal nerve stimulation sometimes can slow down the rapid heart rate and convert SVT back to a normal sinus rhythm.
Although the vagal maneuver is in fact taught to doctors, nurses and paramedics, this widely-circulated email confuses the difference between a "heart attack
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
" and a "cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
" and cardiac dysrhythmia. Cough CPR is supposedly intended only for imminent cardiac arrest, yet it would be impossible for anyone to know if cardiac arrest was imminent. Neither the American Heart Association
American Heart Association
The American Heart Association is a non-profit organization in the United States that fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke. It is headquartered in Dallas, Texas...
nor the American Red Cross
American Red Cross
The American Red Cross , also known as the American National Red Cross, is a volunteer-led, humanitarian organization that provides emergency assistance, disaster relief and education inside the United States. It is the designated U.S...
endorses cough CPR during a heart attack..
This confusion appears to revolve primarily over the public's failure to discriminate between a heart attack
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
and cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
and cardiac dysrhythmias. A heart attack occurs when an occlusion (e.g. blood clot) of an artery in the heart slowly causes tissue to die. This can result in chest pain and discomfort, and requires immediate medical attention to resolve the occlusion by emergency surgery or cardiac clot-busting drugs
Thrombolysis
Thrombolysis is the breakdown of blood clots by pharmacological means. It is colloquially referred to as clot busting for this reason...
. A cardiac dysrhythmia is primarily an electrical problem within the heart, and is sometimes treated with electrolytes, vagal maneuver, or electrical cardioversion. Many dysrhythmias may herald an impending heart attack.
"Cardiac arrest" occurs when the heart stops beating, usually due to a heart attack, other prior medical condition or disturbance of the heart's electrical system. "Cough CPR" is intended not for a heart attack, but rather, imminent cardiac arrest. The author of the email attests that coughing can increase blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...
to the brain, preventing the person from fully arresting, though there is no scientific evidence that increased blood to the brain prevents cardiac arrest. Most people cannot identify when they are about to go into cardiac arrest even if they are monitored by an electrocardiogram
Electrocardiogram
Electrocardiography is a transthoracic interpretation of the electrical activity of the heart over a period of time, as detected by electrodes attached to the outer surface of the skin and recorded by a device external to the body...
at a hospital. The American Heart Association does not recommend Cough CPR even when a patient is monitored by an electrocardiogram with imminent signs of cardiac arrest.
Many experts are deeply concerned that people experiencing a heart attack may attempt to perform Cough CPR before attempting to call for emergency medical assistance first. The action of coughing itself may worsen myocardial ischemia
Myocardial ischemia
Myocardial ischemia is an imbalance between myocardial oxygen supply and demand. Left untreated, it results in angina pectoris, myocardial stunning, myocardial hibernation, ischemic preconditioning, postconditioning, or under the most severe instances, acute coronary syndrome and myocardial...
and infarction
Infarction
In medicine, infarction refers to tissue death that is caused by a local lack of oxygen due to obstruction of the tissue's blood supply. The resulting lesion is referred to as an infarct.-Causes:...
(i.e. worsen a heart attack) due to the breath holding individuals experience while trying to cough, preventing the inhalation of oxygen.
Chain E-mails
Cough CPR has been the subject of a series of chain email campaigns. These emails are typically of the following format:External links
- Article in CBS News about Cough CPR
- Hoax slayer debunking the legend
- Snopes.com debunking the legend