Why 'cough CPR' doesn't work (and what to do instead)

By Genaro C. Armas, ·¬ÇÑÊÓÆµ News

Jolygon/iStock via Getty Images
(Jolygon/iStock via Getty Images)

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Misinformation has circulated for years on social media about how coughing forcefully can treat a heart attack. Health experts are quick to debunk that myth and warn that "cough CPR" is ineffective.

Does cough CPR work?

There is no evidence to support cough CPR as a recommended practice. In fact, a review conducted for the ·¬ÇÑÊÓÆµ's in 2023 did not yield any research about cough CPR.

The term itself is a misnomer because CPR is for someone in cardiac arrest, meaning the heart has stopped beating. At that point, coughing would not be possible, nor would it be considered CPR.

"It physiologically does not make sense," said Dr. Bryn Elissa Mumma, a professor of emergency medicine at UC Davis Health in Sacramento, California. She is a co-author of the 2023 guidelines. "(Coughing) just would not work to restart a heart that's not beating."

The Association does not endorse cough CPR.

Where did the cough CPR come from?

Confusion about cough CPR might be traced to a temporary measure that may be used for a sudden arrhythmia, or abnormal heartbeat, in medical settings in which patients are constantly monitored, such as a cardiac catheterization lab, said Dr. Manesh Patel, distinguished professor of medicine and chief of the cardiology division at the Duke University School of Medicine in Durham, North Carolina.

During a sudden arrhythmia, a doctor or nurse may coach a patient to cough vigorously to maintain enough blood flow to the brain to remain conscious for a few seconds until the arrhythmia is treated. But this technique is not effective in all patients and should not delay definitive treatment, according to the Association.

The misconception about cough CPR and heart attack may be tied to an idea that coughing can change the pressure in the chest, and, in turn, affect the heart, Patel said.

"I think people believe that it is changing, somehow, the heart's squeeze. But (coughing) has not been shown to do that," he added. "If somebody has lost a pulse, we very much know that you have to do CPR."

Heart attack vs. cardiac arrest: What’s the difference?

Heart attack and cardiac arrest are medical emergencies requiring immediate medical treatment, though it is important to note they are two different conditions.

A heart attack is a circulation problem and occurs when blood flow to the heart is blocked. Common warning signs of a heart attack include:

  • Chest discomfort
  • Discomfort in other areas of the body such as the arms, back, neck, jaw or stomach
  • Shortness of breath
  • Other signs such as fatigue, nausea or lightheadedness
A heart attack is a common cause for cardiac arrest.
 
Cardiac arrest is an electrical problem and occurs when the heart suddenly stops beating. Signs that someone is in cardiac arrest include:
  • Sudden collapse
  • Loss of responsiveness
  • No breathing or just gasping
Cardiac arrest can lead to death if not treated within minutes.

What to do if you think you’re having a heart attack

Because a heart attack can lead to a cardiac arrest, experts say it's critical to call 911 when symptoms start. These can include chest pain, jaw pain, shortness of breath, sweating and nausea.

"Anytime anyone is having chest pain or other symptoms of a heart attack, get to a hospital. Calling 911 is the safest way to get to a hospital for chest pain," Mumma said.

After calling 911, sit and rest until the ambulance arrives. "Avoid exertion," she said.

An aspirin may help for those not allergic to it, Mumma said. She also said someone with a prescription for nitroglycerin for chest pain should take the medication.

What to do if someone is in cardiac arrest

If you're around someone who has gone into cardiac arrest, call 911 and start hands-only CPR, Mumma said. This means placing the heel of one hand in the center of the chest at the nipple line. Place the other hand on top and interlock the fingers. Start pushing hard at a rate between 100 and 120 beats per minute.

Get an automated external defibrillator, or AED, if one is close by or send someone to find an AED, Mumma said. People should use an AED as soon as it's available. Even untrained people can use the device by following its voice instructions.

Keep performing CPR and/or following the instructions of the AED and 911 operator until emergency services arrive.

CPR, especially if administered immediately after cardiac arrest, can double or triple a person’s chance of survival.

But one thing you don't need to do, both experts said, is cough.

Want to be ready to help in a cardiac emergency? , AED and first aid skills through the ·¬ÇÑÊÓÆµ. The Association's can help you get a feel for the recommended CPR compression rate of 100-120 beats per minute.

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