‘Cough CPR’ is a social media myth

A popular social media post that first surfaced in the ’90s is popping up again. It says that regular and vigorous coughing can keep you alive if you have a heart attack while you’re by yourself.

The theory is that the coughing can change the pressure on your heart to keep it beating until you can get to help. Sounds reasonable, right? There’s one little problem, though: It’s not true. It may even be dangerous. More on that later.

I can see why there may be some confusion.

A patient may be told to cough when there’s a sudden abnormal heartbeat (arrhythmia) during a medical procedure, such as in a cardiac catheterization lab, Dr. Manash Patel of the Duke University School of Medicine told the American Heart Association. “I think people believe that coughing is changing, somehow, the heart's squeeze. But coughing has not been shown to do that,” he said.

It seems to me that people are also confused about what a heart attack is and what cardiac arrest is. A heart attack is the result of a buildup of plaque in the coronary arteries, disrupting the blood flow to the heart and potentially damaging it. Johns Hopkins details the symptoms:

• A feeling of heaviness, tightness, pressure, aching, burning, numbness, fullness, or squeezing. The pain can either last for several minutes, go away, or come back repeatedly.

• Pains in the torso/upper body, including the arms, left shoulder, back, neck, jaw, or stomach

• Difficulty breathing/feeling out of breath

• Sweating or “cold” sweats

• A sense of fullness, indigestion or choking

• Nausea or vomiting

• Lightheadedness, dizziness, feeling like you might faint

• Unexplained tiredness, weakness, extreme weakness (like you can't do easy tasks), or severe anxiety reacting to symptoms

• Rapid or irregular heartbeat

To those I would add feelings of indigestion (especially in women) or just a general feeling that “something’s not right.”

In cardiac arrest, the heart suddenly stops beating, and the patient won’t be conscious to cough — or do anything else. It’s a major medical emergency. If you’re lucky, bystanders will start hands-only CPR or use an AED (automatic external defibrillator) after calling 911. Someone who has cardiac arrest when there’s no help nearby has a poor chance of survival.

So the question remains: What should you do if you feel a heart attack coming on and you’re alone, or, say, driving home from work?

First, because a heart attack can be a prelude to cardiac arrest, immediately call 911 before you call anyone else. Don’t attempt to drive if heart attack symptoms arise. Pull off the road and call 911.

You might be told to stay on the line with the emergency dispatcher, but if you have a second line, call someone to be with you in case your heart attack turns into cardiac arrest.

Next, unlock the door so first responders can get to you. If you’re able to take aspirin, chew two 81-milligram children’s aspirin or one regular aspirin. Aspirin will help keep your platelets from clotting, and chewing them will get the medication into your bloodstream faster.

People with cardiac issues often are prescribed nitroglycerin. If you have some around, place one under your tongue.

Then, and this is a tough one, do your best to stay calm and quiet. Avoid exertion. Take deep, steady breaths. Count slowly to 100 (“one Mississippi, two Mississippi…”). Sit upright with your back supported, or you can lie on the floor or bed with your legs elevated.

Don’t eat or drink anything. You don’t want to risk aspiration if you lose consciousness, and if you need an immediate procedure, such as a catheterization, your stomach should be as empty as possible.

And don’t cough. Johns Hopkins advises: “This probably won't work, and worse still, attempting this technique may put you in more danger. Attempting this procedure on your own can cause you to accidentally work against the rhythm of your heart and make it harder to get oxygen into your blood rather than easier.”

I’ve said it before and I’ll say it again: Dr. Facebook is not the best source of medical advice. Stick with authoritative sources like WebMD, university hospitals and the Centers for Disease Control and Prevention (cdc.gov). And don’t believe everything you read.

• Teri (Dreher) Frykenberg, a registered nurse, board-certified patient advocate, is the founder of www.NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” available on Amazon. Frykenberg offers a free phone consultation to readers. Contact her at Teri@NurseAdvocateEntrepreneur.com.