Coughing does not protect you during a heart attack

22 December 2023
What was claimed

People who think they are having a heart attack should cough repeatedly and very strongly.

Our verdict

This is incorrect advice. People who think they are having a heart attack should call an ambulance immediately. ‘Cough CPR’ is a longstanding myth that might make someone’s condition worse.

Many posts on Facebook are once again sharing a popular myth that people who think they are having a heart attack should protect themselves by coughing vigorously.

This is not good medical advice. People who think they or someone else is having a heart attack should call the emergency services immediately—on 999 in the UK.

The British Heart Foundation says: “There is no medical evidence to support ‘cough CPR’.”

Resuscitation Council UK calls this “incorrect ‘advice’”, and says: “The majority of people having a heart attack will not suffer a cardiac arrest, and by attempting ‘cough CPR’ they could make their condition worse.”

We have written about this myth twice before.

False information can spread widely on social media and may be harmful if people use it to make decisions about their health. In this case, people might delay treatment or make their condition worse while trying to follow this bad advice.

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What the posts say 

Many of the posts on social media share an identical or very similar passage of text that includes a list of ten points.

The passage begins: “If I’m alone and have a heart attack. What am I gonna do then?”

It then claims to describe “how to survive a heart attack when you're alone”.

In particular, point six says: “You can help yourself by coughing repeatedly and very strongly! Take a deep breath for each cough, and it has to be deep and lingering, like coughing mucus from the bottom of the pelvis. You have to repeat breathing and coughing every second until you get to the hospital or until the heart starts to beat normally.”

The text does not mention calling the emergency services.

At the end, the list claims that “cardiologists say that if anyone who receives this message will send it to 10 people, we can expect to save at least one life”. This may explain why this incorrect advice has been so widely shared.

Similar posts have been shared on the internet since at least 1999.

Resuscitation Council UK says that the myth of “cough CPR” may be loosely based on case reports of people with cardiac arrest who were able to maintain a heartbeat by coughing, under close supervision in hospital.

Real heart attack advice

A heart attack happens when there’s a sudden loss of blood flow to a part of the heart muscle. It can lead to the heart being seriously damaged.

The symptoms of a heart attack vary. They can include sudden pain or discomfort in the chest that doesn’t go away, and this may spread to the arms, neck, jaw, back and stomach. The person may feel sick, sweaty, light-headed or short of breath. Less commonly there may also be a sudden feeling of anxiety or lots of coughing or wheezing.

However it’s possible to have a heart attack without all these symptoms.

The NHS describes the signs of a heart attack as “chest pain, pressure, heaviness, tightness or squeezing across the chest”.

A heart attack is a medical emergency, so if you think you or someone else is having one, the priority is to call 999 for an ambulance immediately.

The Facebook posts also seem to confuse a heart attack and a cardiac arrest. During a heart attack, the person will be in pain but conscious and breathing. In a cardiac arrest, the heart stops suddenly and without warning, leading to the person quickly losing consciousness.

The posts mention CPR, which stands for cardiopulmonary resuscitation, and is used in cases of cardiac arrest to keep the heart pumping blood around the body until emergency help arrives. A heart attack can lead to a cardiac arrest if it goes untreated.

A systematic review of alternative methods of CPR conducted by the University of Warwick and published in February 2021 found that so-called “cough CPR” offered “no benefit in saving lives”.

The British Heart Foundation publishes advice on how to do CPR correctly.

Image courtesy of Giulia Bertelli

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