Vigorous coughing will not save you during a heart attack

A Facebook post which claims that “coughing repeatedly and very vigorously” will help someone survive a heart attack is misleading and could be potentially dangerous, as it could make the condition worse or delay treatment.

Medical advice shared by the British Heart Foundation states: “The absolute priority when you think you or someone else is having a heart attack is to call 999.”

Heart attack symptoms can include chest pain or discomfort (though not always), and pain spreading to the arms, but there are a combination of other signs.

The procedure described in the Facebook post, known as “cough CPR”, has not been endorsed by either the British Heart Foundation or the Resuscitation Council UK (a professional body which trains people in CPR and publishes guidelines on it). Both groups have expressed concern that attempting the technique could delay someone contacting the emergency services. 

The post also fails to understand the difference between a heart attack and a cardiac arrest. A heart attack occurs when the supply of blood to the heart becomes blocked, which can starve it of oxygen potentially causing serious muscle damage. 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. This means a person who has suffered a cardiac arrest will not be able to cough to restart their heart. 

The Resuscitation Council UK 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.”

The British Heart Foundation advises that people going into cardiac arrest will be unconscious, and need actual CPR (and 999 should be called).

A systematic review of alternative methods of CPR conducted by the University of Warwick and published in February 2021 found that while cough CPR misinformation circulates frequently on social media, the technique offered “no benefit in saving lives”.

The review states: “There are periodic stories, often on social media, instructing members of the public to perform cough CPR, in order to ‘survive a heart attack when alone’. 

“In these reports, ‘heart attack’ is used erroneously in place of ‘cardiac arrest’. Indeed, the term ‘cough CPR’ itself is a misnomer as it is a proposed treatment that cannot be carried out once the patient has sustained a cardiac arrest.”

The lead author of the review, Dr Christopher Smith, a Clinical Lecturer at Warwick Medical School said: “Those who have chest pains and are unwell need to seek medical advice without delay. Early intervention by members of the public has the biggest impact on survival.”

You can read the British Heart Foundation’s advice about how to do CPR here.

Cough CPR

The advice given in the Facebook post began circulating as early as 1999 and was the subject of a Snopes fact check that same year. 

As we’ve written before, the Resuscitation Council UK says the rumour is likely “very loosely” based on some academic case reports of people with cardiac arrest who were able to maintain a heartbeat by coughing. Vitally, this was achieved in hospitals “during tests or treatments on the heart in which the person was being monitored closely and supervised by doctors throughout.” It should not be attempted by the public.

According to the American Heart Foundation, coughing may be used in certain supervised settings as a temporary measure to help restore an abnormal heartbeat but it does not endorse the use of the procedure outside of a hospital. 

Image courtesy of Towfiqu Barbhuiya