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Fact Check: No, Coughing Is Not As Effective As CPR During Heart Attack

Hyderabad: A Facebook post advising coughing as an emergency CPR (Cardiopulmonary resuscitation) method till medical help arrives is being widely shared on social media.

The viral post reads, "You can help yourself (during a heart attack) 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. Deep breathing makes it possible to get oxygen into the lungs, and the coughing movements strengthen the heart and blood circulation. The pressure on the heart also helps in regaining a normal heartbeat. This way, victims of heart attack can come to the hospital to receive proper care."

NewsMeter found that the claim is misleading.

Firstly, it would not be possible to perform CPR on someone conscious. If you are unconscious and need CPR, you cannot cough because you are unconscious. If you are conscious and can cough, then you do not need CPR. So, calling it a CPR method is highly misleading.

Moreover, heart attack and cardiac arrest are different. Heart attacks occur when the heart's oxygen supply gets cut off, which is usually caused by blockages in the cardiac arteries that feed the heart oxygen-rich blood.

Whereas, a cardiac arrest is when your heart suddenly stops beating and serious irregularity in the heartbeat (arrhythmia) can cause this.

Cleveland Clinic says that cough CPR is an effective way to maintain circulation for a minute or two following cardiac arrest. However, it's not useful for during a heart attack.

According to Heart.Org while experiencing a sudden arrhythmia (abnormal heart rhythm), a conscious, responsive person may be able to cough forcefully and repetitively to maintain enough blood flow to the brain and remain conscious for a few seconds until the arrhythmia is treated. This has been mislabelled 'cough CPR' although it's not a form of traditional resuscitation.

However, UChicago Medicine called out that the idea of cough CPR is only supported by anecdotes and case reports. It further said that simply coughing will not always correct an irregular chaotic rhythm, and it cannot prevent the patient from going into cardiac arrest.

It should be noted that there is no medical evidence to support 'cough CPR', which suggests you can help yourself by coughing vigorously if you think you're having a heart attack.

Further, refuting the claim an article on Heart Matter says, "The 'cough CPR' myth has been circulating the internet for a while now, especially on social media sites such as Facebook. If you come across it, please avoid spreading it any further and consider letting the person who posted it know that there's no truth in it."

We further reached out to Dr S Vijay Mohan, MD, senior consultant physician, Care Hospitals, and the HoD for the Department of Internal Medicine, to debunk the claim.

"Heart attack is always due to reduced blood supply to the heart muscle, what we call a demand/ supply mismatch. The severity of a heart attack depends on the size of the artery occluded and the area of the heart muscle in jeopardy. The treatment includes either blood clot dissolving medicine in the first three hours, i.E. The window period, or doing an angioplasty with a stent. If the level of obstruction is higher, the muscle damage is greater. And this is why 20 per cent of people die in the first couple of hours of chest pain," he said.

"Sometimes, we do CPR when there is sudden cardiac standstill or in case of some cardiac rhythm irregularities. CPR is a cardiac massage that may help some patients with this condition. CPR repeatedly increase the chest pressure to stimulate the heart. Any method that causes pressure on the chest alternately can stimulate the heart, technically. Cough does the same thing but is not as effective as scientific CPR. Even when we give a shock to a patient with cardiac arrest the same principle applies. There is nothing wrong in making someone cough during heart attacks but that is not all that is needed. It may help in restoring the heart rhythm sometimes. It's not a bad idea but taking the patient to a nearby hospital within the window period is vital because time is muscle and heart muscle is life," he added.

I Caught A Heart Attack At 26

by NATASHA COURTENAY-SMITH, Daily Mail

When Dawn Grant fell ill one weekend, she thought she had flu. It turned out she was on the verge of heart failure, caused by a common virus. Here, Dawn, now 28, who lives on the Wirral, tells NATASHA COURTENAY-SMITH her story. . .

Before I became ill, I took life for granted. I was married to John, a supermarket administrator, we had a lovely house and two beautiful children, Kyle, eight and Jemma, five. Aside from smoking occasionally, I looked after myself. I took vitamins, worked out at least four times a week and also took the children swimming and on bike rides.

Then at Easter 1999, I spent three days in bed, coughing and sneezing. But a couple of weeks later, I was still tired and breathless, and I couldn't shake off the cough.

My GP said I had a chest infection and gave me a course of antibiotics, which didn't help. I was eating normally, but I lost a lot of weight. My skin was pale, and my hair looked lank and dry. I was also experiencing mild chest pains.

An X-ray showed my heart was slightly enlarged, and my GP made an appointment for me to see a heart specialist two days later.

The next day, I suddenly started feeling terrible - struggling to breathe and having chest palpitations. As the hours passed, I felt worse and worse - I started sweating and feeling as though I was being crushed.

Then I noticed my hands and face seemed to be swelling up. I looked in the mirror and my face was deadly white. I called John and told him to come home immediately. As soon as he saw me, he said: 'I'm calling an ambulance.'

By the time it arrived, I was gasping for air. I could barely speak and I was bent over double with chest pains.

In the hospital, I was given pure oxygen and sent for another X-ray and a ECG. When the doctors looked at my X-ray, one said: 'This can't be the heart of a 26-year-old - it looks more like the heart of a woman of 80.'

That night, I was sent to the cardiac care unit (CCU) and given high doses of blood-thinning drugs. My mum and John came to see me. John took my hand and said: 'You know, you're really ill.'

Then the doctor came in and said he hadn't wanted to tell me everything in case I couldn't cope with the shock, but that he'd already told John and my mother and they had insisted he tell me.

He said I had dilated cardiomyopathy that was attacking my heart muscles. My heart was functioning at just 10 pc of its normal level, and I was having a massive heart attack. My lungs filling with water were causing the crushing sensations.

I also had a massive blood clot in my left ventricle, one in my leg and another in my lung.

If any of them dislodged and travelled to my brain, it would cause a stroke.

A transplant was out of the question - I was too weak. 'We'll keep you on drugs, but I'm sorry, Dawn, I don't think you're going to survive the weekend.'

When John came back in, I whispered: 'I'm 26, I've got two children, I've got you and I'm not going to die.' John just sat holding me while we sobbed.

All my hopes rested on the drugs to strengthen my heart. I survived the weekend and was moved to a general cardiac ward.

Then about two months later, I noticed it was easier to breathe. I asked the doctors if that meant the drugs were working, but it was too soon to tell. Each day, I felt a bit better. After another month, the doctors said I could go home.

But then the reality of how near I'd been to death hit me. All I could think about was dying. I went for a check-up every week. My heart was getting stronger and, though the doctors were positive, it was still a case of waiting.

Then my GP arranged for me to see a psychiatrist, who said I was depressed. Just hearing that my thoughts of death were a normal reaction made me feel better.

Until then, I'd spent all my time on the sofa, but I decided to have a go in the wheelchair the hospital had given me.

The children loved it - they'd push me up and down kerbs. I was thinking, 'This will give me a heart attack,' but I managed to laugh.

Then in December 1999, I was told my heart was strong enough for the blood clots to be removed - but they'd vanished. The doctor said he'd never seen a heart heal so quickly.

In August 2000, more than a year after my initial diagnosis, we decided to have an 'I'm alive' day.

The children made banners saying 'I'm alive' which we stuck up all round the garden, then we invited all our friends over for a barbecue.

We're planning our second 'I'm alive' day for this August, which is an extra big celebration as I've just had more news.

This time last year, my heart was functioning at 80pc - the level of a 50-year-old. I still thought I'd be on drugs for the rest of my life and always have to go for regular check-ups.

But my heart is now functioning at 90pc of its normal level, I've stopped taking drugs and I've gone back to the gym. I can do whatever I want - I'm back to being me again.

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Heart Attack

heart attack

Our heart is a muscular organ beating 100,000 times a day. Located slightly towards the left of the chest, it pumps 5000 gallons of blood throughout the body in 24 hours. The main function of the heart is to supply oxygen and nutrients to our tissues. It also helps the body get rid of carbon dioxide and other wastes. The consequences can be life threatening if this organ fails to perform its duties. There could be various cardiac issues that lead to heart failure. Myocardial infarction, commonly known as heart attack, can be one of the major culprits behind its failure.

What Is A Heart Attack?

A heart attack is known as myocardial infarction in the medical fraternity. The word 'Myo' means muscle while 'cardial' denotes heart. 'Infarction', on the other hand, refers to death of tissue caused by insufficient blood supply. The death of tissue may lead to a long-lasting damage of cardiac muscles. Heart attack is a condition which usually occurs when the blood supply to the heart is blocked suddenly due to complete blockage of the artery supplying blood to the cardiac muscles. This causes the heart muscle cells to die. The blockage of artery is often caused by plaque formation (deposition and hardening of fatty substances and cholesterol on the walls of arteries) resulting in coronary heart disease (CHD). If left untreated it can be fatal. The severity of damage to the heart tissues caused by a myocardial infarction or heart attack depends on the longevity of the attack. The earlier you receive medical care, the lesser is the damage.

Heart Attack Symptoms

The classic symptom of a myocardial infarction is chest pain or discomfort. But there are other signals too. Here is a low-down on the crucial ones.

Upper body pain

If you have pain, discomfort or pressure in your chest, that branches out to your arms (especially left arm), jaw, throat and shoulder blades, chances are that you are getting a myocardial infarction.

Breaking out in cold sweats

Don't ignore if you suddenly break out in a cold sweat, especially when you are going through the other symptoms of a heart attack.

Sudden dizziness

Starting from empty stomach to dehydration, a lot of things could trigger dizziness or light-headedness. But if your feeling of unsteadiness is associated with chest discomfort, it could well be the sign of a heart attack. Evidences suggest that women are more likely to feel this way during a myocardial infarction.

Irregular heartbeat

A racy heart could be the result of many factors including excessive caffeine intake and poor sleep among others. But if you feel that your heart is beating faster than normal for more than just a few seconds, seek medical intervention immediately.

Stubborn cough and cold

Normally, cold and flu symptoms aren't considered to be an alarm bell for a heart attack. But if you are in the high-risk group for the condition (have a family history, obese, or are suffering from diabetes), then this can be a warning sign for sure. If you experience flu-like symptoms that don't go, get your mucus tested. A pink mucus could indicate your heart isn't functioning to its maximum potential. That's why blood is leaking back in the lungs.

What Causes Heart Attack?

The muscles of your heart constantly need oxygen-rich blood which is ensured by your coronary arteries. This blood supply gets blocked when your arteries become narrow due to the build-up of plaque. It is formed by fat, calcium, proteins, and inflammatory cells. The outer layer of the plaque deposit is hard while the inner layer is soft. The outer shell breaks in case the plaque is hard. This is known as rupture, a condition that leads to the formation of blood clots around the plaque. If a blood clot blocks your artery, then blood supply to your heart is cut which, in turn, depletes the cardiac muscles of oxygen. This causes the muscle to die, resulting in permanent damage. The intensity of damage depends on the time gap between treatment and the attack. After a heart attack the cardiac muscles start repairing themselves. On an average, it takes them about 2 months to heal.

Apart from this, there could be another condition that can lead to a heart attack: Spasm in your coronary artery (ischemia). This can also restrict blood supply to the heart and can occur even if you don't have any coronary artery disease. However, this is a rare occurrence.

Heart Attack Risks

There could be many risk factors behind a heart attack. Here, we guide you on the most prominent ones:

Age: This plays an instrumental role in increasing your risk of a heart attack. Evidences suggest that men over 45 and women above 55 are more likely to experience heart attack.

Gender: Men are 2-3 times more likely to have a heart attack than women. The female hormone, oestrogen, works as a shield in case of women.

Genetic predisposition: If you have a first-degree relative (a parent, brother or sister) with a history of heart disease – such as angina, heart attack or stroke – you are twice as likely to develop similar problems, compared to the general population.

High blood pressure: Uncontrolled blood pressure levels over a long period of time can damage your blood supplying arteries making you vulnerable to heart attack.

High levels of bad cholesterol and triglyceride: Bad cholesterol or LDL has a narrowing effect on your arteries. Moreover, a blood fat known as triglyceride, can also increase your chances of getting a heart attack. Both these factors are largely related to your diet. So, eating mindfully is crucial to reduce your risk of heart attack.

Obesity: Excessive body weight is likely to increase your LDL, triglyceride levels while increasing your chance of developing diabetes. All these are potential risk factors behind heart attack. Staying physically active and eating mindfully are the cornerstones of maintaining ideal body weight.

Diabetes: This condition is marked by high blood sugar levels, another condition that can make you vulnerable to heart attack.

Stress: It is known to elevate your blood pressure levels which, as already mentioned, is a major risk factor behind myocardial infarction.

Smoking: It tightens your arteries and raises your blood pressure levels. All these increase your heart attack risk.

Diagnosis Of Heart Attack

A heart attack is usually suspected by typical clinical symptoms and is confirmed by carrying out the following tests:

ECG: Electrocardiogram or ECG is a diagnostic test which measures electrical signals that travel through the heart, causing it to pump blood through its chambers. These impulses are recorded in the form of a graph showing waves in a distinct pattern. Depending on the shape of these waves, doctors can evaluate any abnormal condition of the heart.

Blood test: Bloodwork is needed to detect the presence of cardiac enzymes which are raised during a heart attack. With the help of these readings, your doctor is able to identify the size and time of the attack. Some blood tests also measure the levels of certain heart cell proteins that are released when damage occurs due to the lack of blood supply.

Echocardiography: This is an imaging test performed during and after a heart attack. It tells your doctor whether or not your heart is pumping well. This test also reveals if any part of your heart is injured during the attack.

Angiogram: This is an imaging test to detect blockage in the arteries. It is rarely used to diagnose a heart attack. In this test, a liquid dye is injected into your heart arteries with the help of a tube known as catheter.

Cardiac CT or MRI: These imaging tests reveal the extent of damage to your cardiac muscles.

Treatments Of Heart Attack

A heart attack requires emergency assessment and treatment. It is important that you are treated quickly to minimise damage to your heart. The line of treatment, which varies depending on the severity of the condition, includes medicines, surgical intervention and other procedures.

MEDICINES

Your doctor prescribes drugs to prevent clot formation, relieve pain, regularise your heart rhythm, broaden blood vessels, regulate blood pressure levels, so on and so forth. While your doctor may suggest many medicines, we guide you about the most common ones:

Aspirin: This emergency medicine reduces blood clotting, ensuring blood flow through the narrow artery.

Thrombolytics: These drugs also help in busting clots that cut off blood supply to your heart. Thrombolytics, administered on time, increase your chance of survival.

Antiplatelet agents: They not only keep new clots at bay but also prevent existing clots from getting bigger.

Pain relievers: Morphine is commonly used for reducing chest pain.

Beta blockers: They ensure better functioning of the heart by relaxing your heart muscles , regulating heartbeat and blood pressure levels. Beta blockers can also be instrumental in preventing future heart attacks.

ACE inhibitors: These medicines function as blood pressure lowering agents while reducing your heart's stress level.

Statins: They keep your blood cholesterol levels under control.

SURGERY AND OTHER PROCEDURES

Along with drug therapy, you may need any of the following procedures:

Angioplasty: This involves performing a coronary angiography, locating the blocked artery and opening the block with a balloon and finally implanting a stent at the site of the block, to keep the artery open and your blood flowing freely.

Bypass surgery: In this procedure, the surgeon sews your veins or arteries in a location away from the blocked or narrowed artery. A bypass surgery allows your blood to reach your heart after bypassing the narrowed area. It can be performed at the time of a myocardial infarction or a few days later.

Diet For Heart Attack

The cornerstone of a heart attack treatment is preventing a relapse and other future complications like stroke. Your food habit influences, to a large extent, how different organs of your body function and your heart isn't an exception. Having healthy meals can be instrumental in reducing your chance of getting another heart attack. Fill up your plate with foods that are low in saturated foods. Some examples could be:

Fruits and vegetables

Lean meats

Poultry

Nuts, beans, and legumes

Fish

Whole grains

Plant-based oils, such as olive oil

Low-fat dairy products

While it is important to include healthy foods in your meals, there is another golden rule that you need to follow. Cut out certain foods that are harmful for your heart. They are:

Foods high in salt

Refined sugar and carbs

Processed food

Lean Meat

Foods high in saturated fats

Prevention Of Heart Attack

Modifying your lifestyle and taking up a few healthy habits can go a long way in preventing or reducing your risk of a heart attack. Here are a few small steps that will help for sure:

Eat a healthy, balanced diet (avoid excess fat/ oil/ meat; include more of green veggies, fruits, nuts, fish).

Avoid smoking and excessive alcohol intake.

Keep your blood pressure, blood sugar levels and cholesterol within normal limits.

Exercise regularly. This is extremely necessary to maintain a healthy body weight. Obesity is a major risk factor behind heart attack.

Manage stress by practising meditation, breathing techniques and yoga exercises.

Yearly health check-ups with a physician.

The content has been verified by Dr. Nilesh Gautam, Senior Interventional Cardiologist, Head of Department of Preventive Cardiology and Rehabilitation at the Asian Heart Institute, Mumbai.

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