Can coughing stop a heart attack?

Internet myths have resurrected the idea that coughing can stop a heart attack in its tracks or fix an irregular heart rhythm.

Does “cough CPR” really work? We talked with University of Chicago Medicine cardiologist and professor of medicine Matthew Sorrentino, MD, about where this particular myth comes from, and what he thinks about other rumors about heart health. 

How does coughing stop a heart attack or fix an arrhythmia?

The answer is a bit tricky and doesn’t have a precise answer.

Sorrentino notes that when a person coughs there is a change in intrathoracic pressure, which is the pressure surrounding the lungs. That change affects blood flow to the heart and also interacts with the nervous system, especially the vagus nervous system, which links the heart, lungs and abdomen to the brain. When the system is stimulated it has an impact on the heart’s electrical system.

When these two things occur, the subtle change in blood flow and the electrical system can terminate or break the arrhythmia. 

Where did the idea of cough CPR come from?

According to Sorrentino, the idea was initially supported by anecdotes and case reports.

“We would occasionally see that in the intensive care unit or in a cardiac catheterization lab someone would go into a ventricular arrhythmia [an abnormal heartbeat originating in the lower heart chambers] or supraventricular arrhythmia [a fast heartbeat beginning above the heart’s two lower chambers],” Sorrentino said. “And when we tell the patient to cough really hard that could terminate the rhythm.”

In this instance, it seems like the method works successfully. But Sorrentino notes that most heart rhythms are more complex than a single cough can handle.

Why it doesn’t work

“Some rhythms could lead to cardiac arrest, and I think that’s why people thought, ‘Oh, if the cough will prevent the cardiac rhythm maybe it will help the cardiac arrest,’” Sorrentino said. “But most patients that go into cardiac arrest are going to go into a more chaotic rhythm.”

Chaotic rhythms are what prove the method false. Simply coughing will not always correct an irregular chaotic rhythm, and it cannot prevent the patient from going into cardiac arrest.

So what should you do if you’re having a cardiac event or you’re with someone else who is? The best initial response is to call 911. If you or someone else is properly trained, start CPR and, if available, use an automatic external defibrillator (AED).

Debunking other heart myths

Cough CPR isn't the only internet rumor that consumers should approach with caution. Sorrentino warns patients about expensive over-the-counter supplements that purportedly improve the heart’s overall function, but probably have no benefit at all.

Fish oil

The omega-3 fatty acids in fish are what make this supplement so popular. Omega-3 fatty acids can reduce blood clotting, inflammation, relax blood vessels and possibly help stabilize the heart’s rhythm.

“There have been many studies through the years suggesting there may be some benefit. But most of the recent studies in healthy, normal people show no huge benefit,” Sorrentino said. “But it certainly is good to have fish in the diet.”

Coenzyme Q10 and other antioxidants

The supplement coenzyme Q10, also known as CoQ10, is made from the active antioxidant ubiquinol. It is thought to help reduce the risk of repeat heart attacks and lower blood pressure.

“Except in some very small studies in patients with advanced heart disease, it doesn’t appear that these supplements have any benefit,” said Sorrentino. “And yet people are spending lots of money buying coenzyme Q10 thinking that it’s going to help.”

According to Sorrentino there are four major ways to keep the heart healthy: Don’t smoke, follow a good diet, exercise regularly and keep your body at the normal weight.

“If you do all of those things at an optimal level, this leads to normalizing your blood pressure, your cholesterol and preventing the development of diabetes,” said Sorrentino. “A person can get over a 90 percent reduction in the development of heart disease if they follow these four rules, and that’s better than any pill we have on the market.”