Coughing May Help During Heart Attack
Polish Doctor Claims Simple Technique Works Like Do-It-Yourself CPR
Sept. 2, 2003 (Vienna, Austria) - If you're feeling chest pain and there's no one around to administer CPR should it be needed, remember this: cough. It could save your life, says one researcher at an international meeting of heart specialists.
Tadeusz K. Petelenz, MD, a Polish cardiologist, is campaigning to convince other heart specialists to back his "Cough-CPR" program.
Petelenz says that most cases of sudden cardiac death -- an immediate shut down of the heart -- happen in the home (a heart attack, which is brought on by a blocked artery, is the major cause of sudden cardiac arrest, which is an "electrical" malfunction in the heart). By the time help arrives the person is often unconscious, which makes life-saving resuscitation difficult. He says his Cough-CPR can keep the heart functioning long enough for help to arrive.
The mechanical action of the cough acts as a do-it-yourself CPR that delivers needed thumps to the chest, Petelenz says. Those thumps stimulate electrical activity in the heart and keep it beating. To demonstrate the effect, he asked a reporter here at a European Society of Cardiology press conference to find her pulse. "Now cough and feel the difference." The journalist said she did "feel" a difference.
Cough ... 1, 2, 3
Petelenz describes his program this way: the patient is trained to cough every one to two seconds in bouts of five coughs. This process is repeated in regular morning and evening training sessions until the patient can cough for as many as 10 to 30 coughs in each bout.
But learning the cough is only one part of the program -- patients are also taught to recognize symptoms of sudden cardiac arrest: shortness of breath, sudden nausea, dizziness, inappropriate sweating, blurred vision, sudden weakness and trembling hands. These symptoms can occur singly or in combination, he says.
To prove his point, Petelenz taught 115 patients with a history of cardiac arrest symptoms to recognize the symptoms and initiate coughing. The patients used the cough in "365 instances of perceived [warning] symptoms of fainting. As a result symptoms disappeared in 292 cases and only 73 cases needed additional medical assistance," he says. Moreover, all the patients "survived until follow-up therapy was initiated, which included pacemaker implants, heart surgery and medical treatments."
Petelenz, who carries stacks of pamphlets that describe the Cough-CPR program, says he wants community organizations to teach his program just as CPR is taught.
True ... But
Leo Bossaert, MD, executive director of the European Resuscitation Council and professor of medicine at University Hospital in Antwerp, Belgium, tells WebMD that he is not convinced the Cough-CPR works. He says that the Petelenz study falls short of the scientific standards needed to prove that a treatment works. "We don't know if these patients had true cardiac arrest," he says. Moreover, the study didn't include any comparison group so it is unclear if it was the cough that kept the patients conscious or if they would have survived without the cough.
Bossaert says, however, that physiologically Petelenz is correct: cough can be used to keep a patient conscious. "We've been doing this for years in the cath lab," says Bossaert, who explained that sometime patients have cardiac arrest symptoms while undergoing angiography -- a dye test used to diagnose blocked heart arteries. When that happens, the doctors tell the patient to cough until the spell passes.
Given the lack of evidence, Bossaert says it would be irresponsible to recommend Cough-CPR training now. He says he also worries that introducing a program like Cough-CPR could confuse the public, which would further delay treatment. "We don't want someone to be coughing rather than dialing the emergency number," he says.