From a chain email:

What are you to do if you have a heart attack While you are alone. If you've already received this, It means people care about you. The Johnson City Medical Center staff actually Discovered this and did an in-depth study On it in our ICU. The two individuals that discovered this then did An article on it, had it published and have had it incorporated into ACLS and CPR classes. It is very true and has and does work. It is called cough CPR.

A cardiologist says it's the truth

If everyone who gets this sends it to 10 people,You can bet that we'll save at least one life.It could save your life! Let's say it's 6:15 p.m. And you're driving home (alone of course), after an usually hard day on the job. You're really tired, upset and frustrated.Suddenly you start experiencing severe pain In your chest that starts to radiate outInto your arm and up into your jaw.You are only about five miles from the hospitalNearest your home.Unfortunately you don't know if you'll beAble to make it that far.What can you do?You've been trained in CPRBut the guy that taught the course didn't tellYou what to do if it happened to yourself.

Since many people are alone when they suffer a heart attack, this article seemed to be in order.Without help, the person whose heart is beating improperly and who begins to feel faint,Has only about 10 seconds left before losing consciousness.However, these victims can help themselves by coughing repeatedly and very vigorously.A deep breath should be taken before each Cough, and the cough must be deep And prolonged, as when producing sputumFrom deep inside the chest.A breath and a cough must be repeatedAbout every two seconds without let upUntil help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart andKeep the blood circulating.The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a hospital. Tell as many other people as possible about this, it could save their lives!From Health Cares, Rochester General Hospital via Chapter 240s newsletter 'AND THE BEAT GOES ON ' (reprint from The Mended Hearts, Inc. Publication, Heart Response)BE A FRIEND AND PLEASE SENDTHIS ARTICLETO AS MANY FRIENDS AS POSSIBLE

Is that likely to do anything?

  • 7
    I do not think a chain mail makes a claim notable.
    – Suma
    Commented Jun 27, 2012 at 9:56
  • 1
    Look at the spelling. 'nuff said. Commented Jun 27, 2012 at 23:54
  • 4
    @Suma, I consider it notable. I've received this email several times from different sources. When such claims are so widely circulated, I think it needs addressing. Commented Jun 29, 2012 at 22:58
  • 2
    -1 because there is no effort visible to show you made any attempt to answer the question yourself. It is as if you got a piece of chain mail and said hey i bet i can get rep on skeptics if I post it.
    – Chad
    Commented Jul 2, 2012 at 13:35

1 Answer 1


The chain email says:

From Health Cares, Rochester General Hospital via Chapter 240s newsletter 'AND THE BEAT GOES ON ' (reprint from The Mended Hearts, Inc. Publication, Heart Response)


Rochester General Hospital - IMPORTANT DISCLAIMER:

Hundreds of people around the country have received an e-mail message entitled “How to Survive a Heart Attack When Alone.” This article recommends a procedure to survive a heart attack in which the victim is advised to repeatedly cough at regular intervals until help arrives.

We can find no record that an article even resembling this was produced by Rochester General Hospital within the last 20 years.

Furthermore, the medical information listed in the article can not be verified by current medical literature and is in no way condoned by this hospital’s medical staff.

Also, both The Mended Hearts, Inc., a support organization for heart patients, and the American Heart Association have said that this information should not be forwarded or used by anyone.

Mended Hearts - Cure this Contagious Rumor: Coughing Won’t Fend Off a Heart Attack:

Despite a contagious rumor, coughing doesn’t prevent a heart attack.

An e-mail that spread around the world like a contagious disease a few years ago claimed that anyone who feels heart attack symptoms while alone should cough “repeatedly and very vigorously, repeating a breath about every two seconds…until help arrives, or (a normal heartbeat returns).”

The coughing technique known as “cough CPR” has been used in hospitals by physicians to treat sudden irregular heartbeats in monitored patients during cardiac catheterization procedures. In this case, a responsive patient who develops a sudden irregular heartbeat could possibly maintain blood flow to the brain and remain conscious for a few seconds if they cough vigorously and forcefully while being directed by a physician.

But traditional CPR is not used to treat heart attack victims who remain conscious – but only if the heart attack if followed by cardiac arrest, the American Heart Association says.

American Heart Association:

The American Heart Association does not endorse "cough CPR," a coughing procedure widely publicized on the Internet.

As noted in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, “cough CPR” is not useful for unresponsive victims and should not be taught to lay rescuers.

During a sudden arrhythmia (abnormal heart rhythm), it may be possible for a conscious, responsive person to cough forcefully and repetitively to maintain enough blood flow to the brain to remain conscious for a few seconds until the arrhythmia is treated. Blood flow is maintained by increased pressure in the chest that occurs during forceful coughs. This has been mislabeled "cough CPR," although it's not a form of traditional resuscitation.

Why isn't "cough CPR" appropriate in CPR training courses?
"Cough CPR" should not be taught in lay-rescuer CPR courses because it is generally not useful in the prehospital setting. In virtually all lay-rescuer CPR courses, the finding that signals an emergency is the victim's unresponsiveness. Unresponsive victims will not be able to perform "cough CPR."

Are there situations when "cough CPR" is appropriate?
“Cough” CPR may be considered in settings such as the cardiac catheterization laboratory where patients are conscious and constantly monitored (for example, with an ECG machine). A nurse or physician is also present who can instruct and coach the patients to cough forcefully every one to three seconds during the initial seconds of a sudden arrhythmia. However, as this is not effective in all patients, it should not delay definitive treatment.

[LINK with references to studies]

American Red Cross:

The American Red Cross does not endorse the "How to Survive A Heart Attack When Alone" coughing technique that is being publicized on the Internet.

Cough CPR is a self-administered form of cardiopulmonary resuscitation described by CM Criley in 1976. According to Criley, self-initiated CPR is possible; however, its use is limited to clinical situations in which the patient has a cardiac monitor, the arrest is recognized before loss of consciousness, and the patient can cough forcefully.

To date, there is insufficient scientific research concerning the efficacy of Cough CPR. Therefore, American Red Cross cannot advocate teaching the technique until it has been thoroughly tested in national studies and found to be effective.

Ressuscitation Council (UK):

The BLS/AED Subcommittee has received a number of enquiries from people who have been informed about "cough CPR" and "How to survive a heart attack when alone". Advice has been put on the Internet that someone who thinks he or she is suffering a heart attack should repeatedly cough and go at once to a hospital, by car if necessary.

This advice is based (very loosely) on published case reports of people being able to maintain some sort of cardiac output during cardiac arrest by vigorous coughing - so-called "cough CPR".

The scenario has usually been of a patient developing ventricular fibrillation whilst being monitored, often whilst undergoing cardiac catheterisation. The patient has been encouraged to cough and a measurable circulation has been recorded. This anecdotal evidence supports the theory that chest compressions during CPR are successful because they increase intrathoracic pressure and result in a flow of blood. The collapsed veins and patent arteries at the thoracic inlet result in this flow being in a forward direction. Coughing produces the same effect.

The BLS/AED Subcommittee knows of no evidence that, even if a lone patient knew that cardiac arrest had occurred, he or she would be able to maintain sufficient circulation to allow activity, let alone driving to the hospital.


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