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Old 07-18-2003, 07:51 AM   #1 (permalink)
Peetster
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Hoax of the day: How to survive a heart attack

Claim: It's recommended one attempt to rhythmically cough during a heart attack to increase the chance of surviving it.
Status: False.

Example:


This one is serious . . . Let's say it's 4:17 p.m. and you're driving home,(alone of course) after an unusually hard day on the job. Not only was the work load extraordinarily heavy, you also had a disagreement with your boss, and no matter how hard you tried he just wouldn't see your side of the situation. You're really upset and the more you think about it the more up tight you become.
All of a sudden you start experiencing severe pain in your chest that starts to radiate out into your arm and up into your jaw. You are only about five miles from the hospital nearest your home, unfortunately you don't know if you'll be able to make it that far.

What can you do? You've been trained in CPR but the guy that taught the course neglected to tell you how to perform it on yourself.

HOW TO SURVIVE A HEART ATTACK WHEN ALONE

Since many people are alone when they suffer a heart attack, this article seemed in order. Without help the person whose heart stops beating properly 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 sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without let up until 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 and keep 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 phone and, between breaths, call for help.

Tell as many other people as possible about this, it could save their lives!

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




Origins: This
helpful e-mail began its life on the Internet in June 1999. Those kindhearted souls who started it on its way likely had no inkling the advice they were forwarding could potentially be harmful to someone undergoing a heart attack, but that is indeed the case. Those in the know have come down strongly on the side of cough CPR being a dangerous procedure for the uninitiated to attempt.

If you were a doctor and knew exactly what you were doing, it might help save your life. If, however, you are not a physician and you misjudge the kind of cardiac event you're experiencing, cough CPR could kill. This "helpful" e-mail could help you right into a grave.

The e-mailed advice about coughing during a heart attack leaves the impression that "cough CPR" technique is endorsed by Rochester General Hospital and Mended Hearts. Rochester General had nothing to do with any of this -- how its name came to be attached to this message is a mystery. See their web page which denies their having endorsed this e-mail

Mended Hearts (a support group for heart disease patients and their families) is not nearly so blameless.

Although the text of the e-mailed advice was published in a Mended Hearts newsletter, the organization has since disavowed it and for a time had a page on its web site asking readers not to take the e-mail seriously because they didn't stand behind it. The piece on "cough CPR" found its way into that publication through a blend of too much enthusiasm and a dearth of fact checking. From there, other chapters picked it up, spreading the notion to an even wider audience. Attempts now to distance the organization from it don't begin to undo the damage done by the piece having been picked up from there.

Darla Bonham, Mended Heart's executive director, has since issued a statement about cough CPR:


I've received email from people all across the country wanting to know if it is a valid medically approved procedure. I contacted a scientist on staff with the American Heart Association Emergency Cardiac Care division, and he was able to track a possible source of the information. The information comes from a professional textbook on emergency cardiac care. This procedure is also known as "cough CPR" and is used in emergency situations by professional staff. The American Heart Association does not recommend that the public use this method in a situation where there is no medical supervision.
Dr. Richard O. Cummins, Seattle's director of emergency cardiac care, explains that cough CPR raises the pressure in the chest just enough to maintain some circulation of oxygen-containing blood and help enough get to the brain to maintain consciousness for a prolonged period. But cough CPR should be used only by a person about to lose consciousness, an indication of cardiac arrest, he cautions. It can be dangerous for someone having a heart attack that does not result in cardiac arrest. Such a person should call for help and then sit quietly until help arrives, he says.

In other words, the procedure might be the right thing to attempt or it might be the very thing that would kill the afflicted depending on which sort of cardiac crisis is being experienced. Without a doctor there to judge the situation and, if cough CPR is indicated, to supervise the rhythmic coughing, the procedure is just far too risky for a layman to attempt.

Forget about coughing — key to surviving a heart attack is obtaining proper medical assistance within a very limited window of opportunity. Once an acute myocardial infarction (AMI) has been diagnosed, speedy injection of thrombolytic agents to dissolve clots is of the utmost importance — the more quickly those drugs are delivered, the better the chances of survival are. It's a race against the clock.

Most patients who present with minor chest pains usually look healthy and show no signs of a heart attack. Electrocardiogram (ECG) results tell the story though, so be sure to insist upon one being performed if you've any doubts at all. Often mild heart attacks are left untreated and undetected because hospital staff mistake a heart attack for something more benign because the presenting symptoms are minor.

Rather than risk killing yourself with cough CPR, those experiencing a heart attack should heed the advice of physicians the world over — down a couple of Aspirin as an emergency remedy. Doctors believe that during the early stages of a heart attack, Aspirin — which is known to prevent blood platelets from sticking together — can prevent a clot from getting bigger. In 1991 Dr. Michael Vance, president of the American Board of Emergency Medicine, recommended that people who think they are having a heart attack should "Call 911, then take an Aspirin."

Oh, and it probably makes a great deal of sense to chew the Aspirin before swallowing. The sooner it is dispersed by the stomach, the sooner it gets to where it is needed. During a heart attack, waiting for the enteric coating surrounding the pill to break down naturally could be a mistake.

In 1993 The American Heart Association began recommending a 325mg Aspirin at the onset of chest pain or other symptoms of a severe heart attack. That bit of advice is going unheeded though — a follow-up report published in 1997 shows as many as 10,000 American lives a year could be saved if more people who think they're having a heart attack took an aspirin at the start of chest pains.

Okay, so in terms of the drama of it, swallowing an Aspirin seems quite a come-down from bravely trying to induce a perfectly timed coughing fit. Less flamboyant is better, though; Aspirin saves lives, whereas coughing might well cost them.
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