Cough CPR May Work to Prevent Sudden Cardiac Death

By Jancin, Bruce | Clinical Psychiatry News, January 2004 | Go to article overview

Cough CPR May Work to Prevent Sudden Cardiac Death


Jancin, Bruce, Clinical Psychiatry News


VIENNA -- Properly timed self-resuscitative coughing is a life-saving intervention in patients experiencing sudden circulatory arrest in out-of-hospital settings, Dr. Tadeusz K. Petelenz declared at the annual congress of the European Society of Cardiology.

Teaching patients who are at increased risk for sudden cardiac death to recognize the prodromal symptoms and employ cough CPR is simple and inexpensive.

These are skills that should be widely taught, Dr. Petelenz said.

The reason they're not is that very few physicians are familiar with cough CPR because the principal supporting animal and human research was published back in the 1960s and 1970s, according to Dr. Petelenz, who is professor of cardiology at the Silesian Medical School in Katowice, Poland.

Together with American colleagues at the University of Utah, Salt Lake City, and the University of California, Los Angeles, the Polish cardiologist is on a mission to spread the word on cough CPR.

Here's how it works: A patient experiencing sudden circulatory arrest due to ventricular fibrillation or other causes typically has a 20-to 30-second prodromal period prior to loss of consciousness.

This prodrome is marked by sudden onset of dizziness, shortness of breath, nausea, inappropriate sweating, and/or sudden weakness.

If cough CPR can be initiated during this window, the patient can maintain consciousness and call for help.

Animal studies demonstrate that forceful rhythmic coughing causes a sharp upswing in pressure in the heart, lungs, and thoracic blood vessels.

With each cough, blood is expressed from the lungs through the inert left atrium of the fibrillating heart and then out into the aorta.

From there the blood is pushed out of the thorax and selectively directed to vascular beds served by low-pressure veins.

With each deep inspiration between coughs, blood is drawn along a pressure gradient from the relatively high-pressure aorta through the right heart chambers and into the pulmonary vessels and coronary arteries, Dr. …

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