While the title of this article mentions cardiac arrest, any type of cardiovascular emergency can occur in a bathroom setting. Here, I’ll answer the question, why do cardiac arrests happen in the bathroom? Which can be for several reasons.
The important thing to remember is what to do if this happens to you or a loved one. I’ll also provide suggestions and a cardiac plan that may help reduce your risk of a cardiac event or death.
>>To skip to a handy infographic on how to avoid cardiac emergencies in the bathroom, click here.<<
Table of Contents
What is a Cardiac Arrest?
A cardiac arrest is a serious cardiac emergency that can happen anywhere. It is defined as a sudden loss of heart function, breathing, and consciousness (1). This can be deadly if proper action is not taken as soon as possible.
Cardiac arrest is different than a heart attack. A heart attack is caused by a lack of blood flow to the heart. During a heart attack, there is no loss of heart function, breathing, or consciousness. However, it is important to note that a heart attack can lead to cardiac arrest.
Why Does Cardiac Arrest Happen in the Bathroom?
You may not feel stressed when taking a bath, shower, or having a bowel movement. But these everyday routines can put stress on your heart and body. This excess stress may lead to a syncopal episode (passing out), cardiac arrest, stroke, or even death.
According to research, we only spend about 30 minutes per day on the toilet (2). However, 8 to 11% of individuals with a history of heart disease will experience a cardiac event on the toilet (2, 3, 4).
It is also crucial to note that 9 out of 10 of these individuals who have a cardiac arrest outside of a hospital setting will likely die within minutes (4).
The risk of these events is even higher in older populations with a history of cardiac issues, like coronary heart disease or high blood pressure (4).
Sudden cardiac arrest can also occur when doing moderate-intensity tasks like bathing, walking, or cycling.
Toilet Straining
Having a bowel movement requires you to use certain muscles in your colon and rectum.
I’m sure you’ve heard that straining to get a bowel movement out is something you should NOT do. This is 100% correct.
Straining on the toilet happens for many different reasons, including:
- changes in breathing (AKA the Valsalva maneuver)
- using an unnatural sitting position
- constipation
Changes in Breathing (the Valsalva Maneuver)
If straining on the toilet, you are likely using a maneuver called the Valsalva maneuver.
This maneuver is a breathing technique that is sometimes used to correct abnormally fast heart rhythms. However, it should not be used when attempting to have a bowel movement.
This is because it uses forced expiration, similar to what you do when blowing up a balloon. You inhale first. Then when exhaling, you try forcing it through a closed glottis. This adds pressure on your chest, heart, and blood vessels.
After finally releasing a bowel movement, you exhale and your colon and rectal muscles relax. This sudden relaxation triggers your vagus nerve. This results in a drop in blood pressure and heart rate. When this happens, it can result in fainting, stroke, heart attack, or cardiac arrest.
Unnatural Sitting Position
Believe it or not, there is an efficient and effective way to sit on the toilet to prevent a cardiac event or heart attack while pooping.
If you sit upright at a 90-degree angle, you will likely end up using the Valsalva Maneuver described above.
Your parents may have told you to sit up straight, but this does not make the process of elimination easy. This is because a “sitting” position does not fully open your rectum, making bowel movement elimination more difficult.
Instead, try a squatting position. Lean forward slightly at a 30-degree angle, with your knees above your hips. It may also help if you elevate your feet on a step stool or some books.
Research reports that using proper toilet position may make elimination quicker and more convenient (5). Additional health benefits of proper sitting posture on the toilet include:
- preventing stretched or damaged pelvic nerves
- maintaining continence
- preventing and treating hemorrhoids
- making it less likely to get hernias
- making childbirth easier for females
Constipation
Another study assessing people in a hospital setting suggests that cardiac arrests happen in a bathroom setting due to “increased emphasis on early mobility, constipation, or medications such as opiates” (6).
Opiates are a type of medication used to control pain. They are known to cause constipation.
If constipation is not a usual occurrence for you, you may be able to prevent it by adjusting the amount of fiber and fluid in your diet.
Keep in mind that constipation may also be a symptom of other health conditions such as:
- Thyroid issues
- Micronutrient deficiencies
- Medications that list “constipation” as a side effect
- Hormonal imbalances
- Increased stress
For more information on a high-fiber diet, this article and printable high-fiber list from fellow dietitian, Katie Dodd, will help.
If you feel that constipation is a chronic issue or there is any cause for concern, speak with your doctor. They may have you try stool softeners, or laxatives, or refer you to a registered dietitian for more individualized dietary care.
Water Temperature
The temperature of your bath water is also very important in preventing cardiac arrest.
According to one study, water temperature may be more important than water immersion in reducing atherosclerosis (the thickening and hardening of arteries caused by plaque build-up).
There are some precautions however when it comes to water temperature. You must make sure not to make water temperatures too hot or too cold. Higher temperatures can cause overheating or a drop in blood pressure. And colder temperatures can constrict blood vessels, preventing enough blood from getting to your heart and brain.
Most research suggests keeping water temperature between 90 degrees and 105 degrees Fahrenheit (7). This can improve arterial stiffness and increase blood flow. In fact, regularly bathing 4 to 5 times per week shows promise in the prevention of atherosclerosis and preserving heart function in the older population.
Water Pressure
Submersing yourself in water when taking a bath can also have risks. During bathing, the water’s pressure surrounding your body can cause a shift in blood flow. Blood will begin to shift from your extremities (legs) to a more central location (heart).
This sudden shift may increase your risk of stroke, reduce your heart rate, and cause your heart to pump harder. Although research on this topic is conflicting. For example, some studies show the benefits of hot water bathing while others report an increase in cardiac complications (8).
My advice is to ensure that the water’s temperature is between 90 and 105 degrees Fahrenheit as mentioned above. And if you choose to take a bath, ease into the tub slowly so the pressure doesn’t hit you too quickly.
Air Temperature
The temperature of the air can also determine the risk of cardiac arrest in the bathroom.
For most people, the temperature in your bathroom is often cooler than the rest of your house as well as the water in your bath or shower. The greater this difference is, the higher your risk for a cardiac emergency.
Findings from one Japanese study show that cardiac arrests occur most often in the colder winter months and also when victims submerge their faces in hot water.
The significant shift in temperature from the hot bath to the cooler air when getting out of the bath may also lead to dizziness or a syncopal episode (passing out), which could be detrimental (9).
Thus, to prevent cardiac issues for yourself, try:
- decreasing the difference between the temperature in your bathroom and the temperature of your bath/shower water
- refraining from taking long baths in hot water
- only filling the tub halfway, to mid-chest height
Sequence of Bathing
Although you may have heard about a specific sequence of bathing such as starting at the feet and working your way up, there is no scientific evidence to confirm that this reduces cardiac events from occurring.
Yet science does suggest that half-body bathing may be better for circulation compared to full-body bathing.
This means that when taking a bath, try filling the water up to the middle of your chest. Avoid submerging your whole body or face.
Half-body baths may not only more superior to full-body baths, but also to showering. This is because bathing with water up to your mid-chest helps increase circulation and blood flow better than other options (10).
However, you still need to be mindful of any drastic differences between water temperature and air temperature.
Why are Heart Attacks in the Bathroom More Dangerous?
Having any type of heart-related emergency is a scary and dangerous situation. Heart-related emergencies in a bathroom setting, however, are at a whole other level of danger.
Cardiac emergencies in a bathroom are more dangerous because:
- you are alone
- help may be delayed
You Are Alone
This may be the most obvious reason for being more dangerous. More times than not, while going to the restroom, you are by yourself. Adding to that, you will most likely have the door locked. This is, after all, a very private setting.
This occurrence is extremely dangerous, as you have no one present to witness the event and call 9-1-1. In this case, your chances of survival are slim to none.
Help is Delayed
In other instances, help is present, although delayed.
If you do happen to live with others, it may take them time to figure out that help is needed. This is a scary situation, as cardiac events are very time-sensitive.
As I mentioned earlier, 9 out of 10 cardiac emergencies that occur outside of the hospital end in death. This is usually because the event is unwitnessed and no one is there to assist.
Preventing Heart Attack in the Bathroom
Putting a plan into place is imperative to preventing sudden death on the toilet or in a bathroom setting.
First, you need to familiarize yourself with the signs of a possible cardiac event. Then put an individualized plan into place.
Signs You May Need Help
It is crucial to familiarize yourself with the warning signs of a cardiac event.
The second you begin to experience any of the following, you need to get help immediately:
- Chest pain
- Nausea or vomiting
- Dizziness
- Palpitations
- Shortness of breath
Keep in mind that men and women have different signs and symptoms of cardiac arrest.
Men more often experience chest pain, while women report shortness of breath. However, this can be different for everyone.
Develop an Action Plan
Even after following the above recommendations and suggestions, an emergency may still occur.
Having a clear plan of action is always a good precautionary measure. In this case, it could save your life.
Whether you live alone or with other people, there is always something you can do to decrease your risk and increase your chance of survival.
If You Live Alone
First off, while studies show that the likelihood of you calling for help or utilizing a life alert system may be slim during a cardiac emergency, it is still a good plan to have in place.
If you start having symptoms, you may be able to alert someone before fainting or becoming unconscious.
Second, living alone doesn’t mean people can’t check on you. Recruiting family or friends to call every hour or a few times a day is a great way to ensure you’re safe.
Some people even rely on neighbors who are close, in case of an emergency. For family members who live out of town, calling your loved one’s neighbor may also be an option for physically checking in.
And third, keep your bathroom door unlocked. If you live alone, there is no need to fear someone walking in on you. And, if an event occurs, an unlocked door means help will be able to reach you in less time.
If You Live With Others
Living with others while being an at-risk individual is very much to your advantage. Not only do you have someone available to hear if something is wrong, but you also have someone to get help quickly.
Have them check on you if you’re taking too long in the bathroom. If they hear any loud noises, or if you’ve been silent for too long, have them check on you.
Additionally, have those you live with learn CPR and how to use an automated external defibrillator (AED). They can attend in-person classes through their local American Red Cross location or even online through the National CPR Foundation.
I would highly recommend attending live classes. By choosing the in-person route, you can learn and practice CPR and how to use an AED device first-hand. You can also get any questions answered right away.
You can also purchase an at-home AED. There are many AEDs available at competitive prices, including refurbished ones.
Here is a handy infographic on how to avoid cardiac emergencies in the bathroom. Save, print, and share it with others who may need it.
Conclusion
Overall, my recommendation is to take precautions if you feel you are at risk of a cardiac event while in the bathroom. Remember that the risk is greater in older populations or those with a history of heart issues.
Don’t ever strain when using the toilet and make sure you are using proper toilet posture. Following a heart-healthy diet that is high in fiber will help prevent constipation.
Be careful of not only water temperature but also room air temperature before taking a bath or shower.
Finally, make sure loved ones are aware of the possibility of a cardiac event happening in the bathroom. Whether you live alone or with others, develop a plan for checking in. This can be physically or via phone calls or recruiting neighbors for help.
With proper planning, you can save your life or the life of someone you love.
For more information on how to live a cardio-protective lifestyle, read my article “5 Things You Can Do To Support Heart Health NOW!”.
Kiran Campbell is a registered dietitian and entrepreneur with 13 years of experience. She has a degree in psychology as well as dietetics. She is also a proud member of the Academy of Nutrition and Dietetics’ and its Cardiovascular Health and Well-being Dietetics Practice Group among others. Kiran proudly presents and promotes the most up-to-date, science-based nutrition information on all things heart-related. She aims to serve not only individuals with heart disease, but also those wanting to protect against it. Learn more about Kiran by visiting her About Page.