'Golden Hour' in Heart Attack

The term “golden hour” is used to refer to the essential period of time following the commencement of a heart attack during which quick medical intervention can considerably enhance the patient’s results. This period of time is referred to as the “golden hour” in the context of the management of heart attacks. It is a widely held belief that the first hour after a heart attack is the most critical period in which to begin appropriate therapy in order to restore blood flow to the portion of the heart that was damaged.

The Golden Hour is a window of opportunity that impacts a patient’s survival and quality of life following a heart attack. It is a critical time and time, is a muscle. This is because the heart muscle starts to die within 80-90 minutes after it stops getting blood, and within six hours, almost all the affected parts of the heart could be irreversibly damaged. So, the faster normal blood flow is re-established, the lesser would be the damage to the heart.

To reduce the damage, it is important to get to the hospital as soon as possible. Other than the consequences of a damaged heart muscle, the most common killer in the early period are abnormal heart rhythms called ventricular tachycardia and ventricular fibrillation where the heart muscles contract at a rapid rate, but no effective pumping of blood from the heart takes place. This is why once the person reaches a medical facility (ambulance or hospital), they are immediately put on an ECG monitor to assess the heart rhythm so that they can be given prompt treatment in case of an abnormal rhythm, which could be delivering a shock (Cardioversion) or administering certain medication.

Recognizing the symptoms of a heart attack is the first step in taking advantage of the Golden Hour. While chest pain or discomfort is the most common symptom, especially a feeling of pressure, squeezing, fullness, or pain that lasts more than a few minutes, there are other signs to watch for:

50.     Discomfort in other areas of the upper body, such as one or both arms, the back, neck, jaw, or stomach.
50.     Shortness of breath with or without chest discomfort.
50.     Cold sweats, nausea, or lightheadedness.
50.     Unexplained fatigue or sudden weakness.

It’s important to note that not everyone experiences the classic chest pain symptoms. Women, in particular, may have subtler symptoms or experience discomfort in areas other than the chest.To summarize, the “golden hour” often means as soon as possible. Good judgment calls are always essential in trauma and emergency care.

• For some patients, for example, those with anaphylaxis (a life-threatening allergic reaction), the “golden hour” is only a few minutes, or they may die.
• For road traffic accidents with amputations of the hands or fingers, the sooner the parts can be attached, the better. This must be done within a maximum of 6 hours of injury, or the digit or body part will die.
• Re-establishing of the blood flow for the damaged heart muscle in a heart attack is advised within 1.5 hours of symptom onset to avoid death of the heart cells.
• Although field intubation can be a good thing, it may not always be the correct thing to do if it will take a long time and eventually delay reaching the hospital.

How to get treatment in the golden hour

1. Don’t delay in seeking medical help when presenting with chest pain or an equivalent sensation. Be particularly suspicious of a cardiac problem if you have risk factors, like diabetes, hypertension, smoking, high cholesterol or strong family history of heart attacks or strokes.
2. Try to get to a hospital with specialised cardiac facilities. Get to know where such specialised hospitals are located close to your home, and make sure family members know this, as well. 
3. Ascertain beforehand whether your medical aid or plan type allows you to be admitted to the cardiac unit closest to your home.
4. If no specialised cardiac units are near your home, get to know where the nearest district hospital is located, so that at least thrombolytic therapy can be administered without delay. 

References

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