How to deal with a heart attack within the ‘golden hour’?

“Time is money”, is a well-established phrase, but when it comes to the matter of the heart, the proverb changes to “time is muscle”. The bigger the delay, the greater the suffering to the heart. The human heart, like every other organ, requires a continuous supply of oxygen and nutrients to maintain its vitality, but when “myocardial infarction”, a.k.a. “heart attack” happens, the supply is abruptly cut off, which leads to starvation, death, and ultimately leading to irreversible damage. Your heart is the most important organ of your body and is responsible for maintaining the circulation of the entire body, and impairment of any level will impact the functioning of the entire body.

Heart attack, as the name suggests, presents mostly as left-sided chest pain, or heaviness, occurring at rest, or on exertion, which often radiates to the left hand, and can be associated with sweating and vomiting. The first hour after the onset of a heart attack is called the golden hour. The damage of the heart attack can be minimised if, effective treatment at an angioplasty-capable centre is done, during this period.

The concept of “Golden Hour” is important because most of the deaths and cardiac arrests occur during this period. According to the centres for disease control and prevention (CDC), nearly 47% of deaths occur due to sudden cardiac arrests before an individual reaches the hospital. But, if he/she reaches the nearby hospital within this period can expect a near-complete recovery. It is a critical time. This is because the heart muscle starts to die within the 80-90minutes after it stops getting blood and within six hours almost all the affected parts of the heart could be irreversibly damaged. So, the faster blood flow is re-established the lesser there will be damage to the heart.

When a patient reaches the hospital; an ECG monitor is attached right away to assess the patient’s heart rhythm and to provide appropriate treatment with this is because of another fatality during the early period besides the damaged heart muscle known as “abnormal heart rhythms” or “ventricular tachycardia” and ventricular fibrillation, where the contraction of heart muscles occurs at a fast rate without any active pumping of blood from the heart. This fatality can be reverted by delivering a shock (Cardioversion) or administering certain medications.

Important Steps to be Taken–

1. Identify the symptoms
2. Call for help immediately
3. Reach the nearest hospital asap

Warning Signs

Heaviness or burning sensation over the chest white at rest /minimal exertion, associated with perspiration, restlessness, radiation of pain to jaw, back and left arm

Breathlessness without any chest discomfort (if diabetic mainly )

Abdominal pain and bloating are mainly related to acidity, but if the symptoms are more than usual in severity or associated with other symptoms, please take them seriously. Do visit the nearby hospital Emergency and get treated.

How to correct it?

A heart attack is caused when a clot blocks a blood vessel in the heart. The primary goal is to get rid of the clot as soon as possible, if not then that part of the heart dies. Even if there is a slight doubt that the symptoms could be of a heart attack, chew a 300/325mg of Aspirin tablet immediately, it will help dissolve the clot. As soon as you reach the hospital the doctors will try to get rid of the clot either with the help of a very powerful clot buster medicine (thrombolytic medicine) or with a procedure called primary Angioplasty. Both modalities have advantages and disadvantages but primary Angioplasty is the preferred therapy in most cases. In primary Angioplasty, a diagnostic Coronary Angiogram is performed to identify the site of blockage and angioplasty is performed and a stent is deployed in the artery to open up the blood flow.

Prevention of the attack

• Maintain a healthy lifestyle.
• All the risk factors like high blood pressure, diabetes, high cholesterol, obesity
• Sedentary lifestyle smoking symptoms and hence are neglected the most are silent killers as they do not produce uncomfortable
• Get yourself checked by an expert Cardiologist at regular intervals.

Things to do if a person suddenly collapses

• Make the person lie down on his/her back immediately
• Listen to the heartbeat by keeping your ear over the chest of the person
• Check if the person is breathing by keeping your finger near the person’s nose to feel their breath. If not breathing start giving chest compression and intermittent mouth-to-mouth respiration if possible
• Call for Ambulance and shift the person to a nearby hospital.

Our Cardiology Services team at Central Referral Hospital provides heart screening and diagnosis as well as treatment and support. We offer a variety of resources for people with cardiovascular disease and those looking to keep their hearts healthy.

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