THE GOLDEN HOUR - WHEN SECONDS COUNT
A heart attack can strike any adult at any time. Some of us by virtue of our gender, age, family background, accompanying other illness like hypertension, high cholesterol levels, and diabetes and habits like smoking are more at risk to develop it while others are at a lesser risk. No adult is absolutely free of the risk of developing a heart attack. Hence being aware of the symptoms would help one to suspect it early and get medical help as soon as possible. This could make a difference between life and death.
A heart attack occurs when a narrowing in the arteries and /or a sudden blockage from a blood clot cuts of the nutrient and oxygen supply to the heart muscle. The majority of deaths from heart attacks occur suddenly and quickly. A third of patients never make it to the hospital for effective treatment. The patient’s survival and further qualities of life depends to a large extent on a window of opportunity called “The Golden Hour”.
The heart muscle starts to die within 80-90 minutes after it stops getting blood and with in six hours almost all the affected parts of the heart would have been irreversibly damaged.
The golden hour is a critical time and TIME IS MUSCLE. The faster normal blood flow is reestablished, 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 is due to an abnormal heart rhythm called ventricular tachycardia and ventricular fibrillation where the heart muscles are contracting at a rapid rate but no effective pumping of blood from the heart takes place. Once the person reaches a medical facility
(Ambulance or hospital) they are immediately put on an ECG monitor to asses the heart rhythm and can be given prompt treatment in case of an abnormal rhythm.
Many times a person may not realize that he or she is having a heart attack and few who have a doubt spend a lot of time in self denial. The warning signs are chest discomfort or discomfort in the arm, neck, or jaw, shortness of breath, cold sweat, nausea, light headedness. If you think you have one or more of these symptoms you need to call the emergency services of a nearby hospital or get somebody to drive you to the hospital.
Once the patient reaches the hospital the primary goal of treatment would be to dissolve the obstructing clot and restore blood supply to the affected part of the heart. This is done most commonly by clot busting drugs, but of late the preferred modality is mechanical dissolution of the clot by a procedure called as Primary Angioplasty. The only prerequisite is that it can be done only in hospitals where a cardiac catheterization laboratory and doctors well versed with this procedure are available. This procedure involves inserting a catheter through the blood vessels up to the heart, identifying the location of the clot and then it could be dislodged with a balloon and blood supply reestablished to that portion of the heart.
The earlier blood supply is reestablished the lesser would be the damage to the heart and lesser chance of death and functional disability. The earlier the patient reaches the hospital, their response to clot dissolution therapy is better. Thus it is very important to get to an emergency department quickly if one has reason to suspect that he/she is experiencing a heart attack. Saving time at the beginning can save ones life.