Golden Hour In Cardiac Emergency: Importance Of Timely Intervention in Heart Attack

Travelling on a bus in a disconnected area, Sinha suddenly complained of his throat choking and stomach bloating. It took him more than an hour to realize that the problem was far more serious than a stomach ailment

A heart attack happens when an area or two of the heart muscles don't enough oxygen. Clinically called Myocardial Infarction, a heart attack is a deadly medical emergency. While medical science has come up with the most sophisticated techniques to revive a struggling heart, time has always been a deciding factor in a heart attack.

Since a heart attack is a muscle crisis, the more the delay in seeking treatment, the more the chances that muscle cells might become damaged or even die. Delay in seeking treatment for a heart attack can result in permanent damage and even death. It might be interesting to know what causes the patients to delay the medical help they might need at the earliest.

Recognise symptoms, ask for help

As per the article Reducing Delay in Seeking Treatment by Patients With Acute Coronary Syndrome and Stroke, published in ahajournal, patients delaying seeking treatment for heart stroke is a major factor limiting the delivery of definitive treatment in these conditions. As per studies, the longest phase of delay is between the patient understanding the symptoms and deciding to take medical aid for it. The following could be some reasons for the delay-

1. Low socioeconomic status and a resistance to taking help when not necessary
2. Lack of trust in medical practitioners and medical institutions
3. Inability to recognize symptoms and lack of awareness
4. Sometimes social commitments can outweigh the impulse to seek immediate medical help
5. A reason for the delay could also be long-distance travelling to the hospital
6. Studies have shown that people who are resting while experiencing a heart attack are more likely to delay seeking help than those involved in some physical activity.
7. Living alone is also another reason for patients delaying medical intervention.
8. A feeling of embarrassment is also associated with a delay
9. Having experienced false alarms earlier could also account for late intervention
10. Patients sometimes might try to distract themselves from the uneasiness and this might delay their seeking help
11. Sometimes symptoms differ among genders. This can also contribute to the delay in seeking medical care.

Difference between life and death

Soumin Sinha, a man in his mid-sixties suffered a major heart attack once while he was travelling to his parental home in Midnapore in West Bengal. Travelling on a bus in a disconnected area, Sinha suddenly complained of his throat choking and stomach bloating. It took him more than an hour to realize that the problem was more serious than a stomach ailment. In midst of nowhere, Sinha found a small nursing home that assured him that he was suffering from a heart attack. The nursing home provided him with the first aid but couldn't provide the necessary medical intervention. After struggling for nearly nine hours, Sinha found a hospital where he was later treated. The nine-hour gap between the onset of symptoms and his receiving help resulted in him suffering from internal bleeding and a major loss of muscle.

What is the golden hour

Dr. Sanjeev Gera, Director and HOD, Cardiology, Fortis Hospital Noida, said: "So, definitely there is a concept of golden hour. Whenever a patient has a heart attack or symptoms of a heart attack like chest pain, breathlessness, sweating, palpitations, or shortness of breath, the feeling of air hunger with a lot of sweating, and cold sweats especially then he should get an ECG within one hour or as soon as possible for that the patient should reach to any well-equipped hospital within one hour. So, the initial one hour after the start of symptoms is called Golden Hour and if in this golden hour we are timely able to open up that artery, then the heart muscle can be saved. So, in different languages, we say that time is muscle. Time is very crucial and the first hour after a heart attack is very important because in that hour we can save the muscle, we can reverse the heart attack and the patient can lead a normal life."