A heart attack occurs when a sudden blockage from a blood clot cuts off the food and oxygen supply to the heart muscle. The Golden Hour is a critical time 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. Heart is a pump. Like bullet shaped. Once the muscle is damaged bullet shape is not maintained and it can’t pump effectively.
So, the faster normal blood flow is re-established, the lesser would be the damage to the heart. 

Why Within golden hour?

The golden hour is a window of opportunity that impacts patient’s life and death. Or quality of life thereafter.

What is our role in the Golden Hour for a heart attack patient? 

To reduce the damage to the heart, it is important to get to the hospital as soon as possible. (Our patients usually go to clinic, and wait to see doctor and waste lot of time. It is important that they should rush to hospital with cath lab facility if possible) Other than the consequences of a damaged heart muscle, the most common killer in the early period following a heart attack is an abnormal heart rhythm called ventricular tachycardia and ventricular fibrillation where the heart muscles contract at a rapid rate (200 to 400)., but no effective pumping of blood from the heart takes place. 

This is why we must ensure that once the person reaches a medical facility (ambulance or hospital); they are immediately put on an ECG monitor to assess the heart rhythm, so they can be given prompt treatment in case of an abnormal rhythm. 

What is the immediate treatment one can expect in a 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.