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Categories > Heart Health > Heart disease: Symptoms

Making the most of the ‘golden hour’
What happens during the “golden hour”?


Warning signs of a heart attack
Warning signs of a heart attack

You could be having a heart attack if you experience any of the symptoms described below. These symptoms can occur in any combination, and can range from mild to severe or be completely absent.

While the symptoms listed aren’t always caused by heart trouble, it’s best to seek medical care right away. Waiting to see if the pain clears up could mean the difference between life and death.

  1. Intense pressure or crushing pain in your chest. This feeling may extend into your arms, neck or back.
  2. Moderate chest pain, tightness, pressure, vague discomfort.
  3. Feeling faint, dizzy or weak.
  4. Difficulty breathing.
  5. A feeling of severe indigestion that doesn’t go away after taking an antacid.
  6. A feeling of impending doom—that something terrible is happening.

When it comes to treating a heart attack, just one hour can separate those who live from those who die. This “golden hour,” as it’s sometimes called, is that period of time during which oxygen-starved heart tissue lies in limbo between life and death. Although the heart tissue is still alive, it will, like a suffocating person fighting for air, die unless oxygen is restored. If medical intervention is begun inside this golden hour, the prospect for survival is excellent. If not, the likelihood of death increases dramatically.

What happens during the “golden hour”?

To understand why the golden hour is so important, you must first understand the mechanics of a heart attack.

During a heart attack, medically known as myocardial infarction, portions of heart muscle are dying because they’re not getting enough oxygen. Usually, this happens because coronary arteries are clogged, often by a blood clot or plaque, cutting off the heart’s oxygen-carrying blood supply. If oxygen isn’t restored to the affected area of heart muscle, it will die.

If an extensive number of heart cells die, the remaining cells may not be able to keep the heart pumping. So, to minimize damage, it’s crucial to get blood flowing again to all areas of the heart as quickly as possible.

Patients generally receive thrombolytic, or clot-dissolving, treatment when they arrive at the hospital. Half of the patients treated within the first hour do not yet have permanent damage. The patient may have a complete blockage, but the thrombolytic therapy dissolves the clot before part of the heart muscle dies.

Remember, denial that you’re having a heart attack could kill you. Doctors can prevent or limit heart damage for someone who gets help quickly. But they can’t do nearly as much for someone who spends the first three hours of a heart attack at home, denying the severity of his or her chest pain.

If you have chest pain, or any of the other symptoms described in the sidebar below, don’t waste time wondering if it’s indigestion. Put time on your side and call 911 for help.