India’s heart attack crisis: AIIMS doctor explains how to work in Golden Hour
During the heart attack, especially during the “Golden Hour” period, the treatment results can improve, AIMS doctors say.

In short
- Golden Hour is the first 60 to 90 minutes after the symptoms of a heart attack appear.
- Only 25% of Indian patients receive clot-busting drugs on time
- Most Indian symptoms reach hospitals 8 to 12 hours after the onset of Indian symptoms.
In the event of a heart attack, it matters every minute. Nevertheless, in India, many people are remembering the most important window of time to get life -saving treatment.
AIIMS Delhi Senior Cardiologist Dr. According to S Ramakrishnan, understanding “Golden Hour” can mean the difference between life and death.
What is Golden Hour?
The golden bell refers to the first hour after the onset of symptoms of heart attack, usually chest pain, discomfort or chest heaviness.
When a person experiences symptoms such as chest pain, stiffness, hand pain or jaw pain, sweating, or breathing, they should not wait or try to self-diagnose.
Immediate medical assistance should be sought, preferably within the first hour. This quick action can distinguish between a complete recovery and severe, lifetime damage.
This is a 60 -minute window when the heart muscle can still be saved if blood flow is restored in time.
“Time is life here, and time is in muscle,” Dr. Ramakrishnan told india to india .in. “First a person receives treatment, the possibility of limiting permanent heart permanent loss.”
Why is this hour so important?
A heart attack occurs when a blood vessel (called arterial) that takes blood and oxygen into the heart, suddenly blocked, usually from a blood clot.
This obstruction prevents the flow of oxygen in one part of the heart muscle.
Now, the heart is like any other muscle in the body, it requires a stable supply of oxygen to function properly. When this oxygen is not found, even for a short time, that part of the heart starts suffering.
“Once the artery is blocked, the part of the heart muscle that depends on the artery starts to die. If the blood flow is not restored quickly, the damage becomes permanent,” he said.

He explained that in the early minutes of the heart attack, most heart muscle is still alive and can be saved.
If treatment, such as giving a clot-busting medicine or doing emergency process, is done within this first hour, the possibility of saving the heart muscle is very high.
But with every passing hour, the situation worsens. After about six hours, many affected heart muscle is permanently damaged and cannot be cured. By that time, the heart muscle viability falls dramatically, “he said.
What are the treatment options?
There are two main ways to treat heart attack during golden hours:
- Thrombolisis-where clots-busting drugs are given to dissolve the obstruction.
- Primary PCI (angioplasty) – a process for opening a mechanically blocked artery.
Angioplasty is a medical procedure that is used to open blocked or compressed heart arteries. A small balloon is put into the artery through a thin tube and then inflated to clean the obstruction. Often, a small Aries tube called stent is placed to keep the artery open and improve blood flow.
While primary PCI is considered globally the best option, it is not available in many parts of India, especially small towns.
Dr. Ramakrishnan said, “The 24/7 catheter lab and a round-the-clock cardiologist are not possible across the US.”

He said, “For India, the best practical solution is pharmaco-invasive therapy, start with clot-busting drugs and follow with angioplasty where possible,” he said.
Treatment intervals in India
The golden hour presents the opportunity to break and restore blood flow using medicine or intervention, but Dr. Ramakrishnan pointed to a worrying tendency in India: Most patients do not reach the hospital on time.
He said, “More than 35 million people in India have a heart attack every year, but only 25% get clot-busting drugs, and only 5% pass through angioplasty. This means that about 75% remain untreated,” he said.
“Sadly, the most common treatment for a heart attack in India is no treatment,” he said.

Dr. Ramakrishnan has warned that Indians, on average, reach the hospital 8–12 hours after the onset of chest pain – last from the golden window. “If we can take patients to hospitals within the first three hours, we can significantly reduce the loss,” they say.
What you should do
- Identify symptoms: Chest pain, left hand pain, sweating, nausea, and shortness of breath.
- Don’t wait: Take help immediately, it matters every minute.
- Go to a feature with ECG and emergency care: Preferably a hospital equipped for a heart attack.
“Golden Hour can save your life. Know where to go in advance, and don’t waste time,” Dr. Ramakrishnan insisted.
Since a heart attack is the major cause of death around the world, understanding the golden hour and what action is to be taken during this important time, knowing that the possibility of timely treatment and survival can be greatly improved.