Patrick Marleau opened the show for Canada with a tipped-in goal on a shot from Shea Weber at the 13:30 stage of the 1st period after an extended run of shots on goal.
Chris Pronger's dribbling shot at 15:17 was then tipped by Brenden Morrow for Canada's second.
Canada outshot Slovakia 10-4 in the first spell - one that was conspicuously clear of penalties, despite the hard hits on the ice and general dominance of the host nation.
But the second period saw a turnaround in momentum as Slovakia outshot the Canadians and appeared to have more gas in the tank.
Slovakian goalie Jaroslav Halak robbed Dany Heatley and Rick Nash of goal chances late in the period, but the Canadian attack was beginning to appear impatient, relying more on breakaways and hail mary shots rather than possesion and smart build-up.
But an insanely silly penalty for stick holding by Richard Zednick was all the chance Canada needed to push a little further ahead. Leaving Corey Perry alone on the wing for an interminable amount of time, Slovakia almost dared him to shoot - and shoot he did, with Ryan Getzlaf knocking home the airborne rebound.
Slovakia almost brought one back on the break soon after, but Canada's goalie Roberto Luongo stood on his head to beat the shot, then swept away a rebounding puck with the back of his outstretched glove as sticks a barrage of sticks practically broke the ice around it.
Slovakia clawed one back in the 11th minute of the third period when Lubovir Visnosky rattled one ome unassisted, while at the other end, Jarome Iginla was robbed by Halak on a shot that rebonded off the boards and was backhanded goalward by the big Calgary Flame.
With five minutes left, Slovakia's Michal Handzus received some good ol' Canadian justice when he hit Shea Weber in the face with his stick, only for Weber to get up off the ice, stalk Handzus and plow him through the goalmouth, turning it upside down in the process.
That hit 'em hard attitude may have proved costly seconds later when Zednick avoided a sandwich by Canada's defense, using the space left by the upended Canadians to feed Handzus for Slovakia's second goal.
Luongo again performed heroics in the third when more overcommitment from Canada, and a lost puck from Patrice Bergeron saw Slovakia all over his net. Luongo dropped, swatted blindly backwards and clamped down on a puck he had no idea was there as the crowd gasped - then let fly with a resounding "LOOOOOOOOOU."
What followed was three minutes of frenzied defending by Canada as Slovakia threw everything they had at the red-and-whites.
With seconds to go, Vancouver Canuck Pavol Demitra had the puck drop at his feet just inches to the left of the Canadian goal, but Luongo went into superhero mode, again swatting wildly, clipping the shot to safety in what should have been the equalizer.
Canada goes for gold against the United States. Just.
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