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Clinical Specialties - Cardiac

Blackouts, Faints and Unexplained Falls

About Blackouts & Fainting (Syncope)

Fainting is a temporary loss of consciousness that happens when the brain does not receive enough oxygen. It is also often called a blackout. The medical term is syncope (pronounced sin-koe-pee).

Syncope is very common with almost half the general population having one syncopal event during their lifetime.[1] Prior to a syncopal episode, you can feel extremely lightheaded and experience visual sensations such as 'tunnel vision' or 'greying out' and go through variable degrees of altered consciousness without complete loss of consciousness.  This may or may not progress to fully 'blacking out'.

Depending on the age of someone who faints and their circumstances, a fainting spell can be a warning sign of a more serious underlying medical condition. It’s important to seek medical help after fainting and receive a proper evaluation and diagnosis to prevent future recurrences.

About Unexplained Falls

Unexplained falls can happen for a range of reasons including cardiovascular disorders such as orthostatic hypotension (feeling lightheaded when you get up too quickly) and unspecified cardiac arrhythmias. The typical unexplained fall patient is over the age of 55. It is not uncommon for people of this age to experience the odd slip or trip, however if you are experiencing regular unexplained falls the cause is worth further investigation. Thorough assessment, evaluation and testing in the Blackouts & Faints Clinic at the San aims to provide a diagnosis and recommendations for treatment so subsequent falls can be avoided.

Sometimes a fall is actually a faint in disguise because you don’t even remember losing consciousness; especially if other people aren’t around to see you faint.

Both faints and falls can cause serious injury, disability or worse.  Consider the following statistics regarding patients suffering from syncope:[2]

  • Individuals with syncope (fainting) are 1.8 times more likely to experience severe fall-related injuries requiring hospitalisation (ie fractures and traumatic head injuries)
  • Within the year following discharge, 6.7% of the untreated syncope population had a fall-related injury requiring re-hospitalisation (of which 19% had hip fractures) versus 3.2% of people in the normal population

In Australia, syncope is the 15th most common cause of emergency department (ED) presentation and the 5th most common cause of hospitalisation.  In 2017-18, almost 90,000 Australians presented at emergency departments for syncope.[3]

Fall-related injuries can make it difficult to get around or live independently and increase the risk of early death. Often when people fall, they develop a fear of falling, even if they were not injured in the initial fall. Sadly, this fear can limit activity, which in turn leads to reduced mobility and physical fitness and therefore increases the future risk of falling.  It also compromises quality of life, affecting people physically, economically and psychologically.

[1] Brignole M etal, Practical Instructions for the 2018 ESC Guidelines for the diagnosis and management of syncope, European Heart Journal (2018) 39, e43-e80

[2] Nume' A, etal, Risk of post-discharge falls-related injuries among adult patients with syncope: A Nationwide Cohort Study, PLOS ONE, Nov 21, 2018

[3] Australian Institute of Health & Welfare 2018. Emergency department care 2017-18: Australian hospital statistics. Health services series no 89.  Cat. no. HSE 216. Canberra: AIHW.

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