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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 can progress to syncope or fainting or abort without 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 get 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 leap 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 watch you faint.

Both faints and falls can cause serious injury, disability or worse.  Consider the following statistics regarding the reasons for patient presentations at emergency departments in Australia[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 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.

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] "20 most common principal diagnoses for ED presentations" in 2017-2018 from Australian Govt data (CHECK!!)

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