Syncope (Blackouts & Faints) Clinic

Fainting is a temporary loss of consciousness that happens when the brain does not receive enough oxygen. While this is often called a ‘blackout’, the medical term is syncope (pronounced sin-koe-pee). Depending on the age of someone who faints and theircircumstances, a fainting spell can be a warning sign of a more serious underlying medical condition. It’s important to seek medical help and receive a comprehensive evaluation and diagnosis.

Unexplained falls can happen for a variety of reasons including cardiovascular disorders such as orthostatic hypotension (feeling lightheaded when you get up too quickly) and unspecified cardiac arrhythmias. It is not uncommon for people over the age of 55 to experience the odd slip or trip, however regular unexplained falls are worth further investigation. 

Prior to a blackout or fainting episode, people can experience a range of symptoms which may or may not progress to fully ‘blacking out’. The most common symptoms of syncope include:

• Blacking out
• Feeling dizzy or lightheaded
• Falling for no reason
• Nausea (feeling sick) or vomiting
• Feeling drowsy or groggy
• Fainting, especially after eating or exercising
• Feeling unsteady or weak when standing
• Changes in vision, such as seeing spots or having tunnel vision
• Headaches

The main causes of fainting are: 

• Cardiac: episodes can occur without warning and may be caused by an abnormal beating of the heart (arrhythmias) or a vascular or structural heart issue. They can often be picked up by a simple electrocardiogram (ECG) test which monitors electrical activity of the heart
• Neurological: episodes are a result of disturbance to the electrical activity in the brain
• Reflex: episodes are often caused by a disturbance in either the heart rate or blood pressure that controlled by nerves in the brain. Generally termed ‘situational’ (from coughing, sneezing, post-exercise etc) or ‘vasovagal’ (from emotions such as fear, pain, blood phobias etc) they tend to be the more common type of faint and are usually harmless
• Orthostatic: episodes are often caused by a sudden drop in blood pressure upon standing, dehydration and some medications
• Other: even after extensive investigations, sometimes it is difficult to determine a cause for these events

We have a multidisciplinary team (MDT) so our patients benefit from the input of numerous experts with different specialisations. Their combined knowledge contributes positively to a patient’s diagnosis and treatment plan.

Our Syncope MDT will review complex cases referred from the Clinic where no clear treatment pathway has been identified. These patients may be admitted to hospital following their clinic  visit for further evaluation and monitoring and will be reviewed by the MDT within 2 days of admission. 

Our MDT is represented by specialists from the key referring pathways:

• Cardiology - Dr Graham Tanswell (Director), Dr Peter Illes, Dr Grant Shalaby
• Neurology - Dr Peter Puhl, Omar Ahmad
• General Physicians - Dr Ketan Bhatt, Dr Paritosh Zad
• Emergency Medicine – Dr Greg McDonald (Medical Lead)

Please note: if you have been referred to one of these specialists by your GP for reasons other than investigation of blackouts or faints, please contact their rooms directly using our Find a Doctor search function, and NOT the Blackouts & Faints Clinic.

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Patients need a referral to the Blackouts & Faints Clinic from their General Practitioner (GP), and appointments must be made before arrival – we are not a walk-in clinic.

Phone 02 9480 9633 to make an appointment.

We suggest that you allow at least two hours for your visit, and it is useful if someone who has witnessed your faints or unexplained falls comes with you.

During your first visit you could expect the following:

• Verbal assessment – including a thorough exploration of your medical history and any pre-existing conditions
• assessment – including a check of your blood pressure, taking some blood tests, performing an ECG and if appropriate an ultrasound of your heart
• Doctor review – a specialist doctor will review your test results and request any further tests if needed
• Suspected diagnosis and treatment pathway – a specialist doctor will detail your suspected diagnosis (if one is determined) and outline the appropriate treatment pathway
• Referral and discharge information – the doctor will provide a referral to the appropriate specialist if needed (eg cardiologist, neurologist etc), referral to the Multidisciplinary Team  (MDT) or if no further investigation is needed, the doctor will provide educational discharge information.

You should also be aware that if the assessment and associated clinic tests highlight a serious (or the potential of a serious) underlying medical condition then you may be directly admitted to hospital for further monitoring and review. For these instances, it may be beneficial to have an overnight bag with you and to include any of your medications in original packaging.  Please be aware that specialist appointments and hospital stays will be subject to your normal private health fund cover and we recommend you check with your health fund on your level  of cover prior to your clinic visit should an inpatient stay be required.