Blackout and Faints clinic the ‘Bunnings’ for fainting spells

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Electrician Joe Anderson knows Bunnings is a one-stop-shop for everything he needs for work; and now there is something similar helping the 70-year-old deal with the fainting spells that have been plaguing him for more than two years.

The new Blackouts and Faints Clinic at Sydney Adventist Hospital (the San) is the first in Australia to diagnose unexplained blackouts and faints.

Many fainting spells could be due to syncope, which is described as a transient loss of consciousness due to a lack of blood supply to the brain and can be a sign of a range of conditions.

Mr Anderson had been experiencing dizzy spells twice a month for more than two years, but initially took the traditional “alpha male approach” to his conditions – he simply hoped they would stop.

It took a recent bout of pneumonia to bring it up with his general practitioner (GP).

“What was curious was that feeling faint wasn’t just happening when I was doing something strenuous,” he said.

“The feeling of wooziness and weakness could happen at any time, even when just sitting and it was the thought that I might have a serious fall when walking that worried me.

“I’m active and love my job, so breaking a hip or having a head injury would be a setback I really don’t want to be restricted by.”

After a referral from his GP, Mr Anderson’s medical history was taken at the San clinic, bloods were sent for analysis, he had a tracing of his heart rhythm, and an ultrasound of the heart.

His results were reviewed by a geriatrician before he was referred to San cardiologist Dr Maros Elsik.

Mr Anderson said he was relieved the process narrowed down the potential cause and had identified a pathway to resolve the issue.

“As an electrician I compare it to going to Bunnings for your DIY stuff; you know when you get there you are going to get something to answer your problems,” he said.

“After the clinic, I’ve been referred onto the right specialists I need to see, and I expect that in a short time I’ll know exactly what I need to stay alive.”

Syncope has been attributed to twice the incidence of death in cardiac patients, serious head and hip injuries, car and work-related accidents.

One-in-two Australians are expected to suffer from syncope during their lifetime and one-in-five will suffer recurrent episodes, making it the fifteenth most common cause of presentations to emergency departments, and the fifth most common cause of emergency care admissions to hospitals.

Clinical director of the new clinic, Dr Maros Elsik, said syncope was frequently challenging to diagnose and manage.

“Published reports estimate that 90 percent of people who blackout or faint don’t actually end up seeing a doctor,” he said.

“When they do, their syncope may be found to be due to cardiac, neural, or multiple other issues, however in over 36 percent of cases, the cause is not successfully identified at all.”

Lack of knowledge about syncope can result in inappropriate and expensive medical referrals and tests, creating long and potentially dangerous delays to finding a diagnosis.  

“While in most cases the cause may be benign, you should not take the risk that it’s not a sign of something more sinister,” Dr Elsik said.

“Additionally, not knowing the cause of why you are fainting, leaves people in limbo, fearful when it might happen again. This is a particular concern to patients aged 60 and over who seem most commonly affected.”

San geriatrician Dr Ketan Bhatt said there was a significant overlap between fainting and falling.

“Falls in the elderly are significant events that can threaten their independence and lead to injuries, loss of confidence and post-fall anxiety,” he said.

“One of the more feared complications of a fall is a hip fracture, which can have a devastating impact on an older person’s overall health.

“Importantly, studies estimate around seven percent of those suffering hip fracture will die within 30 days."

San cardiologist Dr Peter Illes said correct diagnosis and management could save lives.

“We know that almost one in 10 cases of syncope are due to a cardiac condition and that sadly those patients have a 10 percent greater risk of death within six months of their first episode of syncope,” he said.

“Thankfully however, if diagnosed with cardiac syncope, appropriate treatment measures can be instituted.

“These could include education about preventing or reducing it occurring, advice to start or stop certain medication, or specific treatments such as pacemakers and other cardiac interventions.

"If someone is initially sent to a neurologist they will get a lot of neurological investigations which may not actually be appropriate.

“The clinic offers a screening process that means patients go down a more appropriate cost-effective investigation pathway and process."

The clinic is the first of its kind in Australia set up in a hospital, which allows the patient to have access to a range of multi-disciplinary trained medical specialists who share their expertise to diagnose and recommend treatment.

“If a patient’s diagnosis is uncertain, or their existing treatments have not reduced the frequency of their blackouts and faints, or its cause has not been diagnosed, that’s where the value of this clinic comes into its own,” Dr Elsik said.

“I believe it will reduce excessive testing and healthcare costs, shorten the time until diagnosis and give patients access to allied health services and specialised medications only available in a hospital.

“It will also increase opportunities for clinical research so we can improve how we help more people in the future.”

Mr Anderson added he hoped to be on the road to recovery and looked forward to spending more time with his daughters and grandchildren.

“I liken it to having had my blue and green registration slips done - hopefully I’m still roadworthy for a few more years,” he said.

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