A Word with the DOCTOR
by Dr John Winsor
The Sunday Times of Malta


MANY PATIENTS will complain of having had a 'blackout' but this is a vague and certainly overused word.

It usually means a loss of consciousness for a few minutes but is often used incorrectly.

Patients will sometimes almost boast of having had one of these attacks. It has an alarming sound and to say you have had a blackout means that friends and relatives will be suitably impressed.

But if you enquire carefully, you can nearly always separate the really genuine loss of consciousness from the supposed one.

In a fake faint, the patient's description is very vague. They say they felt dizzy and fuzzy and thought they were going to "pass out'. They might also say they felt a tightness in the chest and broke out in a profuse sweat. The alleged blackout may often have gone on for up to an hour.

During a genuine faint there is an actual loss of consciousness because the brain is temporarily deprived of blood. The attack is usually very short and is often caused by some emotional upset, albeit a temporary one, or by fear.

Waiting to see the dentist or taking one's turn in a blood transfusion clinic are typical causes, and they are not uncommon when a patient is having varicose veins treated.

Very occasionally, a sudden loss of blood internally - such as from a bleeding stomach ulcer - may cause loss of consciousness and diabetes can cause alarming looking fainting attacks. If the patient is taking insulin or having injections for diabetes, a shortage of sugar in the blood may lead to a sudden passing out".

However, feeling dizzy when getting up quickly out of a chair or off the bed are not true, faints.

Obviously, it is not easy for an anxious relative to be sure that a fainting attack is not too serious. However, it is important never to panic.

General rules about what to do if someone faints are well described in First Aid manuals. For example, it is important to keep the patient quiet and well supplied with fresh air.

If there is no obvious cause or if attacks recur it is time to get expert advice. This is particularly true if the patient is over 30.

Despite what you may think, blackouts are seldom connected with heart disease but there are many other conditions which need to be excluded. However, blackouts are generally more dramatic than serious.