Blackout sufferers may be going undiagnosed, says NICE

27 August 2010

DOCTORS could be missing serious conditions like heart disease and epilepsy by failing to properly diagnose patients suffering blackouts, NICE has warned.

The health watchdog said doctors may be missing serious underlying causes of blackouts because of inadequate assessments. They are calling on doctors to treat all cases of blackouts seriously until a diagnosis is made, and to refer to specialists if there are any doubts.

Around half of the UK population will experience blackouts, or transient loss of consciousness, at some point in their lives. While NICE recognise that there will be a simple explanation for most people, they say some can be caused by more serious cardiovascular or neurological problems.

NICE’s latest guidance recommends doctors establish the specific circumstances that happened before a blackout and, if the blackout is symptomatic of an uncomplicated faint, then no further immediate management is needed.

But if doctors are unsure, they should offer to carry out a number of tests including a 12-lead electrocardiogram (ECG). And if this reveals abnormalities, or if the patient has a family history of heart disease, has blacked out during exertion, or has unexplained breathlessness, they should be referred to a specialist within 24 hours for further tests.

Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE said: “Although transient loss of consciousness is a very common symptom that the NHS deals with on a daily basis, its diagnosis can often be inaccurate, inefficient and delayed.

“For example, some people with epilepsy may also have a heart problem which has caused them to blackout, which could initially be overlooked as the healthcare professional may believe that he or she already has the correct diagnosis.

“Lapses such as these could lead to delays in treatment for the cardiovascular cause, which subsequently could put the patient’s health at further risk.”