Fainting / Blackouts
A blackout (transient loss of consciousness) is one of the most common reasons for an A&E attendance — and one of the most common reasons NHS waiting lists run long. Most causes are benign, but the small number that aren't (cardiac syncope, epilepsy, structural heart disease) really matter, so a structured workup is essential.
Led by our consultant cardiology team at The Vesey, Sutton Coldfield. Same-week appointments typical. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix). No GP referral required.
What it is
Vasovagal syncope (a "simple faint") accounts for the majority of blackouts. Other causes include orthostatic hypotension, situational syncope, cardiac arrhythmias (Mobitz II / complete heart block, ventricular tachycardia, long-QT, Brugada), structural heart disease (aortic stenosis, HOCM), seizures, and (rarely) carotid sinus hypersensitivity. The history, witnessed account and 12-lead ECG do most of the diagnostic work.
Symptoms and signs
- Pre-syncope (light-headedness, "going to faint") with or without progression to loss of consciousness.
- Faints triggered by standing, heat, dehydration, prolonged standing, medical procedures.
- Sudden, unwarned collapse with no pre-symptoms — this is a cardiac syncope until proven otherwise.
- Collapses associated with exertion or exercise — always need cardiac workup.
- Witnessed convulsive activity, post-event confusion or tongue biting — evaluate for seizure.
How we investigate
12-lead ECG, postural blood pressures, FBC, electrolytes, glucose, thyroid function. Selected onward investigations: 24-hour Holter, 7-day event recorder, implantable loop recorder, tilt-table test, echocardiogram, exercise tolerance test, cardiac MRI, EEG (via neurology) and brain MRI where indicated. Family history screening for inherited arrhythmia syndromes.
Treatment options at The Vesey
- Vasovagal syncope counselling and physical manoeuvres — counter-pressure manoeuvres, hydration, salt liberalisation, structured trigger avoidance.
- Medication review — particularly antihypertensives and diuretics in older patients.
- Pacemaker referral — for symptomatic bradyarrhythmia or high-grade AV block.
- ICD referral — for malignant ventricular arrhythmia or HOCM-related syncope.
- Driving and occupational advice — DVLA reporting requirements explicitly discussed and documented.
Should I call an ambulance after a blackout? +
If it is a first blackout, particularly if you did not fall safely, had a convulsion, or had chest pain or palpitations beforehand, call 999. For recurrent typical vasovagal faints with full rapid recovery, a same-week cardiology appointment is appropriate.
What is the difference between a faint and a seizure? +
Faints (vasovagal) have a prodrome (nausea, sweating, grey-out), are brief, and recovery is rapid. Seizures may have post-event confusion, tongue biting or limb jerking. A structured history and ECG help distinguish them.
What is cardiac syncope? +
Cardiac syncope is a blackout caused by a sudden drop in cardiac output, usually from an arrhythmia or structural heart problem. It is typically sudden, without warning, and may occur during exertion. It requires urgent investigation.
Will I need to stop driving after a blackout? +
DVLA rules require notification after an unexplained blackout. Driving may need to be suspended pending assessment. Your cardiologist will advise you at the first consultation and document the advice given.
Pricing at a glance
Initial consultant cardiology consultation £260 (ECG £50) · 24-hour Holter from £290 · 7-day event recorder from £450 · Tilt-table test from £550 · Echocardiogram from £320. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if you have had any unexplained blackout, particularly during exertion, while seated, with no warning, or with a family history of sudden death. Drive abstinence may be required pending assessment - we will advise.
Cost and pathway
Initial consultant cardiology consultation £260 (ECG £50). 24-hour Holter from £290. 7-day event recorder from £450. Tilt-table test from £550. Echocardiogram from £320.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our consultant cardiology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
View our cardiology services →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727