Windsor Blackout Clinic

Dr. Vidurath Mayadunne MB, FRCP, Consultant Physician

Dr. Michael Johnson, Dphil, FRACP, FRCP, Consultant Neurologist

Windsor Cardiology Group





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The following are the main areas of clinical interests we like to see and provide a comprehensive assessment and treatment

Clinical services

A transient ischemic attack is a set of symptoms that lasts for a short period of time due lack of blood supply resulting in temporary loss of function in certain parts of the brain. If untreated this may progress to a Stroke, a permanent disability. Urgent investigations are necessary to identify risk factors ( hypertension, diabetes, high cholesterol, irregular heart rhythm, narrowing of neck arteries and blood disorders) and to prevent complications. Though generally TIA’s  do not cause TLOC rare forms can affect consciousness

Strokes & TIA

Gait disorders are the commonest reasons for falls in the older patients. This broadly consists of peripheral problems ( muscle wasting, arthritic joints, poor sensory input) and  central problems ( strokes, parkinsonism, normal pressure hydrocephalus, tumors, spinal cord disease). Further imaging of the brain and spinal cord, nerve conduction studies and electromyography may be required for an accurate diagnosis. Physiotherapy is the main stay of treatment in most cases.

Gait disorders & Unsteadiness

Though hypertension is a strong risk factor for strokes and heart diseases the medications used to treat this can cause adverse effects in the elderly causing postural hypotension and falls. The latter may could result in fractures and increased morbidity. Therefore medications should be used with caution considering other medical conditions. The heart failure again can be difficult to diagnose in the elderly due to normal variation of certain physical signs and the limitations of standard tests such as Echocardiography . These problems are treated best in the hands of Geriatricians with a special interest in cardiovascular diseases.

Hypertension & Heart Failure in the elderly

The irregular heart rhythm is a strong risk factor for strokes and TIA’s. The standard treatment is accepting the rhythm and initiating anticoagulation having failed to establish the normal rhythm. However anticoagulation in the elderly carry certain risks associated with Falls therefore it is vital to treat the patient in a holistic manner, looking into other medications and co-morbidities.

Other novel treatments ( ablation treatment) have recently been introduced into clinical practice and  could be considered on case to case basis.

This area needs special attention of geriatricians.

Atrial Fibrillation in the elderly