Diagnostics

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Tilt Table

  • Purpose of Test:

    If you’ve been having fainting spells, a tilt table test can help your doctor determine the cause of the problem.

    Syncope is the medical term for a fainting spell. It is a sudden and brief loss of consciousness. Syncope occurs when the brain does not get enough blood flow and oxygen. There are many causes for syncope, such as low blood pressure, abnormal heart rhythms, narrowed heart valves, and seizure disorders, to mention just a few.

    The tilt table test is used to asses a common type of syncope, called neurocardiogenic syncope. In neurocardiogenic syncope, the nerves that control the function of the heart and blood vessels do not work properly. This may cause the heart to slow down and blood pressure to drop, and may result in loss of consciousness. Typical symptoms of neurocardiogenic syncope may also include dizziness, sweating, nausea, and a feeling of almost passing out.

    The tilt table is performed to induce symptoms of syncope while your heart rate, blood pressure, and symptoms are monitored.

  • What to Expext During Procedure:

    Tilt table test is generally performed at a hospital, test center, or clinic.

    Several electrodes (small sticky patches) will be placed on your chest to obtain an electrocardiogram (ECG) and monitor your heartbeat. A blood pressure cuff or similar device will be placed on your arm or around one of your fingers to monitor your blood pressure. An IV will be inserted into a vein in your other arm, so that fluids and medications can be injected. You will then be asked to lie down on a special table, called a tilt table. Safety straps will be fastened across your chest and legs.

    You first lie quietly for several minutes. The table is then moved until your head is nearly upright, a tilt of about 60 to 80 degrees. Even though you lie on a table that is at a steep angle, it feels as if you are standing on a footboard at the bottom of the table.

    You remain in this upright position for a relatively long period of time, up to 45 minutes. Your heart rate and blood pressure are continuously monitored. It’s important that you let the doctor or nurse know if you develop symptoms, such as nausea or dizziness.

    Patients who susceptible to neurocardiogenic syncope often develop a decrease in heart rate and a drop in blood pressure. They may also experience symptoms (such as nausea, dizziness, or faintness). In that case, the table is lowered to the flat position, which restores blood pressure within a few seconds. If you complete the 45-minute period of upright tilt without developing a significant drop in your blood pressure, the table is lowered to the flat position and you may undergo the second part of the test.

    The second part of the test evaluates how your blood pressure responds to a medication that is very much like your own adrenaline.

    The medication is injected very slowly through the IV line in your vein. You may feel your heart beating a little faster and stronger. The table is again moved to an upright position, for up to 45 minutes, while you are being closely monitored.

    The test is called “positive” (abnormal) if you blood pressure drops and you develop symptoms. Such symptoms may include dizziness, nausea, a cold and clammy feeling, or a sensation that you are about to pass out. Few patients actually faint during the test, because the tilt table is returned to the flat position before they lose consciousness.

    A complete tilt table test, including preparation for the test, generally lasts from one to two hours. If your test is positive, you may feel a little unsettled and possible queasy for the first minutes after the test. If this happens, you will be allowed to fully recover before you stand up and get dressed. Most patients feel perfectly normal within 5 to 10 minutes after the test.

  • How to Prepare:

    Generally, you will be asked not to eat of drink for at least 4 hours before the test. If you have diabetes and take medication for it, you will need special instructions.

    If you take heart medications, check with your doctor when you schedule the test. He or she may ask you to stop certain medications a day or two before the test.

    Make arrangements for someone to drive you to and from the procedure.

  • When Results will be Available:

    The doctor conducting the test may be able to give you preliminary test results before you leave. Or, your own doctor will discuss the test results with you during a future office visit.

    The test helps doctors determine whether or not you are susceptible to neurocardiogenic syncope. The information gained for this test helps your doctor make an accurate diagnosis of your condition and develop a treatment plan that’s best for you.