Tilt Table Testing

Why is a tilt table test ordered?

Tilt table testing is a test that helps to diagnose the cause of syncope or fainting. For some people, the reason they faint is due to a nervous system reflex which causes the heart rate to slow down and the blood vessels to dilate causing a drop in blood pressure. When the heart rate slows and the blood pressure drops, the brain does not receive enough blood and oxygen and this causes the person to faint. We call this vasovagal or neurocardiogenic syncope. As soon as the person faints and is in a lying down position, the blood flow is restored to the brain and he/she wakes up and feels fine. This is not a life threatening condition, however, it is very bothersome and could cause injury if the person falls.

What do I need to do to prepare for the test?

The only preparation needed for this test is no eating or drinking for 4-6hours before the test. There also may be certain medications that you need to hold before the test, ask your physician.

How is the test done?

During a tilt table test the patient is safely buckled onto a special table that tilts upward to place the patient in a standing position. An IV is started and a blood pressure cuff and heart monitor is applied to the patient. Either a nurse practitioner or doctor, and a registered nurse perform the test. Blood pressure, heart rate and heart rhythm are monitored through out the test to evaluate the patient's response to the change in body position. During the test we ask the patient to stay as still as possible and to avoid moving their feet and knees. They are instructed to let us know if they start feeling any symptoms such as lightheadedness, nausea, sweating, dimming of their vision etc. This part of the test lasts up to 40 minutes or until the patient faints. If after 40 minutes of standing the patient has not fainted, we may use a medication called nitroglycerine to help elicit a transient drop in blood pressure and monitor the heart rate response. If the patient faints during the test it is considered a positive test. Depending on how the heart and blood pressure responded to the test, determines the possible treatment options. Treatment will be discussed with your doctor at a separate visit.