What is a tilt table test

A tilt table test is used to check people who have fainted (syncope) or near-fainting spells (presyncope) or who often feel light-headed. The tilt table test results help your doctor know the cause of your fainting or feeling light-headed. The tilt table test can help determine if the cause is related to your heart rate or blood pressure. If you have symptoms while you’re in the upright position on the tilt table, the part of your nervous system that controls blood pressure and heart rate suddenly lowers them for a short time. Less blood flows to your brain, possibly causing you to faint.

The tilt table test uses a special table that slowly tilts you to an upright position. It checks how your body responds when you change positions.

Why is tilt table test done?

Your doctor might recommend a tilt table test to try to trigger your signs and symptoms — lightheadedness, dizziness or fainting — while your heart rate and blood pressure are being monitored.

Tilt table test checks what causes your symptoms by monitoring them while changing your position. Your doctor can see if you faint or feel light-headed because of problems with your heart rate or blood pressure.

When people move from a lying position to an upright one, their blood pressure normally drops. But the body adjusts to this. Your nervous system senses changes in body position and controls your heart rate and blood pressure.

If the nervous system doesn’t work properly, you might feel light-headed or faint. This can happen if your blood pressure stays too low. Your heart rate also may slow down or speed up. You feel light-headed because your brain is not getting a normal amount of blood for a short time. This problem is called syncope. Syncope might happen during the test when you change to an upright position.

How does a tilt table test work?

A tilt table test checks how your body responds when you change body positions. The body’s nervous system detects changes in body position or stress and regulates your heart rate and blood pressure. If the nervous system doesn’t work properly, you can have a drop in blood pressure and/or a fainting spell.

If you stand up for a long time, you might feel light-headed or you might faint. A specially designed tilt table puts you at an almost upright position, so you don’t use your muscles to stay upright. This lets your doctor see if you faint or have symptoms because of your heart rate or blood pressure.

What happens during the tilt table test?

Tilt table test is usually done in a hospital or a cardiologist’s office. Tell your doctor about any medicines you take. Ask your doctor if you need to stop taking any medicines before the test.

You might be asked not to eat or drink for two hours or more before a tilt table test.

You will have small patches or pads attached to your skin. These are sensors that monitor your heart. You will also have a blood pressure cuff on your arm. And you may have an IV (intravenous) line into a vein in your arm for delivering medication, if needed, during the second part of the test.

• During the test, you will lie flat on a table that can tilt you up to almost a standing position. You will be strapped securely to the table. You’ll start by lying flat on your back on the motorized table for about five minutes.
• Your heart rate and blood pressure are checked regularly as the table is tilted up.
• You’ll be moved to a nearly vertical position, where you’ll remain from five to 45 minutes, depending on the reason for the test. While vertical, you’ll be asked to remain as still as possible but to report signs and symptoms such as nausea, dizziness, sweating, lightheadedness or abnormal heartbeat (palpitations).
• If you don’t faint or have other symptoms after 45 minutes, you might receive the medication isoproterenol (isoprenaline) through an IV line in your arm to speed up your heart rate. The medication might prompt the abnormal nervous system reflex that causes you to faint. Then you will be checked for symptoms again.
• You then remain in the upright position for another 15 to 20 minutes.
• If you faint during the test, the table will be returned to a flat position. You will be checked closely and taken care of right away by your medical team. Most people wake up right away.
• In some cases, if blood pressure and heart rate changes indicate you are about to faint, the table is returned to a horizontal position so that you don’t lose consciousness.

Your heart rate and blood pressure will be monitored in each position to evaluate your body’s cardiovascular response to the change in position.

When the test is complete, you can return to your normal activities.

How long does a tilt table test take?

The test will take about an hour. It may take longer if you get medicine to speed up your heart during the test.

What happens after the tilt table test?

• Your heart rate and blood pressure will be checked before you go home.
• You may need to have someone drive you home after the test.
• You can probably go back to your usual activities right away. But some people feel a little tired or nauseated

Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It’s also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.

Tilt table test results

The results of a tilt table test are based on whether you faint during the test and what happens to your blood pressure and heart rate.

The tilt table test result is normal if your blood pressure stays stable during the test and you do not feel light-headed or faint.

The tilt table test result is not normal if your blood pressure drops and you feel light-headed or faint. These symptoms might happen because of a slow heart rate.

Depending on the results, your doctor might recommend additional tests to exclude other causes of fainting.

Tilt table test risks

A tilt table test is generally safe, and complications are rare. But, as with any medical procedure, it does carry some risk.

Potential complications of tilt table test include:

• Nausea and vomiting after fainting
• Weakness that can last several hours
• Prolonged low blood pressure (hypotension) after the test

These complications usually go away when the table is returned to a horizontal position.