Tilt Table Test

A tilt table test is administered to diagnose the cause of fainting (syncope). Typically, it is administered to patients who have had several unexplained episodes of fainting. In some cases, however, the test is given to a patient who has had only one episode, but it is believed that another episode would put the patient at great risk of injury because of advanced age, other medical conditions or work environment.

Some patients with syncope have symptoms that warn them that they are about to faint, such as pallor, lightheadedness, weakness, nausea, sweating, irregular heartbeats or blurred vision. Fainting may be a response to a particular trigger such as emotional trauma or the sight of blood, but it can also occur in the absence of any such trigger.

Reasons for a Tilt Table Test

Tilt table tests are recommended when there is a suspicion that neurocardiogenic syncope is the cause of fainting, and the diagnosis requires confirmation. Neurocardiogenic syncope occurs when the nervous system alters the heart rate, temporarily lowering the patient's blood pressure. The diminished flow of blood to the brain results in fainting. The tilt table test attempts to replicate the fainting experience for diagnostic purposes.

Tilt Table Test Procedure

The tilt table test is a simple one, performed with the patient lying flat on a special table in the doctor's office. During the test, the patient is strapped in place to the table, while blood pressure and heart rate are constantly monitored. The table is tilted until the patient is in an upright position, simulating the change of position experienced when a patient stands up from a lying or sitting position. The equipment that has been put in place provides data for evaluation of the body's cardiovascular response to this change of position. 

If a patient does not have a fainting episode when moved into an upright position and there is still question of the cause of the fainting, she or he may be referred for a more thorough tilt table test that may include a medication called isoproterenol administered through the IV line. This medication can precipitate an episode of syncope in certain patients. When a patient experiences signs that he or she is about to faint, or actually loses consciousness, the table is returned to its horizontal position immediately. Once the tilt table test has been completed, a patient can promptly return to normal activities.

Risks of a Tilt Table Test

The tilt table test is considered very safe, but, as with any medical procedure, complications are possible. A few patients may experience prolonged lowering of blood pressure or a longer-than-normal pause between heartbeats. In almost all cases, these complications are resolved once the table is returned to its original position and the patient is lying down.

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