Tilt Table Test
What is a Tilt Table Test?
A tilt table test, also referred to as upright tilt testing, is a medical procedure used to evaluate fainting that occurs with no known explanation. If there are persistent yet unexplained occurrences of light-headedness, dizziness, or fainting, your doctor may recommend for you to have this procedure done. Tilt table tests can help determine if the cause of these episodes is related to issues with your heart rate or blood pressure.
How is it done?
The procedure begins with you lying down on a flat, motorized table with safety belts and a footrest. You will also be connected to an echocardiograph machine and blood pressure monitors.
- You will remain in the lying position for approximately 5 minutes, to get a baseline heart rate and blood pressure.
- After the 5 minutes are done, the nurse/physician will begin to raise the table. For up to 45 minutes, the test will continue to be conducted (the table usually reaches up to a 60° to 80° vertical angle). You will be asked to remain still but report any symptoms you may be experiencing.
For the duration of the test, the nurse/physician will be keeping track of your blood pressure and heart rate. If at any point throughout the procedure, your blood pressure drops or you faint, the table will immediately be returned to a flat position to help you regain consciousness and the test will be stopped. If there is no change in blood pressure or heart rate, the second part of the test will begin.
In the second part of the test, the table is returned to the flat position. After it has been returned, the nurse/physician will administer the medication isoproterenol, also called isuprel, through an IV line in your arm. This medication speeds up and causes your heart to beat faster, causing you to feel like you are exercising.
- After isoproterenol is given, the table will begin to be raised once more. The combination of receiving the medication and performing the tilt table test may make you more susceptible to fainting. If your blood pressure drops with the incline of the table, the nurse/physician will return the table to the lying position, stop the IV and end the test.
- If there are no changes in blood pressure after approximately 15 minutes, the nurse/physician will lower the table and the test will be completed.
What Happens After?
Patients are usually monitored for an additional 30-60 minutes. Some patients have reported feeling tired or a little sick to their stomach immediately after the procedure had completed.
- A positive test result is when your blood pressure decreases and you experience fainting and/or dizziness.
- A negative test occurs if there are no significant changes in blood pressure or heart rate and you do not experience symptoms of fainting.
If you did not faint during the duration of the test, you may resume normal activities after observation is over. If fainting does occur, additional monitoring and observation may be conducted. Further instructions from your healthcare provider will differ depending on the test results. You may be asked to change medications or undergo additional tests to rule out other possible causes for the fainting. If it is determined during the test that the fainting was a result of a slow heart rate, a pacemaker may be recommended.
It is not advisable to drive if you have fainted during the test. Please be sure to report all symptoms to the nurse/physician before, during, and after the test.
Risks?
Tilt table tests are generally safe with very few and rare complications.
Possible risks may include:
- planned fainting,
- dizziness or headaches,
- nausea and vomiting after the test,
- weakness and fatigue that may last several hours following the procedure,
- palpitations and changes to heart rate,
- significant changes in blood pressures.
Please be sure to contact your healthcare provider with any concerns prior to and following the test.
