What is Tilt Table Testing?

Tilt table testing is a procedure that is used to evaluate and possibly diagnose the causes of unexplained fainting and severe light-headedness, also known as syncope (SIN-koh-pee) or near-syncope.

Why has my doctor ordered a tilt table test?

Your doctor may have ordered this test if you have had symptoms such as unexplained fainting or light-headedness know as syncope or near-syncope.  Syncopal and near-syncopal episodes are often caused by a significant drop in blood pressure or from a very slow heart rate.  The result is a sudden reduction of blood flow to your brain, causing you to faint, feel dizzy or light-headed.  Syncope can be caused by many different kinds of health problems and therefore, it is often important to determine the cause.

How is the tilt test performed?

You will lie on your back on a special table and be connected to a cardiac monitor to track your heart rate.  You will have two belts across your body: one under the arms and across the chest and one across the thighs.  The belts are to help keep you steady as the table is raised of lowered as well as to prevent body movement during the test.  You will also have a small intravenous (IV) line placed in the vein of an arm.  A doctor or physician's assistant will be with you during the testing.  They will continuously collect blood pressure and heart rate data before, during and after the test have been administered.

Why do I need to have an IV placed?

The intravenous line is placed as a precautionary measure in the very rare event that you would need intravenous fluids during the test or would require the administration of additional medication. 

What will occur during the test?

The first part of the test consists of evaluating how your blood pressure and heart rate responds when you stand up.  A baseline recording of your blood pressure and heart rate will be collected while you are on the table.  Once this is obtained the table will tilt upright to a 70 degree angle.  Your blood pressure and heart rate are then monitored for twenty minutes.  During this period, we ask that you continue to remain quiet and still.  However, should you develop any symptoms of nausea, fainting, dizziness, light headedness, sweating or become uncomfortable in any way, we ask that you inform the clinician.  The test will conclude if you develop any such symptoms.

What if I don't have any symptoms during the test?

If you do not experience any symptoms with positioning alone, we will move on to the second part of the test.  In this segment, you will be administered a very small medication, nitroglycerin, through an oral spray.  This is administered in an attempt to recreate the symptoms associated with syncope.

Should I take my medication before this test?

Very few medications will interfere with the results of the tilt table test.  However, you should always ask your physician ordering the tilt table test whether or not you should take your medications.  As always, please feel free to call our office with any questions.