Tilt Table Test
A tilt table test may be performed in patients with syncope (fainting). This is considered a non-invasive cardiovascular test, which is performed in a special room with heart monitors, blood pressure machine, and a special table that tilts up to 60-70 degrees.
During the test, you lie on this table and are strapped to it so that it can be moved to a nearly upright position. We will monitor your symptoms, heart rate, blood pressure, and electrocardiogram.
The tilt table test is designed to induce (bring on) fainting under controlled conditions. Most patients will develop dizziness or fainting spells during tilt table testing. The nearly upright position during the tilt table test causes blood to pool (collect) in your legs. As a result, less blood returns to the heart, and less oxygenated blood is available for the heart to pump. The heart starts to pump very heavily and this activates specialized nerve fibers, which will send a message to the brainstem. This will result in your blood pressure dropping and/or your heart to slow down significantly. This is usually followed by syncope. That is why the patient is strapped, so that we can avoid any trauma. Once the person lies flat and normal blood flow is restored, the patient will regain consciousness.
Prior to testing an intravenous line is inserted into one arm and a blood pressure cuff, or similar device, is placed on the other arm. The electrocardiogram electrodes are placed on your chest to allow us to monitor your heart rhythm. This will be continuously monitored while you remain in the tilted position for approximately 10-30 minutes. If the patient does not experience any symptoms then a nitroglycerin pill (or spray) is used to help induce syncope (fainting). The drug may cause you to feel your heart pounding. You may also complain of a headache, nausea, or flushing. While on the medication, you will remain tilted for a few more minutes.
At any time during this test, you may develop symptoms that you previously experienced when you fainted or nearly fainted. It is very important for you to notify Dr. Villafañe if you are having similar symptoms.
The test is considered positive if the tilting induces fainting or similar symptoms. This is accompanied by a low blood pressure or a slow heart rate.
A complete tilt table test, including registration, preparation for the test, and monitoring, generally lasts from two to four hours. When the test is over, you will be transferred to a nursing unit for observation and rehydration. Dr. Villafañe will let you know if any medications or special recommendations are necessary. Optimal fluid intake is recommended. Some patients may benefit from added salt in their diet. You should check with Dr. Villafañe about this.
The tilt table test is generally safe. The test may cause nausea, vomiting, fainting, low blood pressure, and slow heart rates. The symptoms are usually transitory. Should any of these symptoms be present, the table is returned quickly to a flat position and the test is terminated. Hospital personnel are available to handle any emergencies. There have been reports of patients requiring CPR during tilt table testing. The patient is instructed not to eat or drink anything for six hours prior to the test. This will help prevent nausea.
A follow-up appointment will be given to you after being discharged home. Please make arrangements for someone to drive you home. If the test is positive, you will not be permitted to drive for six months.
You may be asked to stop taking certain medications a few days before the tilt table testing. Be sure to check with Dr. Villafañe about this.