What is the tilt table test?
The tilt table test is a passive orthostatic stimulation test designed to investigate the causes of syncope (fainting) without an already defined cause presenting with additional symptoms such as unsteadiness or vertigo.
The test is based primarily on the evaluation of heart rate and blood pressure while the patient is lying down (supine), standing (passive standing) and upright.
The test makes it possible to discover the relationship between blood pressure and the occurrence of specific symptoms.
What does the tilt table test consist of?
To perform the procedure, the patient is placed on a reclining bed, firmly restrained with belts and supported by a platform at the base to facilitate an upright position. In this position, the first recording of blood pressure and heart rate is made. Then, the patient is placed in a lying position and the recordings are repeated after 1, 5 and 10 minutes in that position. After 10 minutes the patient is placed in a passive standing position, i.e., tilted between 60° and 80° for 20-30 minutes until syncope symptoms occur. If symptoms do not occur, they will be artificially induced by pharmacological treatment. The test is considered positive if the symptoms of syncope, such as decreased blood pressure and pulse, disappear when the patient returns to the lying position.
Why is it performed?
The test makes it possible to discover the relationship between blood pressure and the occurrence of specific symptoms, in many cases the correct origin of syncope incorrectly diagnosed as epilepsy can be found. The test can also be used to discover the origin of orthostatic hypotension and dysautonomia.
Preparation for the tilt table test
The duration of the test generally does not exceed 40 minutes and the only preparation the patient must undergo is fasting for at least 3 hours before the examination. It is advisable to be accompanied by a family member due to the possible discomfort that may occur for a short period of time at the end of the test. This test is not recommended for people with ischemic heart disease, diabetes mellitus, glaucoma, carotid stenosis, prostatic hypertrophy and severe valvular heart disease. However, it is recommended to always rely on the specialist’s instructions.
What does the test feel like?
The tilt table test is not considered an invasive test, although the induction of fainting prior to the procedure is a nuisance.