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TILT TABLE TESTING
What is a tilt-table test?
For patients who feel faint or lightheaded, a tilt-table test is used to find out why. During the test, you lie on a table that is slowly tilted upward from a lying to standing position. This test will measure how your blood pressure and heart rate respond to the effects of gravity. A cardiac technician keeps track of your blood pressure and your heart rate (pulse) to see how and if they change during the tilt-table test.
An abnormal control of blood pressure (hypotension) or a very slow heart rate (bradycardia) can cause fainting due to not enough blood reaching the brain.
This can give a strange feeling, like you are standing but without your feet touching anything - like being suspended in air.
Why do people have tilt-table tests?
We use this test to trigger symptoms while you are being monitored. The test is normal if your average blood pressure is unchanged as the table tilts upward and if your heart rate increases by a normal amount.
However, if your blood pressure drops and stays low during the test, you may faint or feel lightheaded. This can be corrected as soon as you are tilted back to the flat position.) Your heart rate may not be adapting as the table tilts upward, or your blood vessels may not be squeezing hard enough to support your blood pressure - either can cause this problem.
Feeling lightheaded or fainting can be due to certain medicines, severe dehydration, abnormal heart rhythms (arrhythmias), hypoglycemia (low blood sugar), prolonged bed rest and certain nervous system disorders that lead to low blood pressure.
Are there risks with tilt-table tests?
There are few risks. People rarely can faint during tilt-table testing. If this happened, it is safer than fainting on your own without help. Should you faint, you will usually feel well again within a minute or two after the table is placed in a flat position.
How do I prepare for a tilt-table test?
Don’t eat or drink for at least 2 hours before the test.
If you take medicine, ask your doctor if you should keep taking it on your regular schedule before the test.
What happens during a tilt-table test?
A specially trained technician performs the tilt-table test in our specialized laboratory. First, you lie on your back on a table with straps securing your body to the table. Small stickers with wires are attached to your chest and and you are connected to an ECG (electrocardiograph) machine to track your heartbeat. A cuff on your arm measures your blood pressure. A second cuff is placed on your other arm as a backup.
Then, your vital signs will be studied while you are at different angles (0 (flat), 30, 60, and 90 degrees) with 5 minutes in between movements. Then, a technician tilts the table so your head is slightly higher (30 degrees) than the rest of your body. The technician then checks your blood pressure, your heart rate and your oxygen levels.
This is a cartoon to demonstrate some of the patient positions used in tilt table testing from flat (0 degrees) to upright (90 degrees). There are blood pressure, heart rate, heart tracing and oxygen measurement connections set up during the procedure.
Should your blood pressure or heart rate drop during these movements, or if you become uncomfortable, then we will move you back to a lying position. If you stay well without changes in your vital signs, then after 45 minutes in total, you will be brought back to the lying position. After a few minutes of checking your vitals again, the test will be completed and all materials on your body will be removed.
What happens after a tilt-table test?
Sometimes, patients can feel tired and have nausea right after the test. If this happens, you will stay in a recovery area to keep track of your blood pressure and heart rate. Water will be provided to keep up your hydration. After recovery, most people can drive home and return to their normal activities. However, should you lose consciousness during the test, you may need to have more observation and testing. We won’t let you drive home if you have fainted.
How I do I learn about my results?
You will receive a followup appointment in person or by teleconference to review the results.
If blood pressure did not fall during the test, and you have no other symptoms, the test results are normal.
If blood pressure dropped during the test and you feel faint or dizzy, the test is positive. Your doctor may suggest changing your medicines or having more tests. If your fainting is due to a slow heart rate (bradycardia), your doctor may recommend review with a Heart Specialist.