A tilt table test is a non-invasive medical test to assess the cause of unexplained fainting. Your physician may suggest a tilt table test to evaluate repeated, unexplained episodes of light-headedness, dizziness, or fainting. This test can help evaluate if the cause is associated with heart rate or blood pressure.
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Tilt involves changing a person's positioning to observe how their heart rate and blood pressure react. A positive tilt table test result can suggest autonomic dysfunction, postural orthostatic tachycardia syndrome (POTS) or other similar conditions.

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Why You Need Tilt Table Test?

This medical examination evaluates blood pressure and heart rate as a person changes position. It begins with lying flat in the prone position on the table. The table is adjusted to a standing position as the patient's vital signs are determined.

This study is usually done to identify the cause of unexplained symptoms like:

  • Dizziness
  • Fainting spells
  • Falls
  • Lightheadedness

The purpose of the test is to replicate symptoms so your physician can get a better understanding of the situation under which you have these symptoms. A positive tilt table indicates your blood pressure or heart rate fluctuates significantly and can denote an underlying medical condition.

Also Read: Blood Pressure Monitors: How To Check BP At Home Methods And Benefits

What Does A Tilt Table Test Observe?

While standing, the heart adjusts to avert too much blood from pooling into your legs. This leads to a slight increase in heart rate and a constriction(narrowing) of the blood vessels in the legs. Under normal situations, these adjustments happen very rapidly and are hardly noticeable.

However, in people with certain health conditions, postural changes can cause a remarkable variation in blood pressure or heart rate. These include:

Dysautonomia is a malfunctioning of nerves that control involuntary functions like heart rate, breathing, blood pressure, digestion, and perspiration.

Orthostatic hypotension is a type of dysautonomia that results in a sudden drop in blood pressure when you stand up.

Postural orthostatic tachycardia syndrome (POTS) is a type of dysautonomia that makes your heart rate rise drastically upon standing.

Also Read: When your heart skips a beat

Vasovagal syncope is a striking fall in blood pressure due to the vasomotor reflex, which leads to sudden dilation of the blood vessels in the legs and a slowing of the heart rate.

Ruling Out Seizures

This test is also helpful in differentiating epilepsy from syncope, as seizures are not always related to physical movements and at times syncope is linked to jerking movements.

How Is A Tilt Table Test Performed?

The tilt table test needs a specially designed table that can be readily adjusted or tilted to different angles and is usually done in an outpatient setup.

You would be asked to lie down on the tilt table and your physician would secure you to the table with straps to maintain your position when the table is tilted. Moreover, you would be connected to:

  • A blood pressure cuff on your arm
  • EKG leads on your chest
  • A pulse oximeter is connected to your finger

During the entire test, your medical team will monitor your blood pressure, heart rate, and oxygen saturation and your symptoms. Also, your physician will give you medication such as nitroglycerin or Isuprel, which speeds the heart rate, making symptoms more evident.

Before the test begins, your team will evaluate your vital signs while you are lying flat, and then the table will be mechanically tilted to an upright position. As you are secured, it does not need any extra effort from you.

You will be evaluated at different angles for 10 to 15 minutes and assessed in a motionless standing position for 10 to 60 minutes.

How Long Does It Take To Complete Test?

The tilt table test takes roughly an hour to complete. However, the whole process from start to finish can take a few hours.

Post the test, a few people may feel dizzy or lightheaded, while others may feel better right away. Doctors suggest a three-hour recovery time after the test as it is impossible to predict how long positional changes or medications will affect you.

Adverse Effects

The tilt table test is non-invasive but can make a person feel unpleasant to stay still in one position for the completion of the test. Moreover, the purpose of the test is to trigger your symptoms, thus you may experience some of these symptoms:

  • Dizziness
  • Loss of consciousness
  • Nausea
  • Vomiting

The patient will be continuously monitored during the entire test and if you pass out during the tilt table test, your physician will provide you with medical or modify the angle of the table.

How To Prepare For The Test

It is important to inform your doctor about your current medical history and medication, particularly if you are on any heart or blood pressure medicine you would be asked to stop taking them before the test.

Also, you would be asked not to eat or drink three to four hours before the test, as it may induce nausea.