Tilt Table Test: What is it?

The tilt table test is used to diagnose unexplained syncope or fainting. There are multiple systems in your body that may cause dizziness or fainting. The two main reasons for spontaneous syncope are NEUROgenic or CARDIOgenic causes. Neurogenic breaks down into neuro- and -genic, or “produced by the nerves”. Conversely, cardiogenic breaks down into cardio- and -genic, or “produced by the heart”.

Some people have a disorder called “orthostatic hypotension” which can be caused by sudden upright movement which may cause syncope. This can happen when the person gets up from sitting or laying down too quickly, sudden rotation of their head, or even from posture when standing, sitting, or laying down. Another type of syncope is vasovagal syncope, caused by a combination of your blood vessels and your vagus nerve, which is used to slow down your body’s processes – “neurocardiogenic syncope”.

The goal of the tilt table test is to see if it can reproduce the symptoms of dizziness or syncope. This is an outpatient test, so you’ll be able to go home at the end of the day.

Who needs it?

The tilt table test is recommended if you have:

  • Unexplained syncope (fainting)
  • Unexplained dizziness, vertigo, pre- or near-syncope

What to expect before, during, and after?

 

 

Before

Prior to the test, you’ll be asked to not eat anything 3 hours prior to the exam, this is to minimize your risk of nausea while the test is occurring. You’ll be asked to lie down on the tilt table so preparation for the exam can easily take place. An intravenous line will be placed, and an EKG and blood pressure cuff will be used to monitor your vital signs during the procedure. Velcro straps will be used to secure you onto the table to ensure your safety.

During

After we’ve obtained your “baseline vital signs,” the test will begin. You’ll be slowly raised from a neutral, laying position to an upright, standing position. This will be performed without medication. You’ll be observed carefully over the next 15 minutes.

The second part of the exam may include medication. A small tablet of nitroglycerin (0.4mg) will be given to you, and this is to be placed under your tongue and allowed time to dissolve. At this point, you may experience a headache, lightheadedness, or stomach upset (Please let our nurse know if you do experience any of these symptoms). You’ll be observed carefully over the next 10 minutes to see if the same sensation of dizziness or syncope will occur.
After the 10 minutes of observation, you’ll be lowered back to a neutral, laying position and be allowed to sit upright. If at this point you feel any symptoms, please let our nurse know.

After

After the test is completed, you’ll be given normal saline through your IV and monitored over the next the next 5 to 10 minutes. The doctor will speak to you about your results and give you his recommendations.

Are there any risks I should be aware of?

Due to the medication administration, there is a risk of side effects, but rest assured that our advanced life support providers will be present for the entire test to observe you.

Additionally, due to the test attempting to reproduce your symptoms of dizziness or syncope, you may or may not experience the symptoms. But, again, rest assured that our advanced life support providers will be present for the entire test to observe you.

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