Tilt table test

A diagnostic test used to evaluate the cause of unexplained fainting (syncope).

Overview

The tilt table test is a diagnostic procedure used to evaluate the cause of unexplained fainting (syncope). It is particularly useful in diagnosing vasovagal syncope, a common cause of fainting that occurs when the body overreacts to certain triggers, such as the sight of blood or extreme emotional distress. The test involves placing the patient on a table that can be tilted to different angles while monitoring their vital signs.

Purpose

The primary purpose of the tilt table test is to determine how the patient's body responds to changes in position. It helps in diagnosing conditions that affect the autonomic nervous system, which controls involuntary body functions such as heart rate and blood pressure. The test is often used when other tests have not provided a clear diagnosis.

Procedure

The tilt table test is conducted in a controlled environment, usually in a hospital or specialized clinic. The patient is secured to a table with safety straps to prevent falling. The table is initially in a horizontal position. The following steps are typically involved:

1. Preparation: The patient is asked to fast for a few hours before the test. Electrodes are attached to the chest to monitor the heart's electrical activity, and a blood pressure cuff is placed on the arm.
2. Baseline Measurements: Initial heart rate and blood pressure readings are taken while the patient is lying flat.
3. Tilting: The table is slowly tilted to an upright position, usually at an angle of 60 to 80 degrees. The patient remains in this position for 20 to 45 minutes while vital signs are continuously monitored.
4. Observation: The healthcare team observes the patient for any symptoms of dizziness, lightheadedness, or fainting. If the patient experiences syncope, the table is quickly returned to a horizontal position.
5. Recovery: After the test, the patient is monitored until they feel well enough to leave.

Interpretation of Results

The results of the tilt table test can indicate several conditions:

• Positive Test: If the patient experiences a significant drop in blood pressure or heart rate, leading to fainting, the test is considered positive. This suggests a diagnosis of vasovagal syncope or another form of orthostatic hypotension.
• Negative Test: If no significant changes occur, the test is negative, and other causes of syncope may be considered.

Risks and Considerations

The tilt table test is generally safe, but there are some risks involved, including:

• Fainting: The test is designed to induce fainting, which can be distressing for the patient.
• Nausea and Dizziness: Some patients may experience nausea or dizziness during or after the test.
• Arrhythmias: In rare cases, the test may provoke abnormal heart rhythms.

Related Pages

• Syncope
• Vasovagal syncope
• Orthostatic hypotension
• Autonomic nervous system

Gallery

File:Tilt table test.jpg

A patient undergoing a tilt table test.