Tilt table test

Tilt Table Test

The tilt table test is a diagnostic procedure used to evaluate the cause of unexplained syncope (fainting) and dysautonomia symptoms. It is particularly useful in diagnosing vasovagal syncope, a common cause of fainting due to a sudden drop in heart rate and blood pressure.

Procedure

The tilt table test involves placing the patient on a motorized table that can be tilted to different angles. The test typically begins with the patient lying flat on their back. The table is then tilted to a vertical position, usually between 60 to 80 degrees, while the patient's heart rate and blood pressure are continuously monitored.

A tilt table test being performed.

The test aims to provoke symptoms of syncope by simulating the effects of standing up quickly. If the patient experiences symptoms such as dizziness, lightheadedness, or fainting, the test is considered positive, indicating a possible diagnosis of vasovagal syncope or another form of dysautonomia.

Indications

The tilt table test is indicated for patients who experience recurrent episodes of syncope or near-syncope without a clear cause. It is also used to evaluate patients with suspected orthostatic hypotension, a condition where blood pressure falls significantly upon standing.

Interpretation

A positive tilt table test is characterized by a significant drop in blood pressure and/or heart rate, accompanied by symptoms of syncope. The results help differentiate between different types of syncope, such as vasovagal syncope, orthostatic hypotension, and postural orthostatic tachycardia syndrome (POTS).

Risks and Considerations

While the tilt table test is generally safe, it may cause discomfort or anxiety in some patients. Rarely, it can provoke prolonged syncope or arrhythmias. Patients are monitored closely throughout the procedure to manage any adverse effects promptly.

Related Pages

• Syncope
• Vasovagal syncope
• Orthostatic hypotension
• Dysautonomia
• Postural orthostatic tachycardia syndrome