Tilt table test examines people who have had repeated episodes of fainting. You are placed on a table that starts in a horizontal position and is then tilted upward at different angles. By monitoring your heart rate, blood pressure, and symptoms, a doctor can determine whether vasopressor syncope is responsible for your fainting. In this condition, the nerves controlling blood pressure and heart rate respond abnormally to changes in position by producing a sudden drop in blood pressure.
Purpose of the Tilt Table Test
- To determine whether vasopressor syncope is responsible for fainting episodes
- To diagnose a blood pressure regulation abnormality causing “fainting” (called neurally mediated syncope, neurocardiogenic syncope or vasovagal syncope)
Who Performs the Tilt Table Test
- A doctor assisted by a technician
Special Concerns About the Tilt Table Test
- Antihypertensive drugs or diuretics may interfere with interpretation of test results.
- People who are dehydrated or who have low blood volume may show changes in blood pressure and heart rate similar to those caused by vasopressor syncope.
Before the Tilt Table Test
- You will be asked to avoid food and fluids for 4 hours before the test to prevent nausea.
- Tell your doctor if you take any antihypertensive or diuretic drugs, and if you experience nausea or diarrhea in the 24 hours before the test.
- Wear comfortable clothes and shoes to your appointment and change into a hospital gown for the test.
- Leave jewelry (including wedding rings), watches and valuables at home.
What You Experience during the Tilt Table Test
- An intravenous (IV) line is inserted into a vein in your arm so that you can be given fluids and medications during the test. ECG leads and a blood pressure cuff are used to monitor your heart rate and blood pressure.
- You are strapped in place on the tilt table with loosely fitting Velcro belts.
- As you lie flat for about 15 minutes, blood pressure and pulse measurements are obtained. The examiner then tilts the table in stages to an almost upright position. You remain in this position for 30 to 45 minutes, and then are returned to a flat position.
- If you do not experience symptoms, the examiner may administer an adrenaline-like medication and then repeat the tilt.
- The examiner will ask you about the presence of any symptoms, such as lightheadedness or dizziness, and observe you for fainting episodes.
- The procedure takes up to 90 minutes.
Risks and Complications of the Tilt Table Test
- Because you are held by safety straps and your blood pressure and heart rate are monitored continuously, fainting does not pose any serious risk. Most people who do faint wake up as they are lowered to the horizontal position.
After the Tilt Table Test
- The test can be quite tiring. Arrange for someone to drive you home afterward.
Results of the Tilt Table Test
- The doctor will review the data to determine whether vasopressor syncope is causing your recurrent fainting episodes. If the doctor can make this diagnosis, medication may be prescribed to treat this condition.
- If another diagnosis, such as an abnormal heart rhythm (arrhythmia) is suspected, additional tests, such as Holter monitoring or electrophysiology studies, may be needed.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media