Tilt
Table
Why is the doctor performing this test?
 A
tilt table test is used to evaluate recurrent syncope (fainting
spells) using a table that can be moved to a nearly upright
position (70 degrees). The tilt table test can help determine
how your body responds to changes in position. While at a
70 degree angle, your symptoms and vital signs (heart rate,
blood pressure and oxygen level) are monitored.
The test is designed to induce syncope under controlled conditions.
It is useful for diagnosing vasovagal syncope which is the
“common fain.” Vasovagal syncope is caused by
a malfunction of the nerves that control the action of the
heart and blood vessels. This malfunction causes the heart
to slow down and blood pressure to drop. As a result, the
person loses consciousness. Syncope can also be caused by
an arrhythmia or a strictly narrowed heart valve.
When your body is tilted, less blood returns to the heart,
less blood is available for the heart to pump, and the blood
pressure usually drops. Normally, the nerves that control
the heart and blood pressure do so by increasing the heart
rate by constricting (tightening) the blood vessels. In people
with vasovagal syncope, these nerves do not work properly.
As a result, the heart rate slows down, the blood pressure
drops, and the person loses consciousness. Once the person
lies flat on their back, blood flow is restored and the person
regains consciousness.
How do I prepare for the test?
- Do not eat or drink anything for 6
hours before the procedure this includes taking your
medications. If you take oral medications, talk to your
doctor about your medication schedule during your test day.
- If you are an outpatient, have
someone pick you up after your procedure. You probably will
not be permitted to drive.
- Be sure to check with your doctor
several days before your tilt table test. You may be asked
to stop taking certain medications for 2 to 3 days before
the test. This can help the doctor obtain more accurate
results.
- Bring a list of all medications you
are currently taking.
- Tell the doctor or nurse if you
have any allergies to medications or equipment (such as
latex or iodine).
- Ask questions or share your concerns before the test.
What is the test?
The tilt table test is usually performed on an outpatient
basis. You should arrive 2 hours before your test. After you
go through admitting, you will go to the third floor (3 South)--Outpatient Care. You will change into a hospital gown.
An intravenous line (IV) will be started in a vein in your
arm. You will be transported to the second floor cardiology
unit. Once in the testing room, you will be asked to lay on
your back on the tilt table with your feet against the footboard.
The Nurse will apply electrodes (sticky patches) to your chest
and shoulders to monitor your heart rate and rhythm. A blood
pressure cuff will be applied to your arm. A pulse oximeter
will be applied to your finger to monitor your oxygen
level. Two safety straps are attached across the legs and
chest. Initially, you will lie flat on the tilt table for
10 minutes to obtain baseline data. Then, the entire table
is tilted so you are positioned at a 70 degree angle. You
will be continuously monitored in the tilted position for
20 minutes and then returned to a flat position if you remain
asymptomatic. If you become symptomatic or pass out, the table
is returned to a flat position immediately.
If the test is normal, or “negative” after the
first 20 minutes in the tilted position, an adrenaline-like-medication
called Isuprel is administered per the Cardiologist’s
order. The drug may cause you to feel your heart pound as
it increases your heart rate. Following the administration
of Isuprel, you will be returned to the 70 degree tilted position
for 20 minutes if you remain asymptomatic. Again, if you develop
symptoms or pass out, you will be returned to a flat position
immediately.
At any time during the test, you may experience symptoms
that you previously experienced when you fainted or nearly
fainted. If this occurs, you need to notify the nurse and
doctor performing the test.
The test is considered abnormal, or “positive,”
if the tilting induces loss of consciousness accompanied by
a low blood pressure and/or a slow heart rate.
The Cardiologist conducting the test may be able to give
you preliminary test results before you leave. Or, your own
doctor will discuss the test results during and office visit.
You will be returned to the Outpatient Care unit. The IV will
be discontinued and you will be discharged from there. You
should allow 3 and 1/2 hours for a complete tilt table test
including preparation and discharge.
What do I do after the test?
It may be wise to rest for a while. Have someone drive you
home. Ask your doctor or nurse about taking any medications
that you were told to skip before the test.
Is the tilt table test safe?
The tilt table test is generally safe. The test is intended
to have you faint for a few moments. If you do faint, the
table is returned to a flat position immediately and the test
is stopped. Safety straps are applied to prevent injury if
you do faint. Well-trained staff are available to handle any
emergency.
Where is the test performed?
On the second floor of Sparrow Hospital in the cardiology
department Heart Center
How long does this test take?
You should allow 3 ½ hours for a complete tilt table
test. This includes preparation and discharge.
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