Tilt Table Test
The tilt table test is a procedure that helps assess how the body reacts to changes in position. It is a cardiology procedure that allows for the diagnosis of the causes of dizziness or fainting.
General Description
The tilt table test, also known as the tilt test, is used in cardiology to study the body's reaction to a change in position. It is a useful procedure to determine the causes of syncope (loss of consciousness), especially to differentiate between dizziness caused by physiological factors and that which results from an emotional or psychological disturbance.
This test is based on studying the cardiovascular response and the autonomic nervous system of the patient when, due to a change in body position, a greater amount of blood accumulates in the veins of a specific area of the body.
The tilt test helps diagnose conditions such as vasovagal syncope (the most common type of loss of consciousness), postural tachycardia, orthostatic hypotension (a drop in blood pressure upon standing), or arrhythmias.
When is it indicated?
The tilt table test is performed on patients who have experienced one or more episodes of syncope. It is commonly used to evaluate young individuals without a diagnosed condition or older patients whose previous cardiac tests have been inconclusive.
How is it performed?
The patient lies down on a rigid examination table with a footrest, and straps are placed around their body to prevent movement as the table changes position. Electrodes are then attached to the chest to monitor heart rate, a blood pressure cuff is placed on one arm to measure blood pressure, and a pulse oximeter is placed on a finger to record oxygen levels in the blood.
After preparation, the test itself begins:
- The table remains in a horizontal position for about five minutes while baseline vital signs are recorded.
- The table is then tilted to a semi-upright position (between 60 and 80 degrees) and maintained in that position for approximately 20 minutes. The patient’s vital signs and any symptoms (such as sweating, nausea, or palpitations) are continuously monitored.
- If no symptoms occur, a medication that enhances the response of the cardiovascular and nervous systems is administered. This helps provoke dizziness or syncope.
- Finally, the table is positioned upright for about 15 minutes.
If the patient faints, they are immediately placed in a horizontal position and attended to until they regain consciousness.
Risks
The tilt test is a non-invasive procedure that generally does not pose a risk to the patient.
When the test causes a drop in blood pressure, instability, or dizziness, these side effects typically resolve after spending some time in a horizontal position. In rare cases, allergic reactions to the adhesive used for the electrodes may occur.
What to expect from the tilt table test
Before undergoing the tilt table test, the patient must sign an informed consent form. Then, they are given a medical gown and positioned on the examination table.
The straps securing the patient to the table are soft and do not cause harm, though they may feel tight as they support the body weight when the table is tilted.
The procedure typically does not exceed 45 minutes, and while the patient can resume normal activities immediately, it is advisable to remain accompanied for a few hours afterward in case dizziness occurs.
Medical specialties that request the tilt table test
The tilt test is a common technique in the field of cardiology.
How to prepare
The patient should arrive for the tilt table test fasting for two to three hours.
