Tilt table test

Overview

A tilt table test shows how your body reacts when your position changes. It can help find the cause of fainting or dizziness. The test is often used when fainting, called syncope, happens for no known reason. It also may be done if you have repeated falls.

Why it's done

Your healthcare team may do a tilt table test if you:

• Faint and the cause is not known.
• Have repeated falls.
• Often feel faint or lightheaded.

Fainting can happen for different reasons. A tilt table test can check whether fainting is linked to causes such as:

• Orthostatic hypotension. This is a form of low blood pressure. It happens when you stand up.
• Postural orthostatic tachycardia syndrome (POTS). This condition affects the part of the nervous system that controls things that your body does automatically, such as making your heart beat. POTS causes the heart rate to go up at least 30 beats a minute or more within 10 minutes when you sit up or stand up.
• Reflex syncope. This is a sudden drop in blood pressure and sometimes a slower heartbeat that causes fainting. It also is called neurally mediated syncope.
• Psychogenic pseudosyncope. This is an event that looks like fainting but that happens without a drop in blood pressure.

Fainting also can be caused by irregular heartbeats and other heart conditions. This is called cardiogenic syncope. A tilt table test is not used to diagnose that type of fainting. If you have a heart condition, your healthcare professional may look for other causes of fainting before doing a tilt table test.

A tilt table test may be part of a group of tests called autonomic testing. These tests show how the part of your nervous system that controls things such as heart rate and blood pressure reacts to different triggers.

Risks

A tilt table test is generally safe. Complications are rare.

Some people faint during the test. This can be expected because the test checks whether changes in position lead to fainting. But you are strapped to the table and watched closely so that you do not fall and get hurt.

Other possible risks of a tilt table test are:

• Fainting.
• Low blood pressure.
• Feeling dizzy or lightheaded.
• Irregular heartbeats such as atrial fibrillation (AFib). This is rare.

These possible risks and side effects often go away when the table returns to a flat position.

If medicine is given during the test, some people may get a headache.

How you prepare

Your healthcare team gives you instructions to follow before a tilt table test. The instructions may include information about foods and drinks, smoking and medicines. Tell your healthcare team about any health conditions you have. Also let them know if you are pregnant.

Food and drink

Before a tilt table test, your healthcare team may tell you to:

• Not eat or drink for several hours before the test.
• Not eat or drink anything that has caffeine in it on the day of the test.

Medicines and supplements

Some medicines can change how fast your heart beats or how low your blood pressure gets. That may affect tilt table test results. So your healthcare team may tell you to stop taking some medicines for a short time before your test.

Before a tilt table test, tell your care team about all the medicines you take, especially those used to treat:

• Erectile dysfunction.
• High blood pressure.
• Fast heartbeats or irregular heartbeats.

Also tell them about any supplements, vitamins and other medicines you take that you bought without a prescription.

Do not stop taking any medicine unless your care team tells you to.

Smoking

Do not smoke or use nicotine on the day of your tilt table test. It may affect whether you have symptoms during the test.

What you can expect

Before

Before a tilt table test starts, you lie flat on a table with a footboard. Straps go across your body to hold you in place.

Sticky patches with sensors on them called electrodes go on your chest, and sometimes your legs and arms. Wires connect the patches to a machine that checks your heartbeat.

A cuff placed on your arm checks your blood pressure. A clip placed on your fingertip checks your oxygen level. Sometimes, medicines are needed to do the test. If so, a healthcare professional places a needle in a vein in your arm.

During

Your nervous system controls your heart rate and blood pressure. A tilt table test shows how this system reacts to changes in body position.

Here is how the test is done:

• You lie flat on a table for about five minutes. A member of your care team watches your heartbeat and blood pressure.
• Then the table tilts you to a standing position. Depending on why you're having the test, you may stay like this for 5 to 45 minutes. The care professional keeps checking for any changes in your heartbeat or blood pressure during this time.
• While you are in this position, stay as still as you can. When the table raises your head, your heart rate and blood pressure may drop for a short time. This can lower blood flow to your brain and make you faint. Tell the healthcare professional if you feel sweaty, lightheaded, dizzy, sick to your stomach, or if your heart starts pounding or racing.
• If you don't faint or have other symptoms after 45 minutes, you may get a medicine that can make you faint. A healthcare professional gives you this medicine through a needle in a vein in your arm.
• You then stay standing strapped to the table for another 15 to 20 minutes.

After

If you faint during the test, the healthcare professional puts the table back to a flat position right away and carefully checks you. Most people who faint during the test wake up again almost right away.

If you faint during the test, you may need someone to drive you home. If not, most people can usually go back to their regular activities.

Results

The results of a tilt table test depend on whether you faint during the test. Results also depend on whether your blood pressure and heart rate change during the test.

• Positive result. Your blood pressure drops and heart rate changes. This may cause symptoms such as dizziness or fainting during the test.
• Negative result. Your heart rate goes up only a little. Blood pressure doesn't drop much. You do not faint.

Depending on the results, your healthcare professional might recommend more tests.