Tilt Table Test
A tilt table test shows how your body responds to standing up after lying down. It does it in a safe way, with fabric straps keeping you from falling if your blood pressure drops. We monitor your vital signs while the table you’re on tilts at various angles. This allows us to find out why you faint.
What is a tilt table test?
The tilt table test is a test we use for people who faint. It records your blood pressure, heart rhythm and heart rate on a beat-by-beat basis when the table you’re on tilts at different angles. The table always stays head-up
What does a tilt table test show?
A tilt table test shows how different positions affect your heart rate, heart rhythm and blood pressure. We use this information to find the cause of symptoms like lightheadedness and fainting spells (syncope) and develop the best treatment plan for you.
Fainting or syncope is a brief loss of consciousness and posture (which is why it makes you fall) that happens because of a temporary decrease in blood flow to your brain. This decrease can happen because of a sudden drop in your blood pressure or heart rate or changes in the amount or movement of blood in your body. You may be confused for a bit after you become conscious again.
Whether you’re standing, sitting or lying down, your body should automatically manage your heart rate and blood pressure. However, certain conditions can get in the way of that process. When that happens, your blood pressure may drop suddenly when you stand or sit up too fast.
Syncope often happens because of other medical conditions that may involve your heart, nervous system or blood flow to your brain.
Your doctor or nurse may also order other tests to get a better understanding of your condition.
What to expect before a tilt table test
A doctor or nurse will explain the details of the test, answer your questions and ask you to sign a consent form. You may sign the consent form during a visit before the day of your test. A doctor or nurse will help you get ready for the test and answer any questions you have.
Before your tilt table test, let your doctor or nurse know if they need to avoid using one of your arms for an IV or blood pressure readings.
Before your tilt table test, a doctor or nurse will:
1. Help you lie on the tilt table. This is a motorized table with a metal footboard your feet will rest against.
2. Fasten soft fabric straps across your body, but you’ll need to support your own weight during the test.
3. Place an IV in a vein in your arm or on the back of your hand. A doctor or nurse can use the IV to take blood samples and give you medication(s) during the test if needed.
4. Place blood pressure cuffs around one of your arms and a finger. The cuffs attach to monitors and send information to them throughout the test. The finger cuff will pump nonstop during the test. The arm cuff will check your blood pressure every four to 10 minutes.
5. Place small, sticky patches called electrodes on your chest. The electrodes connect to an electrocardiograph monitor that records the electrical activity of your heart as a graph or series of lines on a moving strip of paper. The EKG shows your heart rate and rhythm during the test.
What to expect during a tilt table test
A doctor or nurse will be with you throughout your tilt table test. They’ll try to keep you as comfortable as possible. Machines will constantly monitor your blood pressure, heart rhythm and heart rate throughout the test. A computer will store the collected information.
First part of test
During a tilt table test, you’ll rest for 15 minutes.
Then, as you lie still, a doctor or nurse will record your blood pressure and EKG.
A doctor or nurse who controls the motorized table will tilt it:
• To 30 degrees for 2 to 3 minutes.
• To 45 degrees for 2 to 3 minutes.
• To 70 degrees for up to 45 minutes.
You’ll always be upright during the test.
For the most accurate test results, follow these directions:
• Stay as still and quiet as possible during the test.
• Don’t move your legs while you’re in the standing position.
• Try not to talk unless you need to.
• Tell the doctor or nurse about symptoms you have during your tilt table test.
Second part of test
If your blood pressure doesn’t fall during the first part of the test, a doctor or nurse may give you medicine to see if your body reacts to it. The medicine makes your heart beat faster. You may get the medicine through your IV or as a pill or spray in your mouth.
After you receive the medicine, a doctor or nurse will tilt the table to 60 degrees for up to 15 minutes. If your blood pressure goes down during this time, it’s the end of the test. Either way, you’re done in 15 minutes with the second part of the test.
How will I feel during the test?
A doctor or nurse will ask you how you feel throughout the test. You may not have any symptoms, or you may have pre-syncope symptoms. These can include, but aren’t limited to, feeling:
• Lightheaded.
• Dizzy.
• Sick to your stomach.
• Palpitations (fluttering in your chest).
• You also may have blurred vision or a headache.
The purpose of the test isn’t to make you faint. However, you may faint, depending on how you respond to the test.
It’s important to tell a doctor or nurse how you feel throughout your test.
They may ask you to rate your symptoms on a scale of 1 to 10, with 10 being the most severe. Your symptoms, along with the information we collect during the test, help them figure out what’s making you faint.
Tell the doctor or nurse if you feel like you can’t continue the test because of symptoms you have. They can stop the test if they have to. But, if they feel you can safely continue the test, they’ll encourage you to so they can get the most complete results possible.
What to expect after a tilt table test
After your tilt table test, a doctor or nurse will lower the table to a flat position. You’ll stay on the table for 5 to 10 minutes as you lie flat. This allows us to make sure you're OK and measure your blood pressure, heart rate and heart rhythm.
It’s rare for severe symptoms to continue after the test. But if this happens, you may need an evaluation in the emergency department.
If the tilt test is the last test of the day, we will remove your IV. If you have other tests that day that require an IV, they may leave your IV in place.
Most people can go home after their test. A responsible adult must drive you home after your tilt table test. You won’t be able to drive for the rest of the day.
You can eat normally after the test unless you have other tests scheduled that require you to fast.
Report any symptoms or side effects that are new or continue after the test.
What are the risks of a tilt table test?
Rarely, people faint during tilt table testing. Because a doctor or nurse are with you, they can put the table back down so you recover quickly. You also may feel tired and/or have an upset stomach. Some people can’t control their bladder and release urine (pee) when they faint.
Are tilt table tests safe?
Yes, tilt table tests are safe. However, all tests and procedures carry some risk. Very rarely, people with narrowed coronary arteries or carotid arteries may have heart attacks or strokes.
Your doctor or nurse will talk to you about the risks and benefits of the tilt table test before you agree to have the test. A doctor or nurse can modify the test if they need to in order to reduce your risks.