Heart Disease: Diagnosing Heart Disease: Head-Up Tilt Table Test

The head-up tilt table test is a way to find out the cause of fainting spells. The test involves lying quietly on a bed and being tilted at different angles (30 to 60 degrees) for a period of time while various machines monitor your blood pressure, electrical impulses in your heart, and your oxygen level.

The head-up tilt table test is performed in a special room called the EP (electrophysiology) lab.

How Should I Prepare for the Test?

To prepare for the test:

• Take all your medications as prescribed.
• Do not eat or drink anything after midnight the evening before your test. If you must take medications, drink only small sips of water to help you swallow your pills.
• When you come for your test, bring with you a list of all your current medications, including the dose.
• When you come to the hospital, wear comfortable clothes. It is best not to wear any jewelry or bring valuables.
• Plan to have someone drive you home after the test.
• If you have diabetes, ask for specific instructions on taking your medications and eating/drinking before the procedure.

What Should I Expect During the Test?

The test usually takes one to two hours to complete, however, that may vary depending on the changes observed in your blood pressure and heart rate and the symptoms you experience during the test., Before the test begins, a nurse will help you get ready. The nurse will start an IV (intravenous) line. This is so the doctors and nurses may give you medications and fluids during the procedure if necessary.

You will be awake during the test. You will be asked to lie quietly and keep your legs still.

The nurse will connect you to four monitors, including a:

• Defibrillator/pacemaker. Attached to one sticky patch placed on the center of your back and one onto your chest as a precautionary measure. Allows the doctor and nurse to pace your heart rate if it is too slow or deliver energy to your heart if the rate is too fast.
• Electrocardiogram or ECG. Attached to several sticky electrode patches placed onto your chest, as well as catheters placed inside your heart. Provides a picture on graph paper of the electrical impulses traveling through your heart.
• Oximeter monitor. Attached to a small clip on your finger. Checks the oxygen level of your blood.
• Blood pressure monitor: Connected to a blood pressure cuff on your arm. Checks your blood pressure intermittently throughout the study.

Depending on your medical history, a blood sample may be taken before and during the tilt test to measure a hormone called adrenaline.

What Will I Feel During the Test?

You may feel nothing at all or the symptoms you feel when you're about to pass out. Or, you may pass out (faint). It is important to tell your doctor or nurse any symptoms you feel. As part of the test, your doctor may give you a medication called Isuprel. This medication may make you feel nervous or jittery or you may feel your heart beat faster or stronger. This feeling will go away as the medication wears off.

What Happens After the Test?

Most likely, you will be able to go home after the test. You should have someone with you to drive you home. After your test is received by your doctor, your medications may be changed or you may need new medications or additional tests or procedures.

Reviewed by the doctors at The Cleveland Clinic Heart Center.