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Heart Disease and the Head-Up Tilt Table Test

The head-up tilt table test is a way to find out the cause of fainting spells (syncope). It measures the difference in heart rate and blood pressure when standing up or lying down. 

The test involves lying on a stretcher and being tilted at different angles (30 to 60 degrees) for a period of time while your blood pressure, electrocardiogram, and your oxygen level are monitored.

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

How Should I Prepare for a Head-Up Tilt Table 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 a list of all your current medications, including the dose.
  • When you come to the hospital, wear comfortable clothes. Do not wear 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 and drinking before the procedure.

What Should I Expect During a Head-Up Tilt Table Test?

The test usually takes one hour. However, the time 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 by starting an IV (intravenous) line in a vein. 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. This is attached to one sticky patch placed on the center of your back and one onto your chest as a precautionary measure. It 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. This is 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. This is attached to a small clip on your finger to monitor the oxygen level of your blood.
  • Blood pressure monitor. This is connected to a blood pressure cuff on your arm to monitor your blood pressure throughout the test.

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 Tilt Table Test?

You may feel nothing at all, you may experience symptoms you feel when you're about to pass out, or you may faint. It is important to describe your symptoms to the doctor or nurse. As part of the test, your doctor may give you a drug called Isuprel or nitroglycerin spray under your tongue. These 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 a Tilt Table Test?

Most likely, you will be able to go home after the test. You should have someone with you to drive you home. 

After receiving results of the test, your doctor may change your medications, add others, or order additional tests and procedures.

 

WebMD Medical Reference

Reviewed by James Beckerman, MD, FACC on July 11, 2014

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