Tilt table testing is a medical procedure used to help diagnose a condition called vasovagal syncope or neurally mediated syncope. This condition involves a sudden drop in heart rate and blood pressure, leading to fainting or near-fainting episodes.

During the test, the patient is strapped to a special table that can be tilted to different angles, simulating a change in position from lying down to standing up. The table is equipped with safety measures to prevent falls.

The test begins with the patient lying flat on the table. They are then gradually tilted to an upright position, typically at an angle of 60 to 80 degrees. The patient's heart rate and blood pressure are continuously monitored throughout the test.

The goal of tilt table testing is to provoke symptoms of lightheadedness, dizziness, or fainting in a controlled environment. This allows healthcare providers to observe the body's response and potentially identify the cause of the fainting episodes.

If symptoms occur during the test, it may indicate a tendency towards vasovagal syncope. The test can be ended early if necessary for safety reasons, and appropriate measures will be taken to ensure the patient's well-being.

Tilt table testing is a valuable tool in diagnosing and managing conditions that lead to fainting spells. It provides important information for treatment planning, which may include lifestyle modifications, medications, or other interventions to help prevent future episodes.

How is it done?

Tilt table testing is performed in a controlled medical environment and typically involves the following steps:

1. Preparation:

• You will be positioned on a special table that can be tilted to different angles. The room will be equipped with safety measures, and medical equipment for continuous monitoring of your heart rate and blood pressure.

2. Monitoring:

• Electrodes will be placed on your chest to monitor your heart's electrical activity (electrocardiogram or ECG). A blood pressure cuff will also be applied to monitor your blood pressure.

3. Baseline Measurements:

• While lying flat on the table, your baseline heart rate and blood pressure will be recorded.

4. Tilting Phase:

• The table will be slowly tilted to an upright position, typically at an angle of 60 to 80 degrees. You will remain in this position for a specified period, usually between 20 to 45 minutes.

5. Observation:

• Throughout the test, healthcare providers will closely observe you for any signs or symptoms of lightheadedness, dizziness, or fainting. You'll be asked to report any unusual sensations.

6. Termination or Intervention:

• If you experience symptoms, the test may be terminated early for safety reasons. If necessary, measures will be taken to help you recover, such as lowering the table or administering medication.

7. Post-Test Evaluation:

• After the test, your vital signs and any recorded symptoms will be reviewed. This information will be used to assess the results of the tilt table test.

8. Recovery:

• If you experienced symptoms during the test, you may be monitored for a short period after the table is returned to the flat position to ensure you're stable.

Tilt table testing is generally considered safe, and healthcare providers are trained to respond to any adverse events. However, it's important to note that the test may provoke symptoms, including fainting, in individuals with certain conditions. Always follow any specific instructions provided by your healthcare team before and after the test. If you have any concerns or questions about the procedure, be sure to discuss them with your healthcare provider.

What can I expect?

1. Thorough Medical History Review: The cardiologist will go through your medical history, including any existing heart conditions, family history of heart disease, medications, and symptoms you may be experiencing.

2. Physical Examination: The doctor will perform a comprehensive physical examination, which may include checking blood pressure, listening to your heart and lungs, and examining other relevant areas.

3. Discussion of Symptoms: If you're experiencing symptoms like chest pain, shortness of breath, palpitations, or fatigue, you'll discuss them in detail.

4. Diagnostic Tests: Based on your medical history and symptoms, the cardiologist may order specific tests such as an electrocardiogram (ECG), echocardiogram, stress test, or other specialized cardiac tests.

5. Interpretation of Test Results: The cardiologist will review the results of any tests and discuss their implications for your heart health.

6. Diagnosis: Based on the gathered information and test results, the cardiologist will make a diagnosis, which could range from confirming a previously known heart condition to identifying a new issue.

7. Treatment Plan: If necessary, the cardiologist will discuss treatment options. This could involve medications, lifestyle modifications, procedures, or surgeries.

8. Education and Recommendations: The cardiologist will provide you with information about your condition, explain any necessary lifestyle changes, and offer guidance on managing your heart health.

9. Follow-Up Plan: Depending on your diagnosis and treatment plan, you may be advised to schedule follow-up appointments for further evaluation and monitoring.

10. Addressing Questions and Concerns: You'll have the opportunity to ask any questions or express concerns you may have about your heart health.

11. Referrals: If specialized care is required, the cardiologist may refer you to other healthcare professionals, such as cardiac surgeons or electrophysiologists.

12. Medical Records**: Your visit and the details discussed will be documented in your medical records.