Why is the doctor performing this test?
Tilt testing is used to help your cardiologist (heart
specialist) or electrophysiologist (heart rhythm specialist)
determine the cause of symptoms you may be having. These
symptoms usually include dizziness, lightheadedness or
fainting. Although there are many reasons for fainting, tilt
testing is used to determine if your symptoms are related to a
reflex in your heart and nervous system causing your heart
rate or blood pressure to drop. This reflex is called
neurocardiogenic syncope or vasovagal syncope.
What is the test?
Another name for fainting is syncope. The most common cause of
syncope is neurocardiogenic syncope or vasovagal syncope. In
neurocardiogenic syncope a normal reflex involving the heart
and the nervous system becomes too sensitive and, under
certain conditions, causes the heart rate to slow and the
blood pressure to drop. This may cause either dizziness or
near-fainting or fainting. Often patients who experience
neurocardiogenic syncope are healthy and have normal hearts.
The tilt test is designed to try determine if you have this
type of fainting or syncope.
Preparing for the test
- Do not eat or drink anything for 8 hours before the
test.
- Discuss any medications you are taking with your doctor
to see if you should stop taking them before the test.
- Take the medicines your doctor approves at your usual
time with a sip of water.
The procedure
For the test, you will be asked to lie on a flat bed called a
tilt table. You will have ECG electrodes attached to you so
that the cardiologist and staff can monitor your heart rate
and rhythm. A blood pressure cuff will measure your blood
pressure at frequent intervals. An IV will be started. Seat
belts will be used to secure you to the table. The seat belts
offer a feeling of security as the table is moved.
After you are flat for several minutes, the physician will
tilt the table to bring you to a near-standing position. If
you do not have symptoms after standing for a period of time,
the cardiologist may give you medication, either intravenously
or under the tongue, which speeds up your heart or opens
(dilates) your blood vessels. You may feel your heart racing
or pounding from the medication, but this sensation will go
away quickly when the medication is stopped. During the test,
you should tell the staff if you have any symptoms such as
dizziness or lightheadedness or a feeling of fainting. The
staff will be watching your heart rate and blood pressure
closely during the test.
If you have symptoms, the cardiologist will bring the table
down so that you are lying flat.
Your cardiologist will review the results of the test with you
as soon as it is complete. If the test shows that you have
neurocardiogenic syncope, your cardiologist may recommend
medication or changes in your lifestyle to help prevent
further episodes.
Most patients are discharged from the hospital after the test.
If you are feeling well, you may drive yourself home.
Where is the test performed?
The test is performed in a procedural room in the Heart
Hospital. The
room contains the tilt table and computer equipment to monitor
your heart rate and your blood pressure.
How long does the test take?
The test takes approximately 2 hours.
What if I have neurocardiogenic syncope?
Your tilt test or your symptoms may have suggested that you
have neurocardiogenic syncope. Neurocardiogenic syncope is the
most common cause of fainting or loss of consciousness.
Sometimes it is provoked by prolonged standing, standing in
a hot environment, by the sight of blood, or other provoking
factors.
You should try to be aware of what situations may
have provoked this in the past and see if you can avoid those
situations. You should try to drink plenty of fluids and avoid
becoming dehydrated. If you do feel the symptoms of
lightheadedness or have the feeling that you might faint, you
should lie down or put your head down right away to try to
avoid completely fainting or losing consciousness.
If these behavioral measures are not effective, there may be
medications which your physician can recommend to try to
reduce the chances of fainting or syncope.
8/3/2008
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