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Tilt Table Test - Background, Procedure, and Indications

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The tilt table test is done in order to evaluate blood pressure or arrhythmia as well as the heart rate. This article is a brief overview of the tilt table test.

Medically reviewed by

Dr. Prashant Valecha

Published At October 6, 2022
Reviewed AtOctober 6, 2022

Introduction

The tilt table test is also referred to as a passive head-up tilt test and head upright tilt test. A tilt table test generally records the blood pressure and any kind of rhythm abnormalities of the heart. The heart rate is also evaluated on the basis of each beat. All three factors can be assessed in several different positions of the heart. Patients suffering from unknown causes of fainting and light-headedness as well as syncope may be suggested to go for a tilt table test in order to frame a proper treatment modality as well as a management strategy.

In addition to the tilt table test, several other diagnostic tests and assessments may be suggested to get a more clear idea of the underlying condition. Syncope, a regularly manifested clinical symptom of several causes, one of them being unknown, refers to the loss of consciousness that is for a short term, due to the absence or sudden decrease in the blood being flown to the brain. These alterations in the blood flow may be due to abnormal blood pressure or underlying cardiovascular or neurological conditions.

How Long Does a Tilt Table Test Take To Be Completed?

The tilt table test generally takes around ninety minutes to be successfully completed. The healthcare provider should be informed prior to the scheduling of a tilt table test in case the patient is undergoing treatment for diabetes, water retention, allergies, a list of all the drugs the patient is currently on, or if the patient simply does not feel up to the mark.

Can Food or Drinks Be Taken Before a Tilt Table Test?

A regular diet can be followed the evening before the commencement of the tilt table test. It is generally suggested to avoid eating or drinking approximately four hours before the test is scheduled. Resuming a normal diet after the test is allowed and encouraged. During the test, the patient is supposed to wear loose-fitting or comfortable clothing.

What Happens During a Tilt Table Test?

Generally, the tilt table test is conducted in specific labs at the hospital setup called a cardiology laboratory. The healthcare provider is supposed to explain the entire test in great detail so that there is no doubt remaining in the patient’s mind. It is also advised to inform the healthcare provider in case the patient is not able to withstand their weight of more than or equal to one hundred and forty-seven kilograms without any support or help.

Mentioned below is the sequence of activities conducted during a tilt table test.

  • The patient is asked to lie on the tilt table platform which is a table that runs on motors and has a footrest of metal for the feet to stay put. Velcro bands are tied across the patient’s body. The patient is asked to manage their weight throughout the test as well.

  • The cuffs to measure blood pressure are placed around the arms and an intravenous cannula is inserted in a vein of the hand. The blood pressure machine is regulated throughout the test and blood pressure readings are recorded every four and ten minutes intervals.

  • Tiny patches are stuck to the heart to help during electrocardiography. These small patches are referred to as electrodes. They connect themselves to the electrocardiography machine and thus record the reading of the heart on paper in the form of several lines. Electrocardiography is continuously done during a tilt table test in order to have a piece of constant information on the heart’s rhythm, heart rate, and the normal functioning of the heart in different positions on the tilt table.

  • During a tilt table test, the motorized table is tilted to several different degrees for a maximum of three minutes. The different degrees in order of being set are thirty degrees, forty-five degrees, and seventy degrees. The patient is always upright during the entire test. The patient is advised not to make any sudden movements during the test and should inform the nurse or the present healthcare provider, if they are facing any form of discomfort or uneasiness.

  • Being still and put in the test will help in getting a more accurate picture of the cardiovascular system and thus will help in the correct diagnosis of the present condition. This will eventually aid the healthcare provider to come up with the best management plan to correct all the present clinical manifestations.

Conclusion

Symptoms such as unexplained episodes of fainting, unexplained lightheadedness, and frequent episodes of syncope are the reasons why a healthcare provider may suggest a tilt table test. Blood pressure, heart rate, and heart rhythm are a few of the features of the cardiovascular system that are evaluated throughout the test. In case the patient faints or goes into a blackout, the result of the tilt table test is positive. On the other hand, in case there are only slight alterations in blood pressure with no other significant deviation in the cardiovascular reading, the result of the test is negative. Depending on the severity of the signs and symptoms as well as the result of the test, the healthcare provider will explain the treatment plan after the correct diagnosis of the condition.

Frequently Asked Questions

1.

How Do We Prepare for a Tilt Table Test?

The doctor may advise a person undergoing a tilt table test not to eat and drink for four hours before the test. They may also be suggested to wear loose-fitting clothes for the test. The patient is also advised to take their regular medications before the test or can be asked to skip some of the medicines if needed.

2.

What Is the Purpose of the Tilt Table Test?

The tilt table test is used to record the rhythmic abnormalities of the heart, and it also records the blood pressure. The test can even evaluate the heart rate based on each heartbeat. All these factors can be assessed in different positions of the heart.

3.

What Conditions Can Cause a Positive Tilt Table Test?

The positive tilt table test can be due to the following heart conditions:
 - Abnormal changes in heart rate.
 - Abnormal changes in blood pressure.

4.

What Is The Duration of a Tilt Test?

The tilt table test usually takes around ninety minutes to complete. Before the tilt table test, a person should inform the doctor about any treatment they are taking for conditions such as diabetes, allergies, and water retention.

5.

How Long Does It Take To Recover From Tilt Table Test?

It normally takes around 30 to 60 minutes for a person to feel normal after the tilt table test but may vary from person to person. A person can start drinking and eating after the test usually. But a person may feel tired after the examination and take several hours to recover completely.

6.

Why Is Nitro Given During a Tilt Table Test?

Nitro or nitroglycerin is given during a tilt table test sometimes to induce a vasovagal response and reproduce symptoms. Nitro is known to enhance pooling and induce venous dilation. In addition, nitroglycerin is lipophilic and can readily pass through cell membranes in humans.

7.

How Long Does a Tilt Table Test Take for POTs?

The time taken for POTs test can vary but normally takes almost 40 to 45 minutes for a tilt table test for POTs (postural orthostatic tachycardia syndrome). However, the table test usually identifies POTs correctly in nearly 93 % of patients suffering from this condition.

8.

Can We Still Have Pots With a Negative Tilt Table Test?

A person can have POTs (postural orthostatic tachycardia syndrome) with a negative tilt table test. A negative Tilt test does not signify negative POTs. A person with postural orthostatic tachycardia syndrome doesn't need to show symptoms during the tilt table test constantly. These people can have chronic daily symptoms of POTs but negative tilt table tests.

9.

How Accurate Is Tilt Table Test Accurate for POTs?

The tilt table test is susceptible but has very poor accuracy for POTs. The test can identify 93 % of POTs patients correctly but can also show 60 % false negative results. In such cases, additional diagnosis is needed to confirm the Tilt table test results for POTs.

10.

Can a Person Take Fluids Before a Tilt Table Test?

A person is advised to eat a regular diet in the evening before the tilt table test. They are also told to avoid drinking water and eating at least four hours before the start of the test. A person can eat a regular diet after completing the tilt table test.

11.

What Happens If Tilt Table Test Is Positive?

Positive till table test indicates the following heart condition:
 - Abnormal changes in heart rhythm or heart rate.
 - Abnormal changes in blood pressure.

12.

How Do We Feel After a Tilt Table Test?

A person might feel nauseous after the tilt table test and may be asked to stay in the hospital for 30 to 60 minutes for recovery. Anti-nausea medications are also given to a patient. But a person often feels better after the test and can return home without symptoms.

13.

What Does a Tilt Test for the Heart Mean?

A tilt table test is done to reproduce the cardiac symptom in a safe and controlled condition. It aids in evaluating a person's heart rate and blood pressure. It also helps to identify the cause of fainting, lightheadedness, and dizziness. The person is asked to lie down on a bed, angled at 60 to 90 degrees for a few minutes, and the test is performed for 20 minutes to evaluate the causes of fainting and dizziness.

14.

What Conditions Can Be Diagnosed By a Tilt Table Test?

The tilt table test can diagnose the following conditions:
 - Structural abnormalities of the heart.
 - Ventricular dysfunction or weakness or failure in the pumping function of the ventricles.
 - Heart attack or myocardial infarction or damage to the heart muscle due to insufficient blood supply.
 - Arrhythmia or when a heart rate is too slow, too fast, or is irregular.
 - Sudden drop in blood pressure with or without a decrease in heart rate or vasovagal symptoms.
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Dr. Prashant Valecha
Dr. Prashant Valecha

Cardiology

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