Tilt Table TestBy
Sarah Lewis, PharmD
What is a tilt table test?
A tilt table test is a minor procedure used to diagnose the cause of fainting, near fainting, dizziness, or lightheadedness. It involves lying flat on a table that slowly tilts at near an upright position. A nurse or technician monitors your heart rate, heart rhythm, and blood pressure during the test to see if they change with your position. You may receive medicine through an IV as part of your tilt table test. Your doctor will discuss the results with you after the tilt table test is complete.
A tilt table test is a minor procedure, but it still involves some risk. It is only one method used to diagnose the cause of fainting, near fainting, dizziness, and lightheadedness. Discuss all of your options with your doctor to understand which options are right for you.
Why is a tilt table test performed?
Your doctor may recommend a tilt table test to diagnose:
Autonomic failure (dysautonomia), which is a disorder of the autonomic nervous system that is responsible for regulating internal organs such as the heart
Orthostatic hypotension, which is a drop in blood pressure with changes in position due to blood pooling in the legs
Vasovagal syncope (neurocardiogenic syncope), which is also called the “common faint” and is the most common cause of fainting or near fainting
Who performs a tilt table test?
Nurses and technicians with specialized training perform tilt table tests. Clinical cardiac electrophysiologists or cardiologists oversee tilt table tests. A cardiologist specializes in diagnosing and treating conditions of the heart and its blood vessels. A clinical cardiac electrophysiologist is a cardiologist who specializes in diagnosing and treating abnormal heart rhythms (arrhythmias) using heart and blood vessel imaging and technical procedures.
How is a tilt table test performed?
Your tilt table test will be performed in a hospital or outpatient electrophysiology (EP) lab. It is a minor procedure that involves the following steps:
You will dress in a patient gown and lie down on your back on a tilt table. Straps around your chest, waist and knees will hold you in position.
Your nurse or technician will insert an IV.
Your nurse or technician will attach painless electrodes to monitor your heart rhythm and rate with an EKG (electrocardiogram).
Your nurse or technician will put a blood pressure cuff around your arm to monitor your blood pressure.
Your nurse or technician will begin to tilt the table up by small amounts until you reach angles of 60 to 80 degrees. This is almost a standing position. The nurse or technician will check your vital signs with each tilt.
You will need to remain quiet during this time, but tell the nurse or technician if you are uncomfortable.
Your nurse or technician will stop the test if you faint or feel too uncomfortable to continue.
Your nurse or technician may repeat the procedure after giving you IV medicine.
You will recover for up to an hour and then go home.
Will I feel pain with a tilt table test?
Your comfort and relaxation is important to both you and your care team. You may have dizziness, lightheadedness, or nausea during a tilt table test. Tell your nurse or technician right away if you have symptoms or are uncomfortable during a tilt table test.
What are the risks and potential complications of a tilt table test?
Complications after a tilt table test are not common, but any medical procedure involves risk and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or recovery. Risks and potential complications of tilt table test include:
Changes in blood pressure
Reducing your risk of complications
You can reduce the risk of certain complications by:
Following activity, exercise and lifestyle restrictions and recommendations
Following instructions after the procedure exactly
Informing your doctor if you are nursing or if there is any possibility of pregnancy
Keeping all scheduled appointments
Notifying your doctor immediately of any concerns, such as dizziness, fainting, or new symptoms
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my tilt table test?
You are an important member of your own healthcare team. The steps you take before your tilt table test can improve your comfort and outcome. You can prepare for a tilt table test by:
Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Arranging for a ride home. You will not be able to drive yourself home if you faint during a tilt table test.
Not eating or drinking as directed before the test. This generally includes no food for six to eight hours before the test.
Taking or stopping medications exactly as directed. Ask your doctor for specific instructions about taking your medications before the test.
Questions to ask your doctor
Having a tilt table test can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before your procedure and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
Why do I need a tilt table test? Are there any other options for treating my condition?
How long will the procedure take? When can I go home?
What restrictions will I have after the procedure? When can I return to work and other activities?
What kind of assistance will I need at home? Will I need a ride home?
How should I take my regular medications?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my tilt table test?
Knowing what to expect after a tilt table test can help you get back to your everyday life as soon as possible.
What can I expect after the tilt table test?
You may feel tired or have nausea or an upset stomach after the tilt table test. To reduce discomfort, take slow deep breaths. Tell your nurse or technician if you feel uncomfortable or if the nausea does not pass quickly.
When can I go home?
You should be able to go home about an hour after the test. You may feel tired for several hours after a tilt table test. Otherwise, most people can resume normal activities and diet after a tilt table test.
When should I call my doctor?
It is important to keep your follow-up appointments after a tilt table test. Contact your doctor if you have concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Chest pain or heart palpitations
Dizziness or fainting
New or unexplained symptoms
Persistent headache or nausea
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- Barón-Esquivias G, Martínez-Rubio A. Tilt table test: state of the art. Indian Pacing Electrophysiol J. 2003 Oct 1;3(4):239-52. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513525/
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- Tilt Table Procedure. Johns-Hopkins. http://www.hopkinsmedicine.org/healthlibrary/test_procedures/cardiovascular/tilt_table_procedure_92,...
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