Tilt Table Test

A tilt table test is used to evaluate the cause of unexplained fainting or severe lightheadedness. During the test, your blood pressure and heart rate are monitored. You begin by lying flat on a table. Then, the table is tilted to raise the upper part of your body — simulating a change in position from lying down to standing up. This test allows doctors to evaluate your body's cardiovascular response to this change in position.

When you stand up, gravity causes blood to pool in your leg veins, reducing the amount of blood that returns to your heart. This causes your blood pressure to drop (orthostatic hypotension). Normally, your autonomic nervous system rapidly accommodates this effect by narrowing (constricting) your blood vessels and increasing your heart rate. But if these mechanisms don't work normally, the drop in blood pressure can be severe enough to cause fainting.

The tilt table test can help detect orthostatic hypotension. Causes of orthostatic hypotension may include diseases that affect the autonomic nervous system, such as diabetic autonomic neuropathy and Shy-Drager syndrome.

To prepare:

Ask your doctor whether you should take your regular medications. Avoid eating or drinking after midnight to reduce the risk of nausea and vomiting during the test. It's best to wear a shirt or blouse that can be easily removed, to expedite preparation for the test.

The test generally takes a total of 1 1/2 hours. This includes preparation, the actual test and the recovery phase. Please make sure that somebody can drive you home after the test.

During the test:

Electrodes will be applied to your chest in preparation for an EKG and you will be hooked up to a blood pressure to enable constant monitoring during the procedure. You'll also have an intravenous (IV) line placed in your arm. Large patches will also be attached to your chest, which are connected to an external pacemaker. This is turned on if your heart rate slows during the test and does not pick up on its own, but usually this is unnecessary since most slow heart rates are transient and correct on their own. You will lay flat on a swivel table, with safety straps across your chest and legs to hold you in place.

After obtaining a baseline heart rate and blood pressure measurement, the motorized table is tilted up to an angle of 80 degrees. This simulates going from a flat (supine) to a standing or upright position. The change in position elevates both heart rate and blood pressure, which is what the test is tracking. You may remain in each position for between five and 30 minutes.

If nothing happens, the table is returned to the flat position and an intravenous infusion of a medication is started to increase your heart rate and blood pressure. This effect is similar to that produced by our own natural adrenaline release, a simulation of what happens when the sympathetic nervous system is stimulated and the "accelerator" is pressed. The tilt table is then raised back up to 80 degrees and the IV medication continued.

Learn more about the Tilt Table Procedure.   »Go

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For more information or to make an appointment please call
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