Tilt Table Test Examination: Procedures, Outcomes, and Additional Info
A tilt table test is a valuable diagnostic tool for individuals who have experienced unexplained fainting episodes, falls, or other symptoms suggesting syncope. This non-invasive test is designed to mimic the effects of standing up quickly, helping doctors identify the underlying cause of syncope.
Preparing for a Tilt Table Test
Before the test, it is essential to fast for at least four hours and remove all jewelry, tight clothing, and upper body garments. During the test, medical staff will monitor a person's blood pressure and ECG readings while tilting the table upward so the person is in an upright "standing" position.
The Tilt Table Test Process
The test begins with the person lying down on the table. Medical staff then tilt the table so the person is in an upright position, simulating the effects of standing up. They will monitor the person's blood pressure and heart rate for at least 15 minutes to see if any changes occur. If the test produces a decrease in blood pressure, the person will be returned to the lying position to recover.
In some cases, medical staff may give a person nitroglycerin under the tongue or via IV to increase their sensitivity or provoke a response during the test.
Common Causes of Positive Tilt Table Test Results and Their Relationship to Syncope
A positive tilt table test is often associated with diagnosing certain types of syncope, particularly neurally mediated syncope (NMS) and orthostatic hypotension (OH).
Causes of Positive Tilt Table Test Results
- Neurally Mediated Syncope (NMS): This is the most common cause of a positive tilt table test. NMS, also known as vasovagal syncope, occurs when the body overreacts to stressors.
- Orthostatic Hypotension (OH): This condition involves a significant drop in blood pressure when standing up from sitting or lying down.
Relationship to Syncope
Both NMS and OH involve changes in blood pressure and heart rate in response to positional changes during the tilt table test. NMS is more common and often triggered by stress or prolonged standing, while OH is related to an inability to maintain blood pressure when standing.
The tilt table test helps differentiate between various causes of syncope by reproducing symptoms under controlled conditions. It is particularly useful when other tests fail to identify a cause, assisting in the management and treatment of syncope types.
Potential Complications
Complications from tilt table tests are rare, but potential serious complications can include loss of consciousness, prolonged low blood pressure, and in rare cases, vomiting and choking while unconscious. However, these risks are outweighed by the benefits of accurately diagnosing and managing syncope.
In summary, a positive tilt table test often indicates neurally mediated syncope or orthostatic hypotension, both of which can cause syncope due to alterations in blood pressure and heart rate. Understandably, these conditions are crucial to diagnose accurately for appropriate management and treatment.
Possible side effects of the test include headache, dizziness, and lightheadedness. However, these symptoms are temporary and usually subside after the test.
Tilt table tests can help determine whether changes in position cause loss of consciousness and why, providing valuable information for the diagnosis and treatment of syncope.
During the tilt table test, medical staff may monitor a person's blood pressure and ECG readings, which can help identify conditions such as orthostatic hypotension (OH), a type of medical-condition that affects cardiovascular-health and contributes to health-and-wellness concerns like syncope. The science behind this tests reveals that a positive tilt table test is often associated with diagnosing both neurally mediated syncope (NMS) and OH, as both conditions involve changes in blood pressure and heart rate in response to positional changes during the test, thereby aiding in the management and treatment of these medical conditions.
