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Tilt Table

The tilt table test measures how your blood pressure and heart rate respond to the force of gravity. During the test, you lie on a table that is slowly tilted upward. A nurse or technician keeps track of your blood pressure and heart rate (pulse) to see how they change during the test.

The test is normal if your average blood pressure stays stable as the table tilts upward and your heart rate increases by a normal amount.

If your blood pressure drops and stays low during the test, you may feel faint or feel lightheaded. That may mean your brain is not getting enough blood during the tilt. Your heart rate may not be adapting as the table tilts upward, or your blood vessels may not be squeezing hard enough to support your blood pressure.

Who is eligible for a tilt table test?

If you have been feeling any of these symptoms, your doctor may recommend a tilt-table test:

  • Nausea.
  • Pale skin.
  • Feeling faint.
  • Lightheadedness.
  • Loss of consciousness.
  • Changes when you suddenly stand up.

What conditions can be diagnosed by a tilt table test?

Doctors may recommend a tilt-table test for patients they suspect may have:

  • Abnormal heart rhythms (arrhythmias): Arrhythmias may cause your heart to beat too fast, too slow, or prematurely. An irregular heartbeat means your heart is not beating effectively, causing lightheadedness, fainting, or near fainting.

  • Hypoglycemia (low blood sugar): Blood sugar (glucose) level is your body's main energy source. Low blood sugar can make you feel faint. It is sometimes related to diabetes treatment.

  • Neurally mediated hypotension: This condition causes a person’s heart rate to slow down instead of speed up when they stand, which keeps blood from pooling in the legs and arms. As a result, a person may feel faint.

  • Neurally mediated syncope: A person with this syndrome can experience symptoms such as nausea, lightheadedness, and pale skin, followed by a loss of consciousness.

  • Postural orthostatic tachycardia syndrome (POTS): This disorder occurs when a person experiences changes when they suddenly stand up.

How do I prepare for a tilt table test?

The purpose of a tilt table test is to help determine the cause of severe dizziness or blackouts. Do not eat or drink anything after the midnight before the procedure. Your doctor will discuss with you which medications you can or cannot take on the day of the test. Wear comfortable clothing with a separate top and bottom.

What should I expect during my tilt table test?

The first part of the test shows how your body responds when you change positions.

  • You lie on your back on a table. Straps at your waist and knees help you stay in position. An IV (intravenous line) is put in your arm. Small discs with wires are attached to your chest and are connected to an EKG (electrocardiograph) machine to track your heartbeat. A cuff on your arm measures your blood pressure.

  • The nurse tilts the table, so your head is slightly higher (30 degrees) than the rest of your body and checks your blood pressure and heart rate.

  • After five minutes, the nurse tilts the table more and continues to check your blood pressure and your heart rate for up to 45 minutes.

  • If your blood pressure drops, the nurse will stop the test. If your blood pressure does not drop, the nurse will start the second part of the test.

The second part of the test shows how your body responds to a medicine that causes your heart to beat faster.

  • The nurse gives you medicine through your IV tube.

  • The nurse tilts the table upwards to a 60-degree angle. You may feel your heartbeat increase because of the medicine.

  • If your blood pressure drops, the nurse will lower the table, stop the medicine, and the test will end.

  • If your blood pressure does not drop after about 15 minutes, the nurse will lower the table, and the test will be over.

The tilt-table test can last about 90 minutes if you do both parts of it. If you only do the first part, you may be done in 30 to 40 minutes. After recovery, most people can drive home and return to their normal activities.

You may get your results as soon as the test is over. If your blood pressure does not fall during the test, and you have no other symptoms, the test results are negative (normal). If your blood pressure drops during the test and you feel faint or dizzy, the test is positive. Your doctor may suggest changing your medicines or having more tests. Your doctor may recommend a pacemaker if your fainting is due to a slow heart rate (bradycardia).

Why choose Presbyterian for a tilt table test?

Presbyterian’s Heart and Vascular team has many different options to help you manage your heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans for your heart health needs. Depending on the type of heart condition you have and its underlying cause, the team can recommend a wide variety of treatment options, including lifestyle modifications, medications, and procedures. Our cardiologists and cardiovascular surgeons work closely together for cases in which surgery is the best treatment option. We also offer a customized cardiac rehabilitation program at our Healthplex, where clinically appropriate, which can improve your endurance and exercise tolerance, as well as improve heart-related symptoms. Your cardiologist will work with the rehabilitation team to create a plan that will be tailored to your individual health needs.