A test to determine how well your cardiovascular system is working

For patients who experience repeated or unexplained fainting or feelings of lightheadedness, a tilt table test can help pinpoint the cause. When a person stands up, gravity causes the blood to pool in the legs and blood pressure to drop (orthostatic hypotension). Under normal circumstances the body compensates for this by tightening the blood vessels and causing the heart to beat faster, which helps quickly push blood back up into the upper body and brain. However, if these automatic processes don’t work or work too slowly, the sudden drop in blood pressure may cause you to feel dizzy or faint.

The tilt table test helps mimic these body movements under controlled conditions. While lying on the table, it is moved into various positions. Your heart rate and blood pressure are tested to see how your cardiovascular system reacts. The test can help identify the potential causes of orthostatic hypotension, which can be the result of a number of nervous system and cardiovascular disorders.

Before the procedure:

The night before the test, after midnight, do not have anything to eat or drink. This can help reduce the likelihood of nausea or vomiting during the test. Your Hurley doctor will review the medications you are taking (including prescription drugs, over-the-counter medications and supplements) and tell you which ones you should stop taking before the test and which you can continue to take. The day of the test, wear comfortable clothing that can be easily removed for placement of the electrodes (if necessary, you will be given a hospital gown to wear). Be prepared for the test to take approximately 90 minutes, and be sure to arrange for a ride home afterward so that you do not have to drive.

During the procedure:

The skin is cleansed and small electrodes will be attached to various places on the chest. Wires from the electrodes will lead to an electrocardiograph (EKG) monitor records electrical activity in your heart. A blood pressure cuff will be attached to your arm and an IV line will be inserted in your arm. Baseline heart rate and blood pressure measurements will be taken. Large patches may also be attached to your chest, which are then connected to an external pacemaker in case your heart rate slows during the test but does not return to normal (this is rare). You will be asked to lie flat on a motorized swivel table, after which safety straps will be placed across your chest and legs to hold you in place during the procedure.

The table will begin to change position, generally moving you from a horizontal position to a nearly vertical position, which mimics the process of standing up after lying down. The time spent in each position may vary, from just a few minutes to nearly a half hour, depending on the way your heart rate and blood pressure respond to the changes in position.

In some cases, there is no unusual effect after the patient is moved into a vertical position. If so, you may be given medication through your IV that will increase your heart rate and blood pressure somewhat, to mimic the body’s natural response to standing. The changes in position will be repeated and additional measurements will be taken.

After the procedure:

The results of your exam will be reviewed and forwarded to your Hurley physician, who will share the information with you.