Tilt Table Test - TTT

What is a Tilt Table Test (TTT)?

A tilt table test, occasionally called upright tilt testing, is a medical procedure used to diagnose unexplained loss of consciousness (syncope). Patients with symptoms of dizziness or lightheadedness, with or without a loss of consciousness (fainting), suspected to be associated with a drop in blood pressure or heart rate changes.are good candidates for this test. The tilt table procedure attempts to cause syncope by creating changes in posture from lying to standing.

Why do I need the tilt table test?

You may need a tilt table test if you have recurring fainting and other causes were ruled out by other tests.

Syncope, or fainting, may be caused by various medical problems. Syncope may occur rarely to frequently, depending on the cause. Some causes of syncope may include:

  • Vasovagal syndrome (also called neurocardiogenic syncope). This is a sudden drop in blood pressure with or without a decrease in heart rate. It’s caused by a problem of the nerves that control the heart and blood vessels.
  • Arrhythmia. This is when a heart rate is too slow, too fast, or is irregular. When this happens, the heart can’t get enough blood flow to the body.
  • Structural heart disease (problems of the heart muscle or valves). Enlargement of the heart muscle or malfunction of one or more of the heart valves may block blood flow within the heart.
  • Heart attack (also called myocardial infarction or MI). This is damage to the heart muscle due to insufficient blood supply.
  • Ventricular dysfunction. This is a weakness or failure of the pumping function of the ventricles (the heart’s major pumping chambers.

What are the risks of the tilt table procedure?

Possible risks of tilt table testing include:

  • Fainting
  • Dizziness or headache
  • Low blood pressure or high blood pressure
  • Nausea
  • Palpitations and/or change in heart rate

What should I expect during a tilt table test?

You will lie down on a table that can be moved from a horizontal to a vertical position. The table has a footrest and safety belts. The belts are placed around your body during the test to help ensure that you don't slip off the table. Once you're positioned on the table, the test progresses this way:

  • Your heart rate and blood pressure are monitored for about five minutes while you're lying flat (horizontal).

  • The bed is then moved to a vertical position (about a 60- to 90-degree angle) so that you are in a head-up position.

  • Depending on the reason for the tilt table test, you may stay in the vertical position for about five to 10 minutes, or you may remain in the vertical position for up to 45 minutes.

  • While you are in the vertical position, you remain as still as possible. During the test, if you feel signs and symptoms such as nausea, sweating, lightheadedness or irregular heartbeats, tell a member of your health care team.

  • If you don't faint or experience any other symptoms after a period of time, a medication may be given through an IV line to speed up your heart rate. This medication lowers your diastolic blood pressure (the bottom number in a blood pressure reading), lowers peripheral vascular resistance, increases your heart rate and may prompt the abnormal nervous system reflex that causes vasovagal or neurocardiogenic syncope.

  • You may be given a medication under the tongue, called nitroglyercin which dilates your blood vessels.

  • You then remain in the upright position and are monitored for a period of time.

  • The test takes approximately one hour

What happens after the tilt table procedure?

  • You should be able to resume your normal diet and activities, unless your doctor instructs you differently.
  • Generally, there is no special care following a tilt table procedure.
  • Tell your doctor if you develop any signs or symptoms you had prior to the test (such as, dizziness or fainting).
  • Your doctor may give you other instructions after the procedure, depending on your situation.
  • You will be given the results of the test at the time of the test.

For Testing Preparation, see patient instructions


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