What Is A Tilt Table Test, And How Does It Help Diagnose The Cause Of My Fainting?

Dr. Paul Friedman answers the question: 'What Is A Tilt Table Test?'

ByABC News
November 24, 2008, 9:48 AM

— -- Question: What is a tilt table test, how does it help diagnose the cause of my fainting, and what does it mean if my tilt table test is 'normal'?)

Answer :A tilt table test is used to identify the cause of fainting spells. During a tilt table test, you would lay on a table, which is relatively abruptly tilted up to 60 or 90 degrees. Ordinarily, when we go from a lying position to a standing position, blood wants to pool in our legs, because gravity pulls it down, and internal nervous system reflexes will tend to push the blood up and keep blood flowing.

In people who are prone to fainting, those reflexes may not work appropriately, so blood pressure may temporarily drop, and when not enough blood goes to the brain, we faint. And when once we fall to the ground, the blood flows to the brain again and we wake up.

In a tilt table test, blood pressure and heart rate are monitored, the table is tilted up and the doctor would then observe the blood pressure and heart rate response. There are a couple of different responses which might be abnormal: the heart might become excessively slow, blood pressure may drop without slowing of the heartbeat or both may occur.

Sometimes, in order to improve the diagnostic yield of the test, an adrenaline-like medicine, such as isoproterenol or nitroglycerin, may be administered in order to further try to provoke one of these abnormal reflexes.

If the test is normal, it may simply mean that the test didn't trigger your fainting spell, or it may mean that the cause of your fainting spell was not an abnormal reflex.

Treatments, depending on the results of the tilt table test, may include modification of diet, use of support stockings, medications or, occasionally, a pacemaker. Pacemakers are not used commonly in younger people.