What is a Tilt Table Test for Evaluating Fainting and Syncope?
Tilt Table Test
The tilt table test (TTT) is widely used to diagnose neutrally mediated syncope or NMS. This test also is used to rule out NMS by Phoenix cardiologists who treat patients with frequent fainting episodes.
Neurally Mediated Syncope (NMS)
NMS is a disorder that occurs in people who often do not have any associated heart problems. Patients with this condition often report syncope (passing out spells) that occurs for several months or years.
These spells can be preceded by nausea or a hot sensation. When these syncope episodes happen, the person may fall to the ground. They often occur during a blood draw, but can happen any time.
Sometimes, the heart rate and blood pressure goes up or down without our knowledge. When this occurs, there is a reduction of blood supply to the brain. This causes syncope. Once the heart rate and blood pressure rises, the blood flow is restored and you wake up.
Before the Test
Check with your Phoenix heart doctor concerning medications you should or should not take before the test. Do not eat or drink anything after midnight to reduce the chance of vomiting during the test. Also, wear comfortable, loose-fitting clothing and leave valuables at home. Expect to be at the testing facility for 1 to 2 hours. Also, bring someone with you who can drive you home.
During the Test
When you come in for the tilt test, expect to be hooked up to an EKG machine and blood pressure monitor. An intravenous line (IV) is started in your arm. Large patches that connect to an external pacemaker are placed on the chest and turned on if your heart rate slows down too much.
You lie on a swivel table with safety straps across your legs and chest. The table is tilted up to an angle of 80 degrees that simulates going from flat to standing. This position change causes the heart rate and blood pressure to rise. If nothing happens, the table is returned to the flat position and you are given IV isoproterenol. This medication increases the heart rate and blood pressure, similar to your own natural release of adrenaline.
You are then put back into the 80 degree position. If an abnormal result is not seen, the test is normal. Patients who have a sudden drop of vital signs often get dizzy and pass out. The TTT simulates a real life situation and establishes the exact cause of syncope.
Risks and Safety Concerns
The TTT procedure is a fairly safe test, but a dramatic result can cause a black out spell. Other risks include a persistent abnormal heart rhythm, allergic reaction to the medication, chest discomfort, and shortness of breath.
Tilt Test Results
The TTT procedure allows your doctor to diagnose NMS. Once the doctor knows the cause of your syncope, he can treat the condition. Common medications used to treat NMS include beta blockers, disopyramide, and certain selective serotonin-uptake inhibitors (SSRIs).
AZ Heart Doctor offers premier Phoenix cardiology treatment with a Double Board Certified noninterventional cardiologist. The office has 2 locations, one in Mesa and the other in Tempe. Most insurance is accepted – call (480) 300-4646 today!
Resources
Heart Site (2012). Tilt Table Test. Retrieved from: http://www.heartsite.com/html/tilt_test.html
Mayo Clinic (2013). Tilt Table Test. Retrieved from:
Leave a Reply