Tilt table test (head-up tilt test) is a diagnostic test used to investigate the cause of unexplained fainting (syncope) episodes. It is the gold standard method for diagnosing vasovagal syncope.
What is a Tilt Table Test?#
A tilt table test monitors changes in blood pressure and heart rate as the patient is moved from a horizontal to a vertical position. This test evaluates the body’s response to position change.
Purpose of Tilt Table Test:
- Determining the cause of fainting
- Vasovagal syncope diagnosis
- Orthostatic hypotension detection
- Treatment planning
Tilt Table Test Indications#
Syncope Evaluation#
- Recurrent fainting episodes
- Unexplained syncope
- Syncope with prodromal symptoms
- Syncope with injury
Presyncope#
- Dizziness
- Vision darkening
- Feeling of fainting
- Imbalance
Other Indications#
- Postural tachycardia syndrome (POTS)
- Orthostatic intolerance
- Chronic fatigue syndrome
Pre-Tilt Test Preparation#
General Preparation#
- 4-6 hours fasting
- Comfortable clothing
- Medication adjustment (with doctor approval)
Medications to Stop#
- Antihypertensives
- Diuretics
- Vasoactive medications
- Beta blockers
How is Tilt Table Test Performed?#
Test Protocol#
Passive Phase:
- 20-45 minutes at 60-80° tilt
- No medication used
- Spontaneous response awaited
Provocation Phase:
- Nitroglycerin or isoproterenol
- Applied if passive phase is negative
- Increases sensitivity
Procedure Steps#
- Horizontal position: 10-15 minutes rest
- Baseline measurements: Blood pressure, heart rate
- Tilt: 60-80° vertical position
- Monitoring: Continuous monitoring
- Provocation: Medication if needed
- Termination: When positive response or time expires
Test Duration#
Total duration: 45-90 minutes
Tilt Table Test Results#
Positive Test#
| Type | Characteristic |
|---|---|
| Vasodepressor | Blood pressure drops, heart rate unchanged |
| Cardioinhibitory | Heart rate drops (asystole) |
| Mixed | Both occur |
Negative Test#
- No symptoms or hemodynamic changes
- Investigate other syncope causes
Tilt Table Test Risks#
Risks are low:
- Fainting (expected response)
- Nausea
- Dizziness
- Rarely prolonged asystole
Post-Tilt Test Treatment#
Vasovagal Syncope Treatment#
- Lifestyle changes
- Physical countermaneuvers
- Increased fluid and salt intake
- Compression stockings
- Medication therapy (if needed)
Frequently Asked Questions#
Is tilt table test painful?
How long does tilt table test take?
Will I faint during tilt test?
Do I need to fast for tilt test?
Can I drive after tilt test?
Appointment and Contact#
If you would like to schedule an appointment for tilt table test:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Diagnostic Tests#
Other diagnostic tests related to tilt table test:
- EKG - Electrocardiography
- Holter - 24-hour rhythm monitoring
- Echocardiography - Heart ultrasound
- Electrophysiology Study - Arrhythmia diagnosis
- Permanent Pacemaker - Bradycardia treatment