Have you ever had a sudden blue eye, felt like things were spinning around you, or felt like you were losing consciousness? If this happens to you often, today we are going to talk about a test that can help you find the cause. This is called the `(Tilt Table Test)`. Don't be afraid, it's simple. Let's see what it is, how it is done, and what you need to know.
What is this (Tilt Table Test)?
Simply put, a ``Tilt Table Test'' is a test that helps to find out the cause of fainting or loss of consciousness (also known as ``Syncope'' in medical terms). It involves having you lie down on a special bed (table) and continuously monitoring your blood pressure , heart rate , and heart rhythm as the bed is tilted at different angles. The bed is always positioned so that your head is above your head.
What can be found with the Tilt Table Test?
This ``Tilt Table Test'' allows us to see how your heart rate, rhythm, and blood pressure change when you change positions (for example, when you suddenly stand up from a lying position). Using this information, your doctor can find out what is causing your dizziness and lightheadedness . This can then help you develop the best treatment plan for you.
Now, look, syncope, or fainting, is a temporary loss of consciousness and loss of control of the body due to a temporary decrease in the amount of blood flowing to the brain. That's why sometimes people fall. This loss of blood can be caused by a sudden drop in blood pressure, a decrease in heart rate, or a change in the amount of blood in the body or blood circulation. Even after regaining consciousness, you may feel a little dizzy.
Whether we're standing, sitting, or lying down, our bodies should automatically regulate our heart rate and blood pressure. However, some medical conditions can interfere with this process. When that happens, your blood pressure can drop suddenly when you stand up.
Syncope is often caused by other conditions that affect your heart, nervous system, or blood flow to the brain. Therefore, your doctor may order other tests along with the Tilt Table Test to better understand your condition.
How do you do this (Tilt Table Test)?
Imagine what happens inside your body when you suddenly stand up from a lying position. That's what this ``Tilt Table Test'' does artificially. But it's much safer . Because you're strapped to the bed with straps, you won't fall off even if you get dizzy when you move the bed to a standing position.
When is a Tilt Table Test performed? Where? How long does it take?
A doctor may perform this ``Tilt Table Test'' if you are experiencing frequent dizziness or loss of consciousness for no apparent reason.
This test is performed in a special ``Tilt Lab'' or ``Electrophysiology Lab'' located in a hospital or clinic.
The test can take about 90 minutes to complete, depending on your symptoms and how your blood pressure and heart rate change during the test. Some people may show symptoms right from the first part of the test, so they don't need to do the test any further. The doctor will have all the information they need by then.
How to prepare for the Tilt Table Test?
Follow your doctor's instructions carefully and know what to do on the day of the test. It's a good idea to ask a friend or relative to drive you home after the test.
About food and drink:
- Eat normally the night before the test.
- Do not eat or drink anything other than a couple of sips of water for four hours before the test.
- Do not drink anything containing caffeine (such as coffee or tea) on the day of the test.
About medicine:
- Take your usual medication on time with a sip of water.
- If you are taking diuretics (water pills), ask your doctor if you can take them after the test.
- Do not take laxatives.
- If you have diabetes or take insulin, ask your doctor how to take your medication on the day of the test. Bring your glucose meter if you feel your blood sugar is low on the way to the hospital.
- Never stop taking medication without talking to a doctor.
What should you wear?
- Wear comfortable clothes and a pair of shoes. You can wear a short-sleeved or sleeveless T-shirt instead of a hospital gown. If you are wearing long-sleeved or tight clothing, you may be asked to change into a hospital gown. It is a good idea to bring extra clothes to change into in case you vomit or urinate during the test.
What do you need to take with you?
- Don't take anything valuable with you.
- Take these things with you:
- A written list of the medications you are currently taking and their dosages.
- Old medical records, if any.
- A written list of all your allergies (to medications, foods, environmental substances).
- Your insurance card.
What happens before the test?
A doctor or nurse will explain the test to you, answer your questions, and ask you to sign a consent form. You may also be able to get this form when you meet with the doctor the day before the test. Someone will help you prepare for the test and answer any questions you may have.
Before the test, if you want to ask your doctor not to use one of your arms to put in an IV (intravenous saline solution) or to check your blood pressure, tell him/her.
Before the test, the medical staff will do the following:
- You will be made to lie down on a ``Tilt Table''. This is a motorized bed with an iron board to rest your feet on.
- Soft fabric straps will be attached across your body, but you will need to bear your own weight during the test.
- An IV will be inserted into a vein in your arm or hand. This can take blood samples and give you medication during the test, if needed.
- Blood pressure cuffs will be attached to one of your arms and a finger. These are connected to monitors that send information throughout the test. The cuff on the finger is on continuously throughout the test. The cuff on the arm checks your blood pressure every 4-10 minutes.
- Small, sticky patches called electrodes are placed on your chest. These are connected to an electrocardiogram (EKG) monitor. This shows your heart's electrical activity as a moving graph of lines on a moving paper strip. This can monitor your heart rate and rhythm during the test.
What happens during the test?
The medical staff will stay with you throughout the test. They will try to make you as comfortable as possible. Machines will continuously monitor your blood pressure, heart rhythm, and heart rate. The information collected will be recorded on a computer.
Part One:
During the ``Tilt Table Test'', you will lie down for about 15 minutes.
Then, while you are still, a doctor will take your blood pressure and an EKG.
The person controlling the motorized table tilts the table like this:
- 2-3 minutes at 30 degrees.
- 2-3 minutes at 45 degrees.
- Up to 45 minutes at 70 degrees.
The most important thing is that you always keep your head up during the test.
To get accurate test results, follow these instructions:
- Stay as still and quiet as possible during the test.
- Don't move your legs when you are in a standing position.
- Try not to talk unless it's absolutely necessary.
- Tell your doctor about any symptoms you experience during the Tilt Table Test (such as dizziness, lightheadedness, or stomach upset).
Part Two (if necessary):
If your blood pressure doesn't drop during the first part of the test, a doctor may give you a medicine to see how your body responds to it. This medicine makes your heart beat faster. This medicine can be given through your ``IV'', as a pill, or as a spray into your mouth.
After giving you the medicine, the doctor will tilt the table to 60 degrees for up to 15 minutes. If your blood pressure drops during this time, the test is over. However, the second part of the test will be completed in 15 minutes.
How will you feel during the test?
Throughout the test, the doctor will ask you how you are feeling. You may not have any symptoms, or you may experience ``pre-syncope'' symptoms. These are the most common:
- Lightheadedness - Feeling lightheaded, like you're floating.
- Dizziness.
- Feeling sick to your stomach, like you're going to vomit.
- Palpitations are a feeling of the heart beating and the chest pounding.
You may have blurred vision or a headache.
The purpose of this test is not to make you nervous. However, depending on how you respond to the test, it could make you nervous.
Very important: Tell your doctor what you're feeling throughout the test. They may ask you to rate your symptoms on a scale of 1 to 10 (10 being the worst). Your symptoms, along with the information gathered from the test, will help your doctor figure out what's causing your symptoms.
If you feel you can't continue with the test because of your symptoms, tell your doctor . They can stop the test if they want to. However, if they think it's safe for you to continue with the test, they will encourage you to wait until the test is complete, as that's when you'll get the most complete results.
What happens after the test?
After the Tilt Table Test, the doctor will lower the table back to a flat position. You will lie on the table for about 5-10 minutes. During this time, the doctor will check to see if you are okay and will again measure your blood pressure, heart rate, and rhythm.
It is very rare for severe symptoms to persist after the test, but if they do, you may need to be taken to the Emergency Department for evaluation.
If this is your last test of the day, the doctor will remove your `(IV)`. If you have other tests that require an `(IV)` that day, they will leave the `(IV)` as it is. The person doing the other test will remove the `(IV)` after your last test.
Most people can go home after the test. But you must have a responsible adult drive you home. You cannot drive that day.
If you don't have any other tests that require you to fast, you can eat normally after the test.
If any new symptoms develop after the test, or if existing symptoms persist, tell your doctor .
Are there any risks with this (Tilt Table Test)? Is it safe?
Very rarely, people are put to sleep during the ``Tilt Table Test''. However, because the doctors are with you, they will quickly lower the table and get you back to your normal position. You may feel tired and/or have stomach pain. Some people lose control of their urine during the test.
This test is generally safe . However, as with all tests, there are some risks. Very rarely, people with narrowed coronary arteries or carotid arteries can have heart attacks or strokes.
Your doctor will discuss the risks and benefits of the tilt table test with you before agreeing to the test. If necessary, your doctor may make some changes to the test to reduce your risk.
What does it mean if the test is (Positive) / (Negative)?
- A positive tilt table test means you may have a medical condition that causes abnormal changes in your blood pressure, heart rate, or heart rhythm.
- A negative tilt table test means that you did not show any signs of a medical condition that causes abnormal changes in your blood pressure, heart rate, or heart rhythm.
What conditions can cause a (positive) test?
Some of the conditions that can cause a `(Positive) (Tilt Table Test)` are:
- Abnormally slow heartbeat (Bradycardia).
- Abnormally fast heartbeat (Tachycardia).
- Low blood sugar levels (Hypoglycemia).
- Low blood pressure (Hypotension).
- Postural Orthostatic Tachycardia Syndrome (POTS).
When will I know the results of the test?
A doctor may review the results and discuss them with you in the following situations:
- If you have significant changes in your blood pressure, heart rhythm, or heart rate.
- If you are in trouble.
- If your symptoms persist after the test.
If the doctor at the lab did not talk to you about the results after the test, call the doctor who referred you for this test and ask about the results. In most cases, the results will be available within a few days, if not immediately.
If the results are abnormal, what do you do next?
Depending on the results of the Tilt Table Test, you may need further tests to determine the exact cause of your syncope. These tests may include:
- A hemodynamic test, which is done with an echocardiogram, to check how blood is distributed throughout your body, the pressure in your blood vessels, and how well your heart is pumping blood throughout your body.
- An autonomic reflex test tests your autonomic nervous system - the system that controls actions we don't control, like breathing, heart rate, and digestion.
- `(Vestibular function test)` (a test related to balance).
- Heart rate monitoring.
- Echocardiogram (ultrasound test of the heart).
When do you need to talk to the doctor?
The doctor who referred you for this test will explain the test results to you and talk to you about your treatment plan.
It is very important to ask your doctor about your medications. You may need to make changes to the types or doses of medications you are taking. Follow the new treatment plan your doctor prescribes exactly.
Panic attacks can make you afraid to be alone or go out. Doctors have been using this ``Tilt Table Test'' for decades to help people find out what's causing their panic attacks. Once they know the cause, they can create a treatment plan to help you.
The most important thing to keep in mind (Take-Home Message)
It can be really disturbing and scary to have frequent fainting spells. But remember, the cause of this can be found and treated. The ``Tilt Table Test`` is an important step in helping with this.
If you have any of these symptoms, don't ignore them. See a doctor and talk about them. Then you can get the help you need. If you have any more questions about this test, don't be afraid to ask your doctor. Taking care of your health is the most important thing!
` Fainting, loss of consciousness, tilt table test, heart rate, blood pressure, diagnosis, syncope
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