Do you also feel like you're constantly being pushed? Let's talk about the Tilt Table Test!

Have you ever suddenly felt dizzy and lightheaded when you stood up from a lying down position? Or have you suddenly lost consciousness and fallen to the ground for no apparent reason? This is a truly frightening experience. Today, we are going to talk about a special test that our doctors use to find out the exact cause of these things.

What is this Tilt Table Test?

Simply put, a tilt table test is a method of closely monitoring, pulse by pulse, how your blood pressure, heart rate, and heart rhythm change as you move from one position to another (especially when you move from a lying position to a standing position). This involves having you lie down on a special table and slowly tilting it vertically. However, the table is always positioned so that your head is up.

Now you might be thinking, "Why do we do that?" Well, when we stand, sit, or lie down, our blood pressure and heart rate should be automatically controlled to suit the position we are in. It's an amazing mechanism in our body. But sometimes, due to certain medical conditions, this automatic control doesn't work properly. That's when you suddenly get up and your blood pressure drops, making you dizzy and lightheaded.

This loss of consciousness is medically called syncope . It occurs when blood flow to the brain is temporarily reduced. So, the tilt table test is a safe environment, under the supervision of a doctor, where you are artificially induced to faint and then you are tested to see exactly what happens to your body at that moment.

How do you prepare for this test?

Your doctor will give you instructions on how to prepare for this test the day before. Following those instructions exactly is very important for the success of the test.

To make it easy to remember, let's look at the things we need to prepare like this.

What happens during the test?

When you go into the room where this test is performed, you are not alone. A doctor and nurses will be with you. So there is no reason to be afraid.

Preparation before the test

First, they will make you lie down on a special bed (tilt table). Then they will do the following:

• Safety straps: To prevent you from falling, several soft straps are placed across your body to protect you when changing positions in bed.
• IV Line: An IV (intravenous) line is inserted into a vein in your arm. This is used to give medication and take blood samples if needed.
• BP Cuff: Two blood pressure cuffs are attached to one arm and one finger. These continuously monitor your blood pressure.
• EKG Electrodes: Several electrodes, which look like small stickers, are attached to your chest. These are connected to an EKG (Electrocardiograph) machine that continuously monitors your heartbeat.

The first part of the test

Once everything is ready, you will be asked to lie on the bed for about 15 minutes. After that, the bed will slowly begin to be raised.

• First, 2-3 minutes at 30 degrees.
• Next, 2-3 minutes at 45 degrees.
• Finally, raise it to about 70 degrees and leave it in that position for up to 45 minutes.

It's very important that you remain as still and motionless as possible during this time. Don't move your legs. Don't talk. But, anything you feel - like you're dizzy, like you're about to vomit, like your chest is pounding - you should tell the doctor or nurse there.

The second part of the test

If your blood pressure doesn't drop and you don't feel dizzy during the first part, your doctor may decide to move on to the second part. This involves giving you a medicine that makes your heart beat a little faster. This can be given through an IV, as a pill, or as a spray into your mouth.

After the medication is given, the bed is raised again to about 60 degrees and you stay there for about 15 minutes. This is to see how your body responds to the effects of this medication. If you feel unwell at this point, the test will end there.

What happens after the test?

When the test is finished, the bed will be returned to a fully reclined position. You will be asked to remain in this position for about 5-10 minutes. This will be monitored until your blood pressure and heart rate return to normal.

Most of the time, once everything is normal, the IV will be removed and you will be allowed to go home. Remember, someone else will definitely have to drive you home . You will not be able to drive that day.

You can eat normally after you go home. If you develop any new symptoms or if your previous symptoms persist, inform your doctor.

Test results and next steps

Your doctor will decide what to do next based on the results of the test.

• A positive (+ve) result: This means that during the test, there was an abnormal change in your blood pressure or heart rate, causing you to feel dizzy. This means that the test has detected a condition that could be causing your dizziness. For example, a heart rate that is abnormally slow (bradycardia) , abnormally fast (tachycardia) , or a condition like Postural Orthostatic Tachycardia Syndrome (POTS) .

• A negative (-ve) result: This means that you did not experience any symptoms during the test, and there was no significant change in your blood pressure or heart rate. This means that the test could not find the cause of your symptoms.

Whatever the result, your doctor will explain it to you. If the result is negative, you may be referred for further testing (such as an echocardiogram ) to find the cause.

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