Tilt Table Tests 

Tilt table tests involve changing a patient’s physical position quickly while monitoring his or her heart rate, heart rhythm and blood pressure. In essence, it allows a physician to evaluate how a patient’s heart function responds to the force of gravity.  

Conditions Diagnosed

A physician may order a tilt table test for a patient who frequently feels faint or lightheaded or completely passes out. The results can help the physician determine if the symptoms are related to the patient’s heart rate, heart rhythm or blood pressure. For instance, a very slow heart rate (bradycardia) may cause fainting. 

Procedure Details 

During a tilt table test, a patient lies on a motorized table that allows his or her head to be elevated 60 to 80 degrees above the rest of his or her body. A medical professional will place several electrodes on the patient’s chest, a blood pressure cuff on the patient’s upper arm and an intravenous (IV) line in a vein in the same arm. 

Next, a physician will carefully monitor the patient while triggering his or her symptoms as follows: 

• The table will be tilted so that the patient’s head is slightly higher (approximately 30 degrees) than the rest of his or her body. The patient’s heart rate and blood pressure will be recorded. 
• After about five minutes, the table will be tilted further so that the patient’s head is approximately 60 degrees higher than the rest of his or her body. The patient will be asked to remain still and quiet for about 45 minutes, during which time his or her heart rate and blood pressure will be monitored. 
• If the patient’s blood pressure drops, the table will be lowered and the test will be concluded. Otherwise, a medication will be administered to the patient via the IV line to cause his or her heart to beat faster and stronger. 
• The table will be tilted so that the patient’s head is approximately 60 degrees higher than the rest of his or her body. 
• After about 15 minutes—or sooner if the patient’s blood pressure drops— the table will be lowered and the test will be concluded. 

What to Expect 

Tilt table testing involves minimal risk of fainting, and even if a patient faints during the test, the fainting will take place in a safe and controlled setting. Usually, the patient will feel well again as soon as the table is returned to a flat position. After the test, the patient may feel tired or nauseous, and he or she will be monitored in a recovery room for 30-60 minutes. At that point, most patients can drive home and resume their normal activities. 

Effectiveness 

If the patient’s blood pressure drops during tilt table testing, or if he or she experiences symptoms such as faintness or dizziness, the test result is positive. A positive result may indicate that the patient has a condition that causes abnormal changes in his or her heart rate, heart rhythm or blood pressure. A physician may suggest additional testing, a change in medication or a pacemaker (if bradycardia is confirmed to be the cause of the symptoms). 

Tampa General Hospital’s Heart & Vascular Institute offers tilt table tests and a full complement of other services for diagnosing heart-related conditions.