What is a tilt test?

The tilt test or tilt table test is an examination carried out to find out the causes of syncope (collapse) without any specific cause, and that is accompanied by other symptoms such as instability or vertigo. Mainly, the test is based on the evaluation of the heart rate and blood pressure while lying down, standing almost upright, and being in an erect position.

What does it involve?

The test involves lying on a tilt table, where you are tightly fastened with straps and with your feet lying on a foot support at the base of the table in order to help you stand in an upright position. While in this position, the first registration of your blood pressure and heart rate is done. Then you are laid flat and more registrations will be taken at the following minute intervals: 1, 5 and 10.

Once 10 minutes have passed, you will be tilted to an almost upright position, between 60° and 80° for 20 to 30 minutes until you experience the same symptoms as when you suffer a syncope. If symptoms don't show they will be artificially provoked using medication. The test is considered positive if it induces an episode of syncope, such as a drop in blood pressure and heart rate. These symptoms disappear when you are laid flat.

Why do you need it?

This test allows the doctor to find out the relation between blood pressure and the appearance of specific symptoms, which in many cases, makes detecting the correct origin of the syncope possible, as it can sometimes be erroneously diagnosed as epilepsy. The test can also determine the origin of orthostatic hypotension and autonomic dysfunction.

How should I prepare for it?

The test lasts for around 40 minutes, and the only preparation you need is not to eat or drink for at least 3 hours before the test. It is advisable to bring someone along to your appointment as you may feel light-headed at the end of the test.

This is not recommended for those who have:

• ischaemic heart disease; 
• diabetes; 
• glaucoma;
• carotid artery stenosis; 
• prostate enlargement and;
• serious valvular heart disease.

It's advised you visit a specialist for advice.

What do you feel during the test?

The tilt table test is not considered invasive, although the induced faint can feel uncomfortable.

What do the results of a tilt table test mean?

You can receive a positive or negative tilt table test.

Positive result

This could mean you have a condition which has caused abnormal changes in blood pressure, heart rate or heart rhythm.  

Negative result

If you receive a negative tilt table test, it means there were no indications of conditions that cause your blood pressure, heart rate or rhythm.

What happens after your get a positive tilt test result?

If a tilt test if positive, you'll undergo further testing.  Doctors will look to see if there are underlying conditions that can cause syncope, such as anaemia or adrenal insufficiency.