What is a tilt table examination?
A tilt table examination is usually performed for a more precise clarification of unclear fainting spells (syncope).
What is syncope?
Syncope is a sudden onset of fainting that lasts a short time. Colloquially, syncope is also often referred to as circulatory collapse. Syncope is divided into different categories according to how it occurs:
- vasovagal syncope: triggered by prolonged standing or by emotions such as shock or pain
- orthostatic syncope: occurs when changing to an upright body position
- cardiac syncope: occurs in the event of circulatory disorders of the brain
- cerebrovascular syncope: is triggered by a so-called tapping phenomenon, which can lead to an undersupply of blood to the brain
When do you perform a tilt table examination?
Do not perform a tilt table exam if you have certain pre-existing conditions. These include:
- pronounced narrowing of the heart valves (aortic or mitral valve stenosis)
- pronounced narrowing of coronary vessels (coronary stenosis)
- pronounced narrowing of cerebral vessels (cerebrovascular stenosis)
What do you do during a tilt table examination?
The doctor performs the tilt table examination on a special tilt table – a movable couch. The patient is strapped down on this table and after some time in a horizontal position, the patient is brought to an upright position.
Before the tilt table examination begins, the patient is given intravenous access for rapid administration of medication. Blood pressure is constantly monitored and an electrocardiogram is recorded to monitor cardiac activity. Nothing should be eaten for about four hours before the examination.
Positive tilt table examination
The tilt table test is considered positive if the blood pressure or pulse decreases in the upright position and the patient experiences fainting. If these symptoms occur, the test is stopped immediately and the tilt table is returned to a horizontal position.
Negative tilt table test
If no fainting or changes in blood pressure or pulse occur after 45 minutes in the upright position, the test is negative.
The tilt table examination is easy to perform and is commonly used. However, the examination is not very accurate, because even if the test results are negative, the patient may suffer from syncope (false-negative result) or healthy people may have positive results in the tilt-table examination (false-positive result). Therefore, further investigations are usually necessary.
What are the risks of a tilt table examination?
Normally, however, the only action required when syncope occurs is to tilt back quickly (in less than ten seconds) to the prone position.
What do I need to do after a tilt table examination?
If no complications have occurred during the tilt table examination, you usually do not need to observe any further precautions after the examination.