Tilt Table Testing
What is a tilt table test?
A tilt table test is a test often done to evaluate symptoms of syncope (fainting)
or near syncope. If you have syncope, your healthcare provider will carefully review
your health history and do a physical exam. If the results of the exam or history
don't show a cause for the syncope, and you have no history of heart disease, then
further test may be scheduled.
A tilt table test attempts to find the cause of syncope by creating changes in posture
from lying to standing. You will lie flat on a special bed or table with safety belts
and a footrest. You will be connected to electrocardiogram (ECG) and blood pressure
monitors. The bed or table is then raised to an almost standing position (60° to 70°
vertical angle) to simulate standing up from a lying position. The blood pressure
and ECG (electrocardiogram) are measured during the test to evaluate changes during
the position changes. If the test causes you to faint, the table will quickly be returned
to a flat position to help you regain consciousness. If no changes are seen and symptoms
are not reproduced, you may be given a medicine such as isoproterenol or nitroglycerin
to try and provoke symptoms. The information collected can then be used to help your
healthcare provider prescribe treatment.
Why might I need the tilt table test?
You may need a tilt table test if you have recurring fainting and other causes were
Syncope, or fainting, may be caused by various medical problems. Syncope may occur
rarely to frequently, depending on the cause. Some causes of syncope may include:
Vasovagal syndrome. This is also called neurocardiogenic syncope. This is a sudden drop in blood pressure
with or without a decrease in heart rate. It’s caused by an exaggerated response of
nerves that control the heart and blood vessels.
Orthostatic syncope. This is when your blood pressure drops when you stand up quickly or after you have
been standing for a period of time. The drop in blood pressure may be related to pooling
of blood in the legs and poor return of blood up to the brain.
Arrhythmia. This is when a heart rate is too slow, too fast, or is irregular. When this happens,
the heart can’t get enough blood flow to the body.
Structural heart disease. This means problems of the heart muscle or valves. Enlargement of the heart muscle
or a defect in one or more of the heart valves may block blood flow within the heart.
Heart attack. This is also called myocardial infarction (MI). This is damage to the heart muscle
due to poor blood supply.
Cardiomyopathy, ventricular dysfunction. This is a weakness or failure of the pumping function of the heart’s major pumping
There may be other reasons for your healthcare provider to advise a tilt table test.
What are the risks of the tilt table test?
Possible risks of tilt table testing include:
Planned episodes of syncope (fainting)
Dizziness or headache
Low blood pressure or high blood pressure
Palpitations or change in heart rate
There may be other risks depending on your specific medical condition. Be sure to
discuss any concerns with your healthcare provider before the test.
How do I get ready for the tilt table test?
Your healthcare provider will explain the test to you and you can ask questions.
You will be asked to sign a consent form that gives your permission to do the test.
Read the form carefully and ask questions if something is not clear.
Tell the technologist if you are allergic to or sensitive to any medicines or latex.
Fasting may be required before the test. Your healthcare provider will give you instructions
as to how long you should withhold food or liquids.
If you are pregnant or think you may be, tell your healthcare provider. Tilt table
testing may be avoided in pregnancy.
Tell your provider of all medicines (prescription and over-the-counter) and herbal
supplements that you are taking.
Tell your healthcare provider if you have a pacemaker or an implanted cardioverter
Based on your medical condition, your healthcare provider may request other specific
What happens during the tilt table test?
A tilt table test may be done on an outpatient basis or as part of your stay in a
hospital. Procedures may vary depending on your condition and your healthcare provider’s
Generally, a tilt table test follows this process:
You may be asked to remove any jewelry or other objects that may interfere with the
You will be asked to remove clothing from the waist up and will be given a gown to
You will be asked to empty your bladder before the procedure.
You will lie down on a special bed or table.
An IV (intravenous) line will be started in your hand or arm to inject medicine and
to give fluids, if needed.
ECG electrodes will be placed on your chest and attached to an ECG machine with wire
leads. A blood pressure cuff will be placed on your arm and will be attached to an
automatic blood pressure monitoring machine. Your blood pressure may be measured using
an invasive blood pressure monitor called an arterial line instead of a blood pressure
cuff. The arterial line can provide more rapid measurement of blood pressure changes.
First, you will lie flat on the bed for several minutes; then you will be raised to
an almost standing angle while on the bed. Straps will be placed across your chest
and legs to keep you from falling if you faint during the test.
You will remain upright for up to 20–45 minutes to see if symptoms such as dizziness,
fainting, low heart rate, or a low blood pressure occur.
If no symptoms occur, you may be given a medicine in your IV line to speed up your
heart rate or to lower your blood pressure. This will be given while you are lying
After the medicine is given (if needed), you will again be tilted upright and monitored
for symptoms of dizziness, fainting, low heart rate, or low blood pressure.
Once enough information is gathered, you will be lowered to a flat position and allowed
to rest for a while. Your heart rate and blood pressure will be monitored.
Sometimes the technician may massage the sides of your neck to see if a slow heart
rate can be induced.
When you are stable, the IV line, blood pressure cuff or arterial line, and ECG electrodes
will be removed.
You will be allowed to dress and leave, unless your healthcare provider tells you
What happens after the tilt table test?
You should be able to resume your normal diet and activities, unless your healthcare
provider instructs you differently.
Generally, there is no special care following a tilt table test.
Tell your healthcare provider if you develop any signs or symptoms you had before
the test (such as dizziness or fainting).
Your provider may give you other instructions after the test, depending on your situation.
Before you agree to the test or the procedure, make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure