Tilt Test

What is it?

One of the most common causes of fainting is called neuro-cardiogenic syncope also called vasovagal syncope. This condition is not really a disease but an abnormal reaction that results in a fall in blood pressure. The blood pressure may become so low that a person may experience light-headedness or fainting. The abnormal reaction that causes neurocardiogenic syncope may be brought on by pain, or anxiety, although frequently, this may occur without a trigger. Because there are other causes for syncope, your doctor may advise you to undergo head-up tilt testing to confirm the diagnosis. Because an episode of syncope may lead to serious injury, this test is important to diagnose the condition and, if necessary, treat it with medications and other regular daily practices, such as tilt training that will reduce your symptoms.

Head -up tilt testing is a way to safely diagnose neuro-cardiogenic syncope by deliberately creating the symptoms of neuro-cardiogenic syncope in a special room called an electrophysiology (EP) lab.

How it is done?

When you have your tilt test:

• You lie on a table that slowly tilts you to a 70 degree angle.
• Your heart rate and blood pressure are monitored with a non-invasive blood pressure cuff placed on the right arm.
• After 15-20 minutes, you are returned to a lying position.

Head - up tilt test
If the first test is positive (a blood pressure drop and similar symptoms as before), you may be given medication in an IV (a small tube in the arm vein) to reduce your symptoms, and the test is repeated as before.If the first test is negative (no blood pressure drop or symptoms), you will be given medication in an IV to increase your heart rate, and the test is repeated as before.

Before ... Precautions & prerequisites

You will be asked not to eat or drink anything for 6 hours before your test.

After

Once your doctor makes a diagnosis of neuro-cardiogenic syncope, treatment with medications may or may not be recommended (depending on how often and how severe your episodes of dizziness or fainting have been).
You can do many things to prevent or lessen your symptoms of neurocardiogenic syncope:

• Stand or sit up slowly.
• Avoid standing or sitting for a long time without moving or exercising your leg muscles.
• Drink plenty of fluids, especially juices and drinks that have sodium (salt) and electrolytes.
• Increase the amount of salt in your diet but only if you do NOT have a history of heart failure or high blood pressure.
• Limit your intake of alcohol.
• Stay away from excessive heat as much as possible.
• Get regular exercise.
• Begin regular tilt training if recommended by your doctor.

To avoid injury when you start your tilt training, be sure to choose a place that is comfortable and safe if you should faint or fall. Have a family member or friend present during each session to help you if needed. Sit or lie down immediately if you experience dizziness.