A tilt table procedure is a diagnostic procedure that may be used to
evaluate a person who has symptoms of syncope (fainting). When a person
has a complaint of syncope, the physician will carefully evaluate the
person's past medical history and perform a physical examination. If
basic components of the examination or history do not reveal a potential
cause for the syncope, and the person has no history of heart disease,
then further diagnostic procedures will be scheduled.
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, but are not limited to, the following:
vasovagal syndrome – a sudden drop in blood pressure with or
without a decrease in heart rate that is caused by a dysfunction
of the nerves controlling the heart and blood vessels
arrhythmia (also called dysrhythmia) – a heart rate that is too
slow, too fast, or too irregular to maintain adequate blood flow
to the body
valve disease – malfunction of one or more of the heart valves
may cause an obstruction of the blood flow within the heart
heart attack (also called myocardial infarction, or MI) – damage
to the heart muscle due to insufficient blood supply
One type of diagnostic procedure that may be used to assess syncope is
the tilt table procedure. This procedure attempts to cause syncope by
creating changes in posture from lying to standing. This test is
performed by having the patient lie flat on a special bed or table while
connected to electrocardiogram (ECG) and blood pressure monitors. The
bed or table is then elevated to an almost standing position to simulate
the patient actually standing up from a lying position. The blood
pressure and ECG are measured during the test to evaluate changes during
the position changes. If the test causes an episode of syncope, then the
cause of the syncope is vasovagal syndrome. The physician can then
prescribe specific treatment for the syncope once the cause is known.
Other related procedures that may be used to assess the heart include
resting or exercise electrocardiogram (ECG), Holter monitor, cardiac
catheterization, chest x-ray, computed tomography (CT scan) of the
chest, echocardiography, electrophysiological studies, magnetic
resonance imaging (MRI) of the heart, myocardial perfusion scans,
radionuclide angiography, signal-averaged electrocardiogram, and
ultrafast CT scan. Please see these procedures for additional
Reasons for the Procedure
A physician may order a tilt table procedure if recurring episodes of
syncope (fainting) occur that have had certain other causes ruled out by
There may be other reasons for your physician to recommend a tilt table
Risks of the Procedure
Possible risks of tilt table testing include, but are not limited to,
episodes of syncope (fainting), which are planned for
dizziness or headache
hypotension (low blood pressure) or hypertension (high blood
palpitations and/or change in heart rate
There may be other risks depending upon your specific medical condition.
Be sure to discuss any concerns with your physician prior to the
Before the Procedure
Your physician will explain the procedure to you and offer you
the opportunity to ask any questions that you might have about
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.
Notify the technologist if you are allergic to or sensitive to
medications or latex.
Fasting may be required before the procedure. Your physician
will give you instructions as to how long you should withhold
food and/or liquids.
If you are pregnant or suspect that you may be pregnant, you
should notify your physician.
Notify your physician of all medications (prescription and
over-the-counter) and herbal supplements that you are taking.
Notify your physician if you have a pacemaker.
You should make arrangements to have someone drive you home
after the procedure, as you will most likely be told not to
Based upon your medical condition, your physician may request
other specific preparation.
During the Procedure
A tilt table procedure may be performed on an outpatient basis or as
part of your stay in a hospital. Procedures may vary depending on your
condition and your physician’s practices.
Generally, a tilt table procedure follows this process:
You will be asked to remove any jewelry or other objects that
may interfere with the procedure.
You will be asked to remove clothing from the waist up and will
be given a gown to wear.
You will be asked to empty your bladder prior to the procedure.
You will lie down on a special bed or table.
An intravenous (IV) line may be started in your hand or arm
prior to the procedure for injection of medication and to
administer IV 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.
A special bed or table will be used for the procedure. You will
lie flat on the bed initially, 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 procedure.
You will remain upright to determine if symptoms such as
dizziness, fainting, low heart rate, and/or a low blood pressure
If no symptoms occur, you may be given a medication in your IV
to speed up your heart rate. This will be given while you are
lying flat again.
After the medication is given (if needed), you will again be
You will be lowered to a flat position and allowed to rest for a
while. Your heart rate and blood pressure will be monitored.
When you are stable, the IV line, blood pressure cuff, and ECG
electrodes will be removed.
You will be allowed to dress and leave, unless your physician
instructs you differently.
After the Procedure
You should be able to resume your normal diet and activities, unless
your physician instructs you differently.
Generally, there is no special care following a tilt table procedure.
Notify your physician if you develop any signs or symptoms you had prior
to the test (e.g., dizziness or fainting).
Your physician may give you additional or alternate instructions after
the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was
not designed to diagnose or treat a health problem or disease, or
replace the professional medical advice you receive from your physician.
Please consult your physician with any questions or concerns you may
have regarding your condition.
This page contains links to other Web sites with information about this
procedure and related health conditions. We hope you find these sites
helpful, but please remember we do not control or endorse the
information presented on these Web sites, nor do these sites endorse the
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For more information, call 1.866.CALL.MLH.