Tilt Table Test: How It Works and What It Diagnoses
Tilt table test tilts patients to 60-80° for up to 45 minutes to provoke and measure fainting episodes. Diagnoses vasovagal syncope, orthostatic hypotension, and POTS by monitoring heart rate and BP in real time.
A tilt table test is a diagnostic procedure for unexplained fainting (syncope) or dizziness. It is used when episodes are infrequent enough that doctors cannot catch one happening naturally. Procedure: 1. Patient lies flat on a motorized table with safety straps and heart/blood pressure monitors 2. Baseline measurements are recorded while lying down 3. The table slowly tilts to 60-80 degrees, simulating standing 4. The patient remains tilted for 20-45 minutes while heart rate and blood pressure are continuously monitored 5. Sometimes medication is administered to provoke a response if the initial tilt doesn't trigger symptoms What it detects: - Vasovagal syncope: the most common type — the nervous system overreacts to a trigger, causing heart rate and blood pressure to drop suddenly - Orthostatic hypotension: blood pressure drops significantly upon standing due to failure of normal compensatory mechanisms - POTS (Postural Orthostatic Tachycardia Syndrome): heart rate increases excessively upon standing The controlled environment allows doctors to measure exactly what happens to heart rate and blood pressure during the episode — data that is impossible to capture during unpredictable real-world fainting episodes.