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A tilt table test is a medical procedure
Medical procedure

A medical procedure is a course of action intended to achieve a result in the care of persons with health problems.A medical procedure with the intention of determining, measuring or diagnosis a patient condition or parameter is also called a medical test....
 often used to diagnose
Diagnosis

Diagnosis is the identification of the nature of anything, either by process of elimination or other analytical methods. Diagnosis is used in many different disciplines, with slightly different implementations on the application of logic and experience to determine the cause and effect relationships....
 dysautonomia
Dysautonomia

Dysautonomia is a broad term that describes any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome , vasovagal syncope, mitral valve prolapse#Mitral valve prolapse syndrome, pure autonomic failure, autonomic instability and a number of lesser-known disorders....
 or syncope. Patient
Patient

A patient is any person who receives medical attention, care, or Therapy. The person is most often illness or injured and in need of treatment by a physician or other Health care provider, although one who is visiting a physician for a routine check-up may also be viewed as a patient....
s with symptom
Symptom

A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality. A symptom is subjective, observed by the patient, and not measured....
s of dizziness or lightheadedness, with or without a loss of consciousness
Consciousness

Consciousness is a difficult term to define, because the word is used and understood in a wide variety of ways, so that it frequently happens that what one person sees as a definition of consciousness is seen by others as about something else altogether....
 (fainting), suspected to be associated with a drop in blood pressure
Blood pressure

Blood pressure is the pressure exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as it moves away from the heart through artery and capillary, and toward the heart through veins....
 or positional tachycardia are good candidates for this test.

re actually taking the test, the patient may be instructed to fast
Fasting

Fasting is primarily the act of willingly abstaining from some or all food, drink, or both, for a period of time. A fast may be total or partial concerning that from which one fasts, and may be prolonged or intermittent as to the period of fasting....
 for a period before the test will take place, and to stop taking any medications.






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Encyclopedia


A tilt table test is a medical procedure
Medical procedure

A medical procedure is a course of action intended to achieve a result in the care of persons with health problems.A medical procedure with the intention of determining, measuring or diagnosis a patient condition or parameter is also called a medical test....
 often used to diagnose
Diagnosis

Diagnosis is the identification of the nature of anything, either by process of elimination or other analytical methods. Diagnosis is used in many different disciplines, with slightly different implementations on the application of logic and experience to determine the cause and effect relationships....
 dysautonomia
Dysautonomia

Dysautonomia is a broad term that describes any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome , vasovagal syncope, mitral valve prolapse#Mitral valve prolapse syndrome, pure autonomic failure, autonomic instability and a number of lesser-known disorders....
 or syncope. Patient
Patient

A patient is any person who receives medical attention, care, or Therapy. The person is most often illness or injured and in need of treatment by a physician or other Health care provider, although one who is visiting a physician for a routine check-up may also be viewed as a patient....
s with symptom
Symptom

A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality. A symptom is subjective, observed by the patient, and not measured....
s of dizziness or lightheadedness, with or without a loss of consciousness
Consciousness

Consciousness is a difficult term to define, because the word is used and understood in a wide variety of ways, so that it frequently happens that what one person sees as a definition of consciousness is seen by others as about something else altogether....
 (fainting), suspected to be associated with a drop in blood pressure
Blood pressure

Blood pressure is the pressure exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as it moves away from the heart through artery and capillary, and toward the heart through veins....
 or positional tachycardia are good candidates for this test.

Preparations

Before actually taking the test, the patient may be instructed to fast
Fasting

Fasting is primarily the act of willingly abstaining from some or all food, drink, or both, for a period of time. A fast may be total or partial concerning that from which one fasts, and may be prolonged or intermittent as to the period of fasting....
 for a period before the test will take place, and to stop taking any medications. On the day of the tilt table test, a patient may be monitored using an electrocardiogram
Electrocardiogram

An electrocardiogram is a recording of the electricity activity of the heart over time produced by an electrocardiograph, usually in a Non-invasive recording via skin electrodes....
 (ECG) while lying down. Some facilities insert an intravenous line in case the patient needs to be given medication
Medication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
 quickly; however, this may influence the results of the test and may only be indicated in particular circumstances. More recently, most investigators monitor cerebral perfusion using mean flow velocity recording with transcranial doppler
Transcranial doppler

Transcranial Doppler is a test that measures the velocity of blood flow through the brain's blood vessels. Used to help in the diagnosis of emboli, stenosis, vasospasm from a subarachnoid hemorrhage , and other problems, this relatively quick and inexpensive test is growing in popularity in the United States....
 ultrasound in supine horizontal position, during and after head-up tilt. An 18 MHz ultrasound transducer is placed on the temporal bone above the zygomatic arch, using a head gear to hold the probe in place.

Procedure

A tilt table test can be done in different ways and be modified for individual circumstances. In some cases, the patient will be strapped to a tilt table lying flat and then tilted or suspended completely or almost completely upright (as if standing). Most of the time, a patient is suspended at an angle of sixty to eighty degree
Degree (angle)

A degree , usually denoted by ? , is a measurement of plane angle, representing 1/360 of a Turn ; one degree is equivalent to p/180 radians....
s. Sometimes, the patient will be given a drug, such as Glyceryl trinitrate
Glyceryl trinitrate (pharmacology)

Glyceryl trinitrate is an alternate name for the chemical nitroglycerine, which has been used to treat Angina pectoris and heart failure since at least 1870....
 or isoproterenol
Isoproterenol

Isoprenaline or isoproterenol is a sympathomimetic beta adrenergic agonist medication.It is structurally similar to epinephrine but acts selectively on beta receptors, activating ?1 and ?2 receptors equally....
, to create further susceptibility to the test. In all cases, the patient is instructed not to move. Symptoms, blood pressure, pulse, electrocardiogram, and sometimes blood oxygen saturation are recorded. The test ends when the patient faints or has other significant symptoms, at which time he or she is given medical attention, or after a set period of time (usually from 20 to 45 minutes, depending on the facility or individualized protocol).

Diagnostic symptoms

A tilt table test is considered positive if the patient experiences symptoms associated with a drop in blood pressure or cardiac arrhythmia
Cardiac arrhythmia

Cardiac arrhythmia is a term for any of a large and heterogeneous group of conditions in which there is abnormal Electrical conduction system of the heart in the heart....
. A normal person's blood pressure will not drop dramatically while standing, because the body will compensate for this posture with a slight increase in heart rate and constriction of the blood vessels in the legs.If this process does not function normally in the patient, the test could provoke minor symptoms to a very severe cardiac episode, depending on the person. A common side effect during tilt table testing is a feeling of heaviness and warmth in the lower extremities. This is due to blood
Blood

Blood is a specialized bodily fluid that delivers necessary substances to the body's Cell s ? such as nutrients and oxygen ? and transports waste products away from those same cells....
 pooling in the legs and, to onlookers, the patient's lower extremities may appear blotchy, pink
Pink

Pink is a pale red color; the use of the word for the color was first recorded in the late 17th century, describing the flowers of Dianthus, flowering plants in the genus Dianthus. Pink itself is a combination of red and white....
, or red
Red

Red is any of a number of similar colors evoked by light consisting predominantly of the longest wavelengths of light discernible by the human eye, in the wavelength range of roughly 625?740 Nanometer....
. Dizziness or lightheadedness may also occur. Tilt table testing could provoke fainting or syncope
Collapse (medical)

Collapse is a sudden and often unannounced loss of postural tone , often but not necessarily accompanied by unconsciousness.If the episode was accompanied by a loss of consciousness, the term Syncope is used....
 as this is the purpose of the test and it may not be appropriate, or indeed possible to stop the test before this occurs as the drop in blood pressure or pulse rate associated with a faint can come on in seconds, This is why the patient's blood pressure and ECG should be continuously monitored during the test. In extreme, rare cases, tilt table testing could provoke seizures, or even prolonged asystole
Asystole

In medicine, asystole is a state of no heart electrical activity, hence no contractions of the myocardium and no cardiac output or blood flow. Asystole is one of the conditions required for a medical practitioner to certify death....
. If at any time in tilt table testing, a patient loses consciousness, he or she will be returned to a supine or head down position and will be given immediate medical attention, which could include being given fluids or perhaps atropine
Atropine

Atropine is a tropane alkaloid extracted from deadly nightshade , jimsonweed , Mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a hard drug with a wide variety of effects....
 or adrenaline.

External links

  • - From Children's Hospital Heart Center, Seattle