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By Mayo Clinic staffDoctors use a tilt table test to help diagnose the cause of fainting. During the test, your blood pressure and heart rate are monitored. You begin by lying flat on a table. Then, the table is tilted to raise your body to a head-up position — simulating a change in position from lying down to standing up. This test allows doctors to evaluate your body's cardiovascular response to the change in position.
Your doctor may recommend a tilt table test if he or she suspects that one of the following is responsible for your fainting:
- An abnormal nervous system reaction. Fainting can occur when your nervous system incorrectly signals the blood vessels in your legs to open (dilate) and your heart rate to slow down (vasovagal or neurocardiogenic syncope). If you're standing when this happens, it causes blood to pool in your legs and reduces the amount of blood flowing to your brain, which results in fainting. Vasovagal syncope is the most common cause of recurrent fainting.
- A drop in blood pressure when you stand up. Normally when you stand up, special cells (baroreceptors) next to your heart and neck arteries trigger your heart to beat faster and pump more blood, which counteracts gravity's downward pull on your blood. These cells also cause blood vessels to narrow, which increases resistance to blood flow and increases blood pressure. A drop in your blood pressure when you stand up (orthostatic or postural hypotension) occurs when that process is interrupted, and low blood pressure is the result. Symptoms of orthostatic hypotension can include dizziness, lightheadedness and, in some cases, fainting.
- Heart problems. Abnormal heart rhythms (arrhythmias) occur when the electrical impulses that coordinate your heart rhythm don't function properly, causing your heart to beat too fast, too slow or irregularly In some cases arrhythmias may reduce blood flow to your brain and cause fainting. Narrowed heart valves and thickening of the heart muscle (hypertrophic cardiomyopathy) also can make it difficult for enough blood to flow from your heart to your brain and lead to fainting.
- Tilt table test. Heart Rhythm Society. http://www.hrspatients.org/patients/heart_tests/tilt_table.asp. Accessed Dec. 6, 2009.
- Olshansky B. Upright tilt table testing in the evaluation of syncope. http://www.uptodate.com/home/index.html. Accessed Dec. 7, 2009.
- Shukla GJ, et al. Syncope. Circulation: Journal of the American Heart Association. 2006;113:715.
- Ropper AH, et al. Faintness and syncope. In: Ropper AH, et al. Adams and Victor's Principles of Neurology. 9th ed. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=3632736. Accessed Dec. 6, 2009.
- Diagnosing arrhythmias. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3. Accessed Dec. 6, 2009.
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