Tilt test: what it is, what it is for and how it is done

The tilt test , also known as the tilt test or postural stress test, is a non-invasive and complementary test performed to investigate episodes of syncope, which occur when a person has fainting and has a sudden or transient loss of consciousness.

Generally, this test is done in an electrophysiology laboratory of a hospital or clinic and must be done with the accompaniment of a cardiologist doctor and a nurse technician or nurse and for that to be done the person must be fasting for at least 4 hours, to avoid malaise and nausea during the test. After the exam it is recommended to rest and avoid driving for at least 2 hours.

What is it for

The tilt test is an exam indicated by a cardiologist to complement the diagnosis of some diseases and conditions such as:

• Vasovagal or neuromediated syncope; Recurrent dizziness; Postural orthostatic tachycardia syndrome; Pre-syncope, Disautonomy.

Vasovagal syncope is usually the main cause of fainting in people without heart problems and can be triggered by a change in body position, so the tilt test is the main test to identify this condition. Understand what vasovagal syncope is and how to treat it.

In addition, the doctor may order other tests to rule out other diseases, such as problems with heart valves, for example, and blood tests, electrocardiogram, echocardiography, 24-hour Holter or ABPM may be indicated.

How the preparation should be

To do the tilt test it is important that the person is completely fasting, including not having drunk water, for at least 4 hours, because as changes will be made to the position of the stretcher, the person may experience nausea and malaise if they have full stomach. It is also recommended that the person go to the bathroom before the exam, so that it is not interrupted in half.

Before starting the exam, the doctor may ask what medications the person uses daily and will also ask questions about the onset of symptoms and whether there is any situation in which the symptoms get worse.

How the tilt test is done

The tilt test is performed in an electrophysiology laboratory in a hospital or clinic and must be done under the supervision of a cardiologist and a nurse or nursing technician.

The total duration of the exam is around 45 minutes and is done in two different phases, the first of which consists of lying on a stretcher, attached to some belts, and the nurse changes the position of the table, tilting it to top at the same time as the devices placed on the chest and arm measure blood pressure and blood rate to check for changes during the test.

In the second part, the nurse offers a medicine to put under the tongue, called isosorbide dinitrate, in a very small dose, so that it is observed how the body reacts with the medication, if the blood pressure and heart rate change a lot, in this step the nurse also changes the position of the stretcher.

This medication used in the tilt test acts like adrenaline and therefore the person may experience a little anxiety or feel the same when doing some physical activity. If your blood pressure is too low or the person is very unwell, the doctor may stop the test, so it is important to communicate what you are feeling.

Care after examination

After the tilt test, the person may feel tired and a little sick, so he must lie down for 30 minutes to be observed by the nurse or nursing technician.

After this period, the person is free to resume normal activities, however, it is recommended to avoid driving for at least 2 hours. If the person has malaise, very low blood pressure or has passed out during the examination, they may need to spend more time under the care of the doctor and the nurse.

The test result usually takes up to 5 days and is considered negative if there were not many changes in blood pressure during changes in the position of the stretcher, however when the result is positive it means that the blood pressure changed a lot during the test.

Contraindications

The tilt test is not indicated for pregnant women, people with narrowing or obstruction of the carotid or aortic artery or with orthopedic changes that prevent the person from standing. In addition, people who have had a stroke should be given extra attention during the exam.