Head-upright tilt test is a diagnostic test which is used to diagnose the cause of fainting or syncope in individuals while your blood pressure and other vital signs are being monitored. A head upright tilt test as the name suggests is a test which is used to determine your blood flow to the brain and change in your blood pressure when your body is tilted at different angles. A head upright tilt test is a non-invasive diagnostic procedure where no anesthesia is used.
When is a head-upright tilt test advised ?
A Head-Upright Tilt Test is advised in individuals who face episodes of frequent fall in blood pressure, fainting or syncope which is not supported by an underlying disease or is of unknown origin. It is also advised in individuals who have increased heart rate while standing, unexplained palpitations, feeling of fainting and history of unexplained momentary loss of consciousness.
When is head-upright tilt test not advised ?
A Head-Upright Tilt Test is not advised in case of the below mentioned conditions.
- Very low blood pressure
- Weak patient
- Comatose patient
- Fracture of the lower extremities
- Recent history of stroke
- Recent history of heart attack
- Metabolic acidosis
- Shock state
- Imbalance of electrolytes
- Severe anemia
- Pregnancy
- Kidney failure
- End stage coronary artery disease
There might be other situations when your doctor might restrict you from the Head-Upright Tilt Test, and hence it is advised that one should cooperate and discuss ones medical history in detail to avoid any complications.
How do you prepare for a head-upright tilt test ?
A Head-Upright Tilt Test is usually advised if you experience unexplained episodes of syncope or momentary loss of consciousness. Your treating doctor will schedule you for the test by taking your detailed medical history, history of medication and history of any medical procedures or treatments in the past. Your medication will be reviewed before the test and you will be asked to avoid eating or drinking anything at-least four hours before the procedure. You will be asked to wear comfortable clothes during the test and will be mostly asked to change into a hospital gown before the test.
What happens during a head-upright tilt test ?
The test takes about 1-2 hours and you will be asked to prepare for the test and is performed in an electrophysiology laboratory. You will be made to lie down on a table on your back and Velcro straps will be used to fasten your body to the examination table. Leads will be attached to your chest to monitor your heart rate and a blood pressure cuff will also be tied around your arm to monitor your blood pressure before, during and after the test. Initially your vitals like your heart rate, blood pressure will be checked before the start of the test. Then an intravenous line will be started to give you saline or any medication if required during the test. The table is fitted with a motor which could be tilted at a required angle required during the test. During the test the table is tilted at various angles like 30 degrees, 45 degrees, 70-80 degrees for a required period and at a particular tilt angle your heart rate and blood pressure is monitored on a time to time basis. You will be asked to limit your movement during the test to avoid any sensitive errors during the test. You will be asked about how you are feeling during the test at each tilt angle and once the readings are recorded you will be brought to the initial flat position and will be made to relax for a few minutes. Your heart rate and blood pressure will be again recorded when the test is completed. During the test if you feel uncomfortable or feel like fainting it is important to inform the same to your doctor as the aim of the test is not to make you temporary unconscious but you might faint during the test. Once the test is completed the intravenous line is removed and you will be mostly allowed to go home.
What do the results of a head-upright tilt test indicate ?
The results will be assessed and shared with you and your family as per the hospital’s reporting policy. The test is positive when an abnormality can be detected which is the cause of fainting or syncope, and the test is negative when no underlying cause could be determined. The further treatment plan is decided depending upon your test results, and occasionally other tests might also be advised with a Head-Upright Tilt Test to confirm the findings.
What are the risks and complications of the head-upright tilt test ?
Head-Upright Tilt Test is a non-invasive test and hence complications related to the same are fainting or syncope, state of confusion, feeling of nausea and vomiting sensations, seizures due to constant low blood pressure, and rarely stroke. It is important for you as a patient to understand the test in detail before going ahead for the same to avoid any potential complications.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
