A tilt test is used to diagnose a condition called vasovagal syncope or neurocardiogenic syncope, also known as common faints.
The test reproduces your symptoms of dizziness or fainting under controlled and monitored conditions to help the cardiologist to make a diagnosis.
Why do I need a tilt test?
We perform tilt tests on patients who have been experiencing dizzy spells or blackouts (passing out) and who are then referred to one of our cardiologists by their doctor.
The cardiologist may feel that your symptoms are related to a change in blood pressure or heart rate, in which case we will make an appointment at our cardiology department for a tilt test.
What does a tilt test involve?
To begin with, you will be asked to undress to the waist so that a cardiac physiologist can position ten small sticky pads (electrodes) on your chest.
Wires are then clipped onto these electrodes and connected to a monitoring machine called an ‘ECG’ (electrocardiogram); this will monitor your heart rhythm. You will then be given a gown to wear.
Next, you will be attached to a blood pressure monitor using a cuff on your finger and arm.
You will be asked to lie down flat on a bed for five minutes.
The bed will then be tilted upwards until you are almost vertical, as in the example below.
If, after 20 minutes, you are still feeling well, you will be given one spray under the tongue of a drug that may cause symptoms similar to those you have experienced (dizzy, faint).
The test is continued in this position for a further 15 minutes or until you feel dizzy/faint, along with a fall in blood pressure or heart rate, at which point the test will be stopped. If you are over 40, a doctor will rub on your neck after the tilt test. This is known as ‘carotid sinus massage’ and is done to see if your heart is prone to slowing down and, if this is so, you might feel dizzy or faint.
If your heart rate slows down for a long time, a doctor may insert a fine needle into a vein in your arm and give you a drug to speed up your heart to a normal rate.
At the end of the test, you will be allowed to sit up and will be offered a drink of water. The heart rate and blood pressure monitoring equipment is removed. You can then freshen up, get dressed and go home.
How long does the test last?
The tilt test could take anything from between 25 and 65 minutes, using the timings below as a guide:
- Preparation: ten minutes
- Lying down: five minutes
- Passive tilt (without drug): twenty minutes
- Tilt after drug has been given: 15 minutes
- Neck rub (if needed): five minutes
Do I need to make any special preparations for the test?
Please eat a light meal (such as a sandwich and a glass of water or a salad and a glass of fruit juice) about three hours before your appointment time and then please do not eat again until after the test.
It is a good idea to arrange for someone to collect you and take you home after the test. If you feel unwell during the test you may not be well enough to drive home safely.
Please tell us if you have any of the following before the test:
- Left ventricular outflow obstruction or hypertrophic cardiomyopathy
- Cerebrovascular disease (strokes, brain haemorrhages in the past)
- Blocked arteries
- Mitral stenosis
- Heart, renal or liver failure
Fainting happens when your blood pressure drops (hypotension). At this time, your heart rate may also drop or even pause for a few seconds.
Tilt test - Harefield Hospital - November 2015 (pdf, 509KB)