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The tilt test, also known as the tilt test or postural stress test, is a non-invasive, complementary test performed to investigate episodes of syncope, which occur when a person has fainting and sudden or transient loss of consciousness.
Usually, this test is performed in an electrophysiology laboratory of a hospital or clinic and must be done under the supervision of a cardiologist and a nursing technician or nurse, and for it to be done, the person must be fasting for at least 4 hours, to avoid discomfort 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;
- Postal orthostatic tachycardia syndrome;
Vasovagal syncope is usually the main cause of fainting in people without heart problems and can be triggered by changing 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 request other tests to rule out other diseases, such as heart valve problems, for example, and blood tests, electrocardiogram, echocardiography, 24-hour Holter or ABPM may be indicated.
How to prepare
To perform the tilt test, it is important that the person is fasting absolutely, including not drinking water, for at least 4 hours, because as the position of the stretcher will be changed, the person may feel nauseated and ill. be if you have a full stomach. It is also recommended that the person go to the bathroom before the exam, so that they are not interrupted in the middle.
Before starting the examination, the doctor may ask which 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 worsen.
How the tilt test is done
The tilt test is performed in an electrophysiology laboratory of a hospital or clinic and must be performed 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 being lying on a stretcher, attached to some belts, and the nurse changing the position of the table, tilting it up while 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 the body reacts with the medicine, if the blood pressure and heart rate are change a lot, at this stage the nurse also changes the position of the stretcher.
This medication used in the tilt test acts like adrenaline and therefore the person may feel a little anxious or have the same feeling when doing some physical activity. If the blood pressure gets too low or the person becomes very unwell, the doctor may interrupt the test, so it's important to communicate what you're feeling.
Care after the exam
After the tilt test, the person may feel tired and a little sick, so they must lie down for 30 minutes to be observed by the nurse or nursing technician.
After this period, the person is free to resume usual activities, however, it is recommended to avoid driving for at least 2 hours. If the person felt unwell, had very low blood pressure, or fainted during the exam, they may need to spend more time under the care of the doctor and nurse.
The test result usually takes up to 5 days and is considered negative if there were not many changes in blood pressure during the changes in the position of the stretcher, but when the result is positive it means that blood pressure has changed a lot during the test.
The tilt test is not recommended for pregnant women, people with carotid or aortic artery narrowing or obstruction, or orthopedic disorders that prevent the person from standing. In addition, people who have already had a stroke should be extra careful during the exam.