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Upright Tilt Test

What is Upright Tilt Test
Preparations before test
How is the test done
Is the test safe
Can I undergo the test if I am not feeling well



Contributed by Dept of Cardiology (website)

What is Upright Tilt Test

The upright tilt test is used to detect recurrent syncope (fainting) of unknown origin. It will confirm whether you have vasovagal syncope, ie fainting due to abnormally sensitive reflexes in the cardiovascular system. The test requires you to be tilted in an upright position and you will be continuously monitored to see if this will reproduce the symptoms of recurrent fainting.

There is no hospitalisation required.


Preparations before test

· Do not eat or drink as overnight fasting is STRICTLY required.
· For males, please shave if you have excessive chest hair.
· Check with your doctor whether you are required to stop any of the cardiac or asthmatic medication you are currently taking.


How is the test done

Before the tilt test starts, a doctor will assess to ensure that you are fit for the test. Thereafter, the Medical Technologist (MT) will place the ECG electrodes on your chest. A small plastic tube will be inserted into a vein on your hand via an injection. This injection is necessary so that in the event of an emergency, we can inject life saving medication via this intravenous access. This intravenous access is also necessary for administration of medication during Stage 3 of this test. You will then be strapped onto a motorised tilt table with foot support. Both ECG and blood pressure will be monitored throughout the test.

There are 3 stages to the test:-

Stage 1:
Finger pressure will be applied to your artery of the neck (carotid artery), first on the right side and then on the left side (carotid sinus massage).

Stage 2:
The table will be tilted upright to an angle of 60-70 degrees. You will remain in that position for up to 30 minutes. During the test, your ECG will be monitored continuously and your blood pressure and pulse rate will be measured at a 5-minute interval.

Stage 3:
Upon completion of Stage 2, a single dose of a drug called glycerin trinitrate (GTN) will be sprayed under the tongue. Alternatively, another drug called isoprenaline will be given via the intravenous access obtained earlier. You may experience some palpitations (strong and rapid heart beating) or a mild headache which are some common side effects of this drug. These side effects are generally short acting and you will recover without the need to administer other drugs. This process will last about 15 minutes.

This test will be terminated as soon as you experience giddiness or are about to faint. If no symptoms occur, the test will be stopped at the end of 45 minutes.


Is the test safe

This test carries a low risk and an informed consent is required before the start of the test. There has been no significant complications from this test.


Can I undergo the test if I am not feeling well

If you are not feeling well because of fever, running nose or acute illness, you should not undergo the upright tilt test. Please call the appointment unit at Tel: 6436 7840 to reschedule the test.


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