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Diagnostic Tests in Cardiovascular Diseases

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11. Tilt Test

The purpose of a 'tilt test'

Tilt testing is done to help understand the cause of fainting or dizzy spells. With this information, your doctor will be in a better position to assess why you are having your symptoms and also to provide some suggestions for therapy. A tilt test is a simple procedure with little risk.

How is it performed?

You will be attached to ECG recording electrodes and also to a blood pressure cuff. A single intravenous line will be inserted. After an initial stabilization period, the bed that you are on will tilt to an upright position for a short time. During this time, you will be asked to lie still. It is worthwhile for you to keep your shoes on to provide further support. The entire duration of the tilt test is about 40 minutes.

Intravenous Isoproterenol infusion

During the course of your test, your doctors may also want to give you an intravenous medication called Isoproterenol. This is a medicine very similar to adrenaline and is designed to increase your heart rate slightly. It lasts only a few minutes in the body after it is given. When you receive this medicine, you may feel a little 'jittery'. Repeat tilting may be performed while this medicine is being given to you.

Possible side effects

The ability to bring on one of your typical fainting episodes is exactly why the test is being performed. Accordingly, it is certainly possible that you may have a fainting episode during the test. You will be monitored very closely throughout the test. If you do have a fainting episode, you may not feel well afterwards for a period of time depending on your particular episodes. The only other risk that you need to be aware of in this test is the side effects related to receiving the intravenous medicine and possible bruising at the intravenous site. The side effects of the Isoproterenol largely relate to the “jittery” feelings mentioned before and include a sense of heart racing or even starting up rapid rhythm disturbances. The effects of this medicine wear off a few minutes after the infusion is stopped.

How do I prepare for my tilt test?

Complete fast: You must have nothing to eat or drink (including water and gum/candy) after midnight the night prior to your appointment.

If you have a 2pm appointment you may have something very light, like toast and some juice, before 6 am only. Wear firm shoes that support your feet (no sandals or heels) and comfortable clothing.

How will I feel during the test?

If the tilt test is able to bring on a fainting spell, then you may have all of the feelings that normally accompany a fainting spell for you. Otherwise, you may feel nothing at all, or perhaps you may be aware of your heart beat beating more quickly during the Isoproterenol medicine infusion. It is very important to let your doctor know how you are feeling. However, we do like to keep conversation to a minimum and the environment relaxed to further assist in the usefulness of this test.

When can I go home after the test is finished?

Generally, people are able to go home as soon as the test is completed. If you are not feeling well, you may wish to stay in hospital and rest for a few hours. No one is expected to stay in hospital overnight.

Because it is possible that you may have a fainting spell during the test and be feeling unwell for a few hours, we recommend that you arrange to have someone drive you home.