Tilt table exam

A medical procedure used to diagnose patients with dysautonomia and/or Neurally Mediated Syncope.

A tilt table is a specially-designed table that can allows the patient to lie flat on his or her back and then be subjected to various inclines. Doctors adjust the incline of the table and examine what (if any) changes occur in the patient's blood pressure as a result. Doctors will also often monitor the patient's heart rate via an electrocardiogram (ECG) while the test is being performed. The test usually takes about 10 minutes to complete.

Sometimes, if a patient who is suspected to have dysautonomia doesn't react to the tilt table as severely as expected, an intravenous drug called Isuprel is administered. Isuprel activates the adrenal response, better simulating the body's environment when it rises from a seated (or lying) position. Dysautonomic/syncopic patients often respond to the tilt table (combined with Isuprel) with dizziness, sleepiness, and light-headedness, while some actually pass out from the resulting blood pressure drop.

Generally speaking, patients who have a drop in blood pressure of 20 mmHg or more during the tilt table test are considered to have "failed the tilt test" and are diagnosed with dysautonomia.