Tilt testing
Your doctor may request for you to have this test if you suffer from dizziness or faints (blackouts). The aim of the test is to monitor your heart rate and blood pressure while you are on a special bed. This bed is tilted up so that you are virtually standing, and you are monitored in this position for up to 40 minutes. The room is kept as quiet as possible, and dimly lit, as we want you to be relaxed and staying still. You will be fully dressed and no needles are involved. It can be a very long test.
Your heart rate is monitored through a few sticky dots (electrodes) on your shoulders and waistline. A blood pressure cuff similar to one your own doctor may use in the GP surgery is placed on one arm. On the other arm we use a special device that measures your blood pressure on every heartbeat through your finger. You will be asked to keep this finger really still, as the equipment is very sensitive.
Some people pass out during this test—this is very common and not dangerous. We immediately put the bed back to a flat position and you will be awake in seconds. This is due to the blood pooling in the large vessels in your legs, as the bed is lowered gravity takes the blood back to your brain. You will not fall off the bed as you will be gently strapped from the waist down. Do not try to fight symptoms as we will be monitoring you closely and ready to put the bed flat.
If 20 minutes into the test we have not seen any change in heart rate or blood pressure, a doctor will administer glyceryl trinitrate (GTN) spray under your tongue. This helps relax the smooth muscle in your blood vessels. It will not cause you to faint but may speed up any drop in blood pressure or heart rate you would experience anyway. The effects of this drug are completely gone in about 20 minutes.
In patients over 40-years-old we may also perform carotid sinus massage. This involves a doctor rubbing on your neck for a few seconds to see if this produces a drop in heart rate. We ask for you to have a responsible adult to travel home with you after the test.