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The test involves lying quietly on a bed and being tilted at different angles (30 to 60 degrees) for a period of time while various machines monitor your blood pressrun, electrical impulses in your heart, and your oxygen level. Heart rhythm, blood pressure and other symptoms are closely monitored and evaluated with changes in position. The patient is completely conscioud for the test and an intravenous line is place prior to the exam. This is an outpatient procedure.
A tilt table test can be done in different ways and be modified for individual circumstances. In some cases, the patient will be strapped to a tilt table lying flat and then tilted or suspended completely or almost completely upright (as if standing). Most of the time, the patient is suspended at an angle of 60 to 80 degree. Sometimes, the patient will be given a drug , such as Glyceryl trinitrate (nitroglycerin) or isoproterenol, to create further susceptibility to the test. In all cases, the patient is instructed not to move. Symptoms, blood pressure, pluse, electrocardiogram, and sometime blood oxygen saturation are recorded. The test either ends when the patient faints or develops other significant symptoms, or after a set period (usually from 20 to 45 minutes, depending on the facility or individualised protocol).
A tilt table test is considered positive if the patient experience symptoms associated with a drop in blood pressure or cardiac arrhythmia. A normal person’s blood pressure will not drop dramatically while standing, because the body will compensate for the posture with a slight increase in heart rate and constriction of the blood vessels in the legs. If this process does not function normally in the patient, the test could provoke signs and symptoms ranging from minor lightheadedness to a very severe cardiac episode, depending on the person.
In extreme cases, tilt table testing could provoke seizures or even cause the heart to stop. The heart resumes beating normally upon being returned to a flat or head down position. If at anytime in tilt table testing a patient loses consciousness, he or she will be retuned to a supine or head down position and will be given immediate medical attention, which could include being given fluids or perhaps atropine or a symptomatic drug like epinephrine or ephedrine which will raise blood pressure and heart rate rapidly.
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