Table tilting | Diseases and conditions: Medical tests.

What is the proof of the tilting table

The tilt table test, called in English tilt test, is used for the study of fainting or feeling light-headed. Thanks to it you can put to the test the cardiovascular system and check if it is able to respond correctly to changes in gravity, blood pressure, or heart rate. When it fails, the heart does not pump the necessary blood to the brain and a few seconds lost blood flow; It is what is known as syncope.
Such tests are carried out since the seventeenth century, but always for scientific purposes (thus studied the human nature of adaptation to changes in the environment). It was not until the year 1886 when it began to use the test with an objective diagnosis, and began to divide the blackouts between the cardiovascular and neurological origin. Today the test is still used without major changes.
Various types of sensors that record biological constants are used during tilt table test. The most commonly used instruments are:
Electrocardiogram, to study heart rate and electrical conduction.
Blood pressure cuff, to monitor blood pressure.
Intravenous, to perform a blood analysis (if necessary during the test) and injecting drugs.
With these elements the physician, which tends to be specialist in cardiology, will be able to identify the source of the problem most of the time or discard a cardiovascular cause.
It is not a particularly expensive test, but their interpretation is difficult, so must be carried out by experts, and only when you go to be useful to determine a diagnosis or deciding a treatment. It is usually done in specific cardiac units that exist in hospitals and clinics. It is unlikely that happen problems during testing, but is sometimes done to patients with a diseased heart can be altered during the procedure, and that the security measures are important.

When the tilt table testing is done

The test of the tilting table is useful when you want to test the heart and the vascular system as diseases that is altered is suspect. In any case, the main symptom of these pathologies is the fainting or feeling light-headed. Some of these diseases are as follows:
Bradycardias and electrical locks: when the heart has alterations of electric conduction heartbeat is slow, and the pumping of blood to the brain is not enough.
Syncope vasovagal: in response to different stimuli (heat, be standing a long time, nausea, etc.) may be a temporary blood pressure drop. This makes the blood not can promote to the brain properly and occurs the fainting.
Angina pectoris: although usually attended with pain, in some cases does not produce another symptom to the fainting or exhaustion (in diabetics, for example). Alterations of myocardial ischemia can be detected during the test.
Neurological Disorders: epileptic seizures, migraines, or transient cerebral ischemia, are some of the causes of fainting. With the tilt table test may not diagnose, but it may be one of the first steps to rule out cardiac alterations and think about such diseases.

Preparation for the tilt table test

If you are performing a tilt table test these are the issues you should keep in mind to go well prepared the day of the test:
Duration: lasts between one and two hours. Carried out in several steps and requires a preparation of material that takes some time.
Income: tilt table testing is performed in a hospital with a cardiac unit, but does not require income, by what can go that same day to the hospital, and after the test you can go home again.
Is necessary to be accompanied?: Yes, it is recommended that someone be with you. Test does not require assistance and can then only return home, but is better that someone is with you if new findings are displayed during test.
Drugs: don't need to take any prior medication. Must be communicated to the doctor all the medicines taken regularly, and will decide which suspend or maintain, especially if you take epilepsy drugs, muscle relaxants, antiarrhythmic drugs, psychiatric disorders, or antihypertensives.
Food: don't eat or drink anything 4 hours prior to the test. If you realized in the morning it is better that you go on an empty stomach.
Clothes: you can go to the quote from the test with the same clothes every day. There they will give you a Pajamas so you change and you're comfortable during the test.
Documents: is better to bring with you the steering wheel which shows the performance of this test. He is recommended to take the national document of identity and medical history on diseases to study, if you have them, although the doctor will already have it with him. Normally you will not you any document after the test because it takes time to analyze them.
Pregnancy and breast-feeding: the tilt table test is not contraindicated in pregnancy or lactation, although not perform much in those situations because the biological constants that are studied are altered for itself during these stages.
Contraindications: do test people with serious heart diseases, because the potential risks outweighed the probable diagnostic benefit.

How the tilt table test

First, the doctor will assess if it is useful to test the tilting table. In many cases of fainting do not you need to do it, because the most useful tool for getting a correct diagnosis is the clinical interview between the patient and the physician. Symptoms that occur before the fainting and the characteristics of the product can guide the therapeutic management perfectly. When you want to study the heart by a suspicion founded cardiac alterations will take place the tilt table test.
They will quote you one day for the test and explain basic measures that you need to know to submit yourself to it. The day of the test you must make a life normal, avoiding eating four hours minimum, or by going in fasting if it is in the morning. The best thing is that you get to the hospital one hour before the start of the test, to be quiet and not get nervous.
There they will give you a Pajamas to keep you more comfortable, and you will be asked you to tumbes into a sort of table or table in horizontal position and face up. They will be placed for a number of sensors in the skin of the chest, arms and legs; It is the electrocardiogram. Also they give you a small puncture in one of the elbows to put an intravenous line, and in the other arm placed you cuff of the sphygmomanometer. Then you will see that all instruments work and properly capture the measures studied. Before starting the test you will surround with a few belts to keep you tied to the stretcher. Don't worry, thanks to them you will not fall from the table when lean.
The first part of the test is carried out without drugs. It consists of tilt table 30 °, with the head slightly higher than the feet. So they will keep you 5 minutes and then tilt even more the table up to 60 °. In this position you will be 45 minutes. If you have any symptoms during that time (dizziness, nausea, blurred vision, etc.) you must communicate this. If at that time shown changes in the electrocardiogram or blood pressure test will end and will not be necessary to proceed to the next phase.
At the beginning of the second part of the test is injected through intravenous drug similar to the natural adrenaline in your body. Table tilt up over 60 and you'll be so for 15 minutes. Normal is that notes that heart rate accelerates and you have palpitations in the chest. If you have any other symptoms you should contact, and any alteration in your cardiovascular constants if the test should be completed.
After this second part testing is complete and you can change your clothes, pick up your things and go home. Days later you will have an appointment with the cardiologist, who interpreted the results of the test and will inform you of the same.

Complications of the tilt table test

The more frequent the tilt table test complication is fainting. Ultimately, it is to reproduce the situations that cause fainting in the studied person. Other complications may include:
Nausea and vomiting.
Sustained hypotension.
Bradycardia maintained without recovery.
Myocardial infarction.
Tachycardia and other arrhythmias.
The personnel responsible for performing the test is ready to detect any of these problems and act accordingly. Do not forget that you are in a hospital you have the means to solve these problems.

Results of the test of the tilting table

Throughout the tilt table test different sensors capture the biological measures, which are stored in a register. At the same time that the test you can see these measurements, but it is difficult to analyze them because it takes time and dedication to study all the components at the same time.
You can go to pick up the results to the doctor who sent you the test, and that is usually a cardiologist or a neurologist. On that date it explain the alterations that have been throughout the study. The results may throw the following conclusions, roughly:
Instant blood pressure fall: usually happens in the context of orthostatic hypotension, i.e., by position, and not so much by heart failure.
Drop in blood pressure after a few minutes without changes in ECG: the main reason is vasovagal syncope, and the stimulus would be the position maintained.
Drop in blood pressure after a few minutes with changes in ECG: should study the electrocardiographic abnormalities and see if there is heart problems that justify the fainting.
In any of these situations, the doctor may recommend treatment. Can be simple recommendations (maintaining a good hydration), medications, or even a pacemaker placement.
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