Download Head-Up Tilt Test

Coordinating Committee in Paediatrics
Effective date: 11 October 2007
Version 1.0
Head-Up Tilt Test(直立傾斜試驗)
Document no.: PILIC0081E version1.0
Page 1 of 2
Head-Up Tilt Test
Introduction
Syncope or fainting is a common symptom referring to the sudden and transient loss
of consciousness. The most common cause of syncope is vasovagal attack.
However, other forms of syncope related to heart, neurological and metabolic
diseases have to be excluded. Head-Up Tilt Test is designed to assess patient’s heart
rhythm and blood pressure in response to upright or almost upright position.
Vasovagal syncope is diagnosed if the test result is positive.
Pre-test Preparation and the Test Procedure
1.
2.
3.
4.
Before the test, patient has to go through detailed medical assessment including
physical examination, electrocardiography and chest radiography. In selected
cases, blood tests, echocardiography, 24-hour ambulatory ECG monitoring, and
electroencephalography may be required to exclude heart or neurological
problem.
The test is performed as an outpatient procedure. Fasting is required for 4-6
hours before the test. The patient is instructed to lie on a tilt-table horizontally and
connected to a monitoring device. When the patient’s heart rhythm and blood
pressure are stable, the table will be tilted to an almost upright slope. The
patient’s feet are supported by a footboard, and the body is restrained by straps
to prevent falling off the table if syncope occurs.
The patient will be staying at the tilting position for 30 to 45 minutes. Patients
may develop fainting, drop in heart rate and blood pressure. The test is positive
for vasovagal syncope if there is significant drop in blood pressure or heart rate.
If there is no decrease in the blood pressure or heart rate after prolonged tilting,
medications such as isoprenaline or nitroglycerin may be administered to elicit
the response. After challenged by medications, if there is still no significant drop
in heart rate or blood pressure, then the test is regarded as negative for
vasovagal syncope. Investigation to diagnose other causes of syncope may be
considered.
Possible Discomfort or Risk Associated with the Procedure
1. Fainting, sweating, palpitations, nausea
2. Decrease in heart rate
Coordinating Committee in Paediatrics
Effective date: 11 October 2007
Version 1.0
Head-Up Tilt Test(直立傾斜試驗)
Document no.: PILIC0081E version1.0
Page 2 of 2
3. Drop in blood pressure
4. Trauma related to falling off the tilt-table
It should be noted that a positive test is dependent on the occurrence of symptoms
and signs as listed from point 1 to 3.
The conduction of the test is monitored by a nurse and a doctor. The tilt-table will be
returned to the horizontal position after positive response is elicited. The discomfort,
heart rate and blood pressure will return to normal within a few minutes. In general
the risk associated with the test is low.
Post-test
After the test, the patient needs resting for 30 minutes. Nurse or doctor will confirm
return of normal heart rhythm and blood pressure before the patient leaves.
Preliminary results of the test will be explained to the patient before discharge.
Remarks
The list of complications is not exhaustive and other unforeseen complications may
occasionally occur. In special patient groups, the actual risk may be different. For any
queries or further information, please consult our medical staff.