Tilt Table Test, also known as TILT test, is a cardiologic investigation used to evaluate the causes of syncope (sudden and transient loss of consciousness). Although less well known among patients, this test is commonly used for suspected reflex (vaso-vagal) syncope, the most common form of syncope.

Sincopa can have multiple causes - cardiac, neurological, vascular or metabolic - and affects large numbers of people. It is estimated that about 35% of people will experience at least one episode of syncope in their lifetime. The TILT test helps identify the exact mechanism underlying these episodes.

How to take the test

The patient is placed on a special table that tilts between 60 and 80 degrees, after being securely fixed with support bands. Throughout the test they are continuously monitored:

• electrocardiogram (EKG),
• blood pressure.

The test is performed under the careful supervision of the cardiologist and generally lasts between 20 and 45 minutes. In some cases, sublingual nitroglycerin may be administered sublingually to facilitate the syncopal response. The test is considered positive if the patient is syncopal during the examination, especially if it reproduces exactly the symptoms experienced previously.

When recommended

The tilt table test is particularly indicated in the case of:

• reflex (vaso-vagal) syncope,
• a sudden drop in blood pressure or heart rate,
• Assess the difference between benign and potentially serious (malignant) syncope.

About cardiac syncope

Cardiac syncope involves temporary loss of consciousness, followed by spontaneous return, and occurs in the context of reduced blood flow to the brain. It can be:

• benignwhen it is caused by postural changes (sudden standing up),
• malignant, when it is related to heart disease and is caused by severe rhythm disturbances or intracardiac obstructions.

If malignant cardiac syncope is suspected, the evaluation does not stop at the TILT test. Further investigations may be needed such as:

• electrophysiologic study (to analyze the heart's electrical system),
• complex imaging and functional assessments of the heart.

These investigations can be essential to prevent severe complications, including sudden cardiac death. At CLINICCO Cardiology Hospital, the tilt-table test is performed safely as part of a comprehensive syncope evaluation protocol.