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A test to determine the reason for blackouts or severe dizzy spells

This leaflet has been written to provide information about a test to try to determine the cause of blackouts or severe dizzy spells (Autonomic function test or Tilt test). We hope it answers some of the questions or concerns you may have about the test. It is not intended to replace talking with medical, nursing or technical staff.

 

What is a Tilt test?

A Tilt test is a simple test which is usually performed when other tests have not been able to determine the reason for blackouts or severe dizzy spells. Sometimes the blackouts are caused by a rapid fall in heart rate or blood pressure.

How is it done?

The test involves lying on a special tilt table while your heart rate and blood pressure are continuously monitored. The table is tilted 70 degrees into a standing up position for approximately 40 minutes, or until symptoms occur, after which the table is returned to a horizontal position.

If your doctor has decided it is appropriate to enhance the test by means of drug administration, GTN (Glyceryl Trinitrate) this will be discussed with you prior to the test.

The table is then tilted as before and the patient monitored.

Increasing the heart rate may reproduce symptoms you have been experiencing at home and cause the heart rate and blood pressure to suddenly drop, reducing the blood supply to the brain and causing blackouts. If these symptoms occur, along with a drop in blood pressure the test would be classed as positive.

GTN Administration

If during the tests you do not experience any symptoms after 20 minutes, one spray of GTN is given under the tongue while you remain in the standing position. This may reproduce the symptoms you have been experiencing at home. You may experience symptoms such as heart racing, drop in blood pressure which may make you feel faint or dizzy. On some occasions patients do experience a ‘black out’ for a very brief period.

Will I have any pain or discomfort during the test?

The test is not painful. You may experience the same symptoms you have at home such as blackouts and dizziness. Sometimes these symptoms are associated with a hot sensation and nausea.

How long does it take?

It can take up to one and a half hours although this varies.

How do I prepare for the test?

You will be informed when to stop eating prior to the test. It is essential to bring a friend or relative to accompany you, as you may feel unwell following the test and require some extra support. If this is not possible please contact the department to discuss this further.

What are the benefits of having the test?

The test may provide important information to help your doctor determine the cause of blackouts and dizziness which may require treatment.

Are there any risks involved?

The test is performed regularly in this hospital and is usually very safe. You may experience dizziness or feel slightly faint during the test. Some people complain of headaches if they have been given medication to increase the heart rate during the test.

What alternatives do I have?

This depends on your symptoms and how often you get them.

Other tests that can provide important information include 24 hour blood pressure monitoring and ECG monitoring. These tests however are dependent on symptoms occurring during the time that you wear the monitoring equipment.

Your doctor would be happy to discuss any alternative tests if they are applicable to you.

What can I expect after the test?

You will be monitored for a short time following the test. You will be given something to eat and drink before you leave the hospital.

What happens if the test is positive?

If the test is positive you may require further treatment. Your doctor will discuss the results of the test with you and discuss any treatment options.

When can I resume normal activities?

If you are feeling dizzy after the test we recommend that you don’t drive until the following day. You may resume normal activities the day after the test. 

For further information

 

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