Diagnostic Symptoms
A tilt table test is considered positive if the patient experiences 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 this 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.
A common side effect during tilt table testing is a feeling of heaviness and warmth in the lower extremities. This is due to blood pooling in the legs and, to onlookers, the patient's lower extremities may appear blotchy, pink, or red.
Dizziness or lightheadedness are also likely to occur in susceptible patients. Tilt table testing could provoke fainting or syncope; in fact, this is the purpose of the test. It may not be appropriate, or indeed even possible, to stop the test before this occurs, as the drop in blood pressure or pulse rate associated with fainting can come on in seconds. This is why the patient's blood pressure and ECG should be continuously monitored during the test.
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 any time in tilt table testing a patient loses consciousness, he or she will be returned to a supine or head down position and will be given immediate medical attention, which could include being given fluids or perhaps atropine or adrenaline (epinephrine).
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