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16
year old Jenny was advised by her doctor to get a Tilt Up Table
test because she was having frequent fainting episodes.
How is the Tilt Table Test
conducted?
The patient lays on their back on a table and is then strapped
to the table by three straps: one under the arms and across the
upper abdomen, one across the pelvis, and the last one across
the knees. The reason for the straps is to prevent the patient
from falling and to prevent body movement during the test.
An intravenous line is also started
so the patient can be given intravenous fluids to be sure that
they are well hydrated.
After recording measurements
in the reclined position the table is tilted up 75 degrees.
Special electrodes to measure
the oxygen saturation in the brain are also placed on the forehead.
Although this is not part of the standard procedure, this is
an aspect that we expect will be used more and more.
What
is being monitored?
While the patient is still in the flat position on the table,
heart electrodes are placed across the chest to record the heart
rate and heart wave (electrocardiogram). Also, the blood pressure
is usually obtained by a cuff pressure or by placing an arterial
line.
Continuous minute-to-minute blood
pressure, heart rate, and oxygen saturation are recorded.
Who performs the test?
The patient cardiologist and a registered nurse.
What happens during the test?
A very important aspect of the test is what is happening to the
patient in relation to what is shown on the monitor. For example,
if the patient is complaining of lightheadedness or dizziness,
we look at the monitor and see that the blood pressure is dipping
down, and we know that, dizziness is caused by the blood pressure
dipping down. We ask the patient at the time when the symptoms
occur, if these symptoms were experienced before in real life.
What is a positive test?
If the patient faints or is very close to faint
Any paradoxical relation between
blood pressure and heart rate, e.g. the heart rate drops while
the blood pressure is dropping.
The cardiologist may be anticipating
a certain response to correlate with the patient pre-stated symptoms.
How long does it last?
The Tilt up Table Test lasts about 45 minutes standing at 75
degrees.
Is this a safe test?
This is a very safe test because we are trying to understand
what is happening to the patient in real life in a very controlled
environment. Your child may faint on the street and there would
be no one around to help. Here in the hospital doctors are present
and if your child is close to fainting the table will be eased
back to a lying position, and consciousness is regained, and
there is no risk of body injury.
We have conducted over 300 Tilt
Table Tests and have not had a single complication. |