[Role of tilt test in the diagnostic and therapeutic management of syncopes]

Following confirmation of one or several episodes of syncope, the most important step is identification of the cause. Unfortunately, despite a careful actiological work-up, a cause is not found in about 30 to 40% of cases, but the tilt test can attribute some of these cases to a vagal cause. The test must be performed according to a rigorous methodology and interpretation must be based on a good knowledge of abnormalities of the autonomic nervous system, particularly the pathophysiology of vagal syncope. The tilt-test can also be useful to evaluate the efficacy of drug treatment prescribed to prevent recurrent syncope.