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Related Experiment Videos

Upright tilt table testing in the evaluation of syncope

R M Kam1, W S Teo, S A Gunawan

  • 1Department of Cardiology, Singapore General Hospital.

Singapore Medical Journal
|February 1, 1995
PubMed
Summary

The upright tilt table test effectively diagnoses vasovagal syncope in patients with unexplained fainting. This diagnostic tool is valuable for identifying the cause of syncope and guiding treatment.

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Area of Science:

  • Cardiology
  • Neurology
  • Diagnostic Medicine

Background:

  • Vasovagal syncope is a common cause of syncope, often diagnosed through clinical history.
  • The upright tilt table test (UTT) is a provocative diagnostic tool used to assess autonomic function and identify causes of syncope.

Purpose of the Study:

  • To evaluate the utility of the upright tilt table test in diagnosing vasovagal syncope.
  • To assess the test's efficacy in an unselected group of patients presenting with syncope or presyncope.

Main Methods:

  • 179 patients with a history of syncope or presyncope underwent the upright tilt table test.
  • Patients were tilted to 60-70 degrees for 30 minutes, with isoprenaline infusion if syncope was not induced.
  • A positive response was defined by syncope recurrence, heart rate changes, and blood pressure drop.

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Main Results:

  • The upright tilt table test yielded a positive diagnosis of vasovagal syncope in 53% of patients.
  • Isoprenaline infusion increased the diagnostic yield, identifying an additional 45% of positive cases.
  • The majority of positive responses (80%) were mixed cardioinhibitory and vasodepressor types.

Conclusions:

  • The upright tilt table test is a valuable and effective diagnostic tool for vasovagal syncope.
  • The test aids in identifying the specific vasovagal response patterns, guiding clinical management.