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Updated: Dec 24, 2025
Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Insights
Situational syncope, or fainting, can occur during religious services (Mass). Sudden position changes during Mass may cause orthostatic hypotension, a drop in blood pressure, especially in older adults.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Syncope is a temporary loss of consciousness due to insufficient blood flow to the brain.
- Situational syncope is triggered by specific events or activities.
- Mass attendance involves dynamic postural changes, a potential trigger for syncope.
Purpose of the Study:
- To investigate situational syncope occurring during Mass.
- To identify the prevalence of orthostatic hypotension in individuals experiencing syncope at Mass.
Main Methods:
- Electronic syncope database search for situational syncope triggers.
- Analysis of tilt table testing results for patients experiencing syncope during Mass.
- Retrospective review of 110 cases of situational syncope.
Main Results:
- 62 out of 110 (56.3%) situational syncope cases occurred during Mass.
- 17 out of 110 (15.4%) of these cases showed evidence of orthostatic hypotension upon tilt table testing.
- Sudden postural changes (sitting, kneeling, standing) during Mass were implicated.
Conclusions:
- Mass attendance can precipitate orthostatic hypotension due to rapid postural shifts.
- The safety of older Mass attendees undergoing significant orthostatic stress warrants further consideration.
- Situational syncope during Mass is linked to orthostatic hypotension.
Abstract:
Introduction Syncope is defined as a transient, self-limited loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. We revisit situational syncope focusing on one situation, Mass. Methods We interrogated our electronic syncope database for key terms associated with situational syncope. From the most commonly encountered situation, Mass, we interrogated the results of tilt testing performed to identify evidence of orthostatic hypotension. Results There were 110 cases of situational syncope identified with 56.3% (n=62) taking place at mass. All had tilt table testing performed and 15.4% (n=17) had evidence of orthostatic hypotension. Conclusion The multiple sudden changes in position during mass from sitting to kneeling to standing can precipitate an episode of orthostatic hypotension. Consideration should be given as to whether it is safe for older mass goers to be subjected to such significant orthostatic stress.
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