A test used to determine the cause of fainting spells. The test involves being tilted, always with the head-up, at different angles for a period of time (2 minutes at 30 degrees, then 2 minutes at 45 degrees, then up to 45 minutes at 70 degrees). Heart rhythm, blood pressure and other symptoms are closely monitored and evaluated with changes in position.

To prepare:

• Do not eat or drink anything, except water for four hours before your test. If you must take medications, drink small sips of water to help you swallow your pills.
• Take all your medications as prescribed. If you are diabetic, check with your doctor about how to adjust your diabetic medications.
• Wear comfortable clothes. You may wear a hospital gown during the procedure, if you prefer. It is best not to wear any jewelry or valuables.
• Most likely, you will be able to go home after the test. You should bring someone with you to drive you home after the test.

• During the head-up tilt (HUT), you will lie on a special bed that has a foot-board and a motor which we control so that it can tilt to different degrees, as described above.
• The nurse will start an intravenous (IV) line in your arm to give you medications and fluids during the procedure, if neccessary to treat your symptoms and/or blood pressure and heart rate changes.
• The nurse will connect you to several monitors (for monitoring your electrocardiogram (ECG) and blood pressure, and sometimes respiration and blood-oxygen).
• You will be awake but will be asked to lie quietly and keep your legs still. However, it is important to report your symptoms as they occur.
• The test involves being tilted at different angles for a period of time. Blood pressure, heart rate and other measurements are recorded during the test. You may feel no symptoms at all; you may feel symptoms of lightheadedness, nausea, dizziness, palpitation (fluttering in the chest) or blurred vision; or you may faint. It is important to tell your doctor or nurse any symptoms you feel.
• The HUT lasts about one hour and 15 minutes.
• At the completion of the test, the findings may indicate you need the tilt test to be repeated with enhancement. In this case, a second tilt test will include up to 3 segments, each with a supine (flat) and a 70 degree portion. Your doctor may give you a medication called Isuprel. This medication may make you feel nervous, jittery, or that your heart is beating faster or stronger. This feeling will go away as the medication wears off. Your blood pressure, heart rate and symptoms will be closely monitored and evaluated.