II. Indications
- Suspected Orthostatic Hypotension despite normal bedside Orthostatic Blood Pressure testing
- Physical limitations preclude standing Vital Signs
- Chronic Orthostatic Intolerance
- Evaluate for Postural Orthostatic Tachycardia Syndrome (POTS)
- Unexplained transient loss of consciousness
- Autonomic disorder monitoring of therapeutic response
III. Procedure: Preparation
- Perform test in quiet, comfortable room
- Rest supine for 5 minutes before test
- Attach automatic Heart Rate monitoring
- Attach automatic Blood Pressure Monitoring and set for desired interval
IV. Procedure: Tilting
- Start after obtaining baseline Heart Rate and Blood Pressure while lying supine for 5 minutes
- Slowly Tilt Table from supine to 60-80 degrees nearly upright position
- Obtain Blood Pressure and pulse after in upright position for 3 minutes
V. Interpretation
- Normal test (negative test)
- Diastolic Blood Pressure increases >20mmHg
- Heart Rate increases by 10-15 bpm
-
Orthostatic Hypotension
- Systolic Blood Pressure drops >20mmHg or
- Diastolic Blood Pressure drops >10mmHg
- Dysautonomic Syncope
- Immediate and persistent drop in systolic and diastolic Blood Pressure
- Heart Rate does not increase to compensate
-
Neurocardiogenic Syncope (Vasovagal Syncope)
- Onset after 10 minutes of testing
- Sudden drop in Blood Pressure results in symptoms
- Paradoxical Bradycardia accompanies the Blood Pressure drop
-
Postural Orthostatic Tachycardia Syndrome (POTS)
- Heart Rate increases at least 30 beats per minute or
- Heart Rate increases over 120 and persists