The progressive cardiac department at Aster hospitals, Bangalore provides all the latest diagnostics for heart patients including the well known head-up tilt test, also known as the passive head-up tilt test (HUTT).
HUTT is a non-invasive test recommended by the cardiologist that measures the heart rate and blood pressure each minute while the patient is tilted on the table at varying levels.
The patient is tilted on the bed from an angle of 30 to 90 degrees, while the head-up tilt test determines the cause of the fainting spell. The oxygen level is measured, too. Health Conditions Treated
- Syncope
- Fainting
- Loss of consciousness
- Dizziness
- Postural headaches
- Autonomic failure
- Orthostatic hypotension
- Postural tachycardia syndrome
FAQs
At Aster Hospitals we provide the highest quality of care and a transformative experience for all your healthcare needs. With our network of multi-speciality hospitals, specialised doctors, and world-class technology, we bring global standards of medical care to our patients.
Where is the head-up tilt test performed?
The test is performed in a particular room called the electrophysiology (EP) lab.
What preparations are needed before the test?
The patient needs to eat a light meal 2 to 3 hours before and then not eat until after the test.
Is there any difference between individuals with positive and negative tests?
There is no significant difference between them regarding age, sex, supine systolic blood pressure, number of syncopal attacks in patients with syncope history, underlying heart disease, ejection fraction, or type of fascicular block.
How much is the sensitivity of the head-up tilt test in patients with syncope?
Tilt head test has an estimated sensitivity of 25% to 75% and specificity of 90% to 100%.
Why is GNT spray given during the head-up tilt test?
GNT spray is given under the tongue during the test to elicit a vasovagal response, which is known to induce venous dilation.
Who conducts the test?
A cardiac physiologist conducts the head-up tilt test.
Is there administration of any medication during the test?
If no symptoms are seen, medicine to increase heart rate may be given during the procedure.
How quickly does one recover from syncope?
The recovery from syncope is spontaneous.
Advanced Technology & Facilities
HUTT is a great way to know the cause of the patient's symptoms. The test results help the medical provider determine the best treatment plan. More tests can be conducted to investigate the cause of the symptoms.
Before the test
The patient is advised not to eat or drink anything after midnight the evening before the test. If the patient has to take medication, then only a tiny sip of water should be drunk to help swallow the pills.
The list and the dosage of current medication should be brought along.
Medication should be taken along with food before the test if the patient has diabetes.
Before the test begins, a blood sample from the patient will be drawn to check adrenaline levels and test for other variables depending on the medical history.
Blood pressure cuffs will also be placed in both arms and tiny ECG electrodes on the chest to measure the heart's electrical activity.
During the test
- The patient will be asked to lie flat for about five minutes on a unique table that can tilt.
- The bed will then tilt from 30 to 90 degrees, allowing the patient at various levels.
- The test will be conducted for approximately 20 minutes or till the patient faints, feels dizzy, or a change in the heart rate and blood pressure is seen.
- A glyceryl trinitrate (GTN) spray is given under the tongue if the patient is well. The test continues for another 15 minutes.
- The GTN will elevate the heart rate while reducing the blood pressure slightly.
- The bed will be tilted continuously at different angles throughout the test while monitoring the patient's heart rate, oxygen levels, and blood pressure.
- The patient is also monitored closely to see how they are feeling and experiencing any symptoms.
- At the end of the test, the patient is allowed to sit upright.
- Once the vitals are stable, the patient can go home.
In case during the test, the patient is not feeling well or faints, then:
- If changes in the heart rate and blood pressure or the patient faints or is about to faint, the patient is immediately placed upright and monitored closely.
- After the test, the patient is monitored until her blood pressure returns to normal.
- Once all vitals are stale, the patient can be sent home.
Before the test, the cardiologist needs to know if the patient has:
- Poor circulation
- Heart failure
- Stroke
- Blocked arteries
- Cardiomyopathy
Risks of HUTT
Possible risks of the tilt table tests involve rapid heartbeats, change in blood pressure, dizziness, nausea and vomiting, and fainting.
After the test
Routine activities and diet can be resumed unless the healthcare provider instructs differently.
There is generally no specific care requirement after the head-up tilt test.
The healthcare provider may give specific instructions to the patient depending on the condition.
Uses of HUTT
The test diagnosis is for autonomic failure, orthostatic hypotension, postural tachycardia syndrome, and other forms of orthostatic intolerance.
HUTT was introduced to diagnose fainting caused by a sudden drop in heart rate and blood pressure (vasovagal syncope).
HUTT results
A positive HUBB result indicates the presence of light-headedness associated with decreased vision, partial loss of postural tone, nausea, or slow response to verbal stimuli (severe presyncope) or syncope. These symptoms are accompanied by marked hypotension with or without bradycardia.
The possible causes of syncope may include:
- Neurocardiogenic syncope: This is also called vasovagal syncope, where a sudden drop in blood pressure is observed with or without any change in the heart rate. The cause is an exaggerated response of the nerve that controls the blood vessels and heart.
- Structural heart disease: Enlargement of the heart may cause problems with cardiac muscle, or malfunction of the cardiac valve may block the blood flow within the heart.
- Arrhythmia: When the heart rates are irregular, the heart can't supply enough blood to the body.
- Cardiomyopathy ventricular dysfunction: Ventricular is too weak to pump blood.
The negative HUBB result will help the doctor in the future to plan a test or treatment from the information collected during the procedure.
The patient needs to meet with the healthcare provider for the results and know if further testing needs to be done.
