Tilt Table Evaluation
A medical problem which can have many different causes is syncope
(fainting). Syncope may occur rarely or frequently, depending on the
cause. Some causes of syncope may include, but are not limited to, the
following:
- vasovagal syndrome - a sudden drop in blood pressure with or
without a decrease in heart rate that is caused by a dysfunction of the
nerves controlling the heart and blood vessels.
- arrhythmia (or dysrhythmia) - a heart rate that is too
slow, too fast, or too irregular to maintain adequate blood flow to the
body.
- valve disease - malfunction of one or more of the heart
valves may cause an obstruction of the blood flow within the heart.
When a physician sees a child with a complaint of syncope, the
physician will carefully evaluate the child's past medical history and
perform a physical examination. If basic components of the examination or
history do not reveal a potential cause for the syncope, and the child has
no history of heart disease or a heart condition, then further diagnostic
procedures, such as a tilt table procedure, may be scheduled.
What is a tilt table procedure?The tilt table procedure attempts to identify the cause for the
onset of syncope by making changes in posture from lying to standing. This
is done by having the child lie flat on a special bed or table while
connected to EKG and blood pressure monitors. The bed or table is then
elevated to an almost standing position to simulate the patient actually
standing up from a lying position. The blood pressure and EKG are measured
during the test to evaluate changes during the position changes. If the
test causes an episode of syncope, then the probable cause of the syncope
is vasovagal syndrome. The physician can then prescribe specific treatment
for the syncope once the cause is known.
If the test does not cause an episode of syncope, and/or the EKG and
blood pressure recordings do not detect an abnormality, then additional
tests or procedures may be scheduled to gather further diagnostic
information.
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