A head upright tilt test (HUTT) is usually performed as part of the evaluation for syncope (passing out). It specifically screens for one of the more common causes of fainting called neurocardiogenic syncope. Individuals who suffer from this disorder usually pass out after being in the standing or sitting position for prolonged periods of time, although in some individuals the duration can certainly be brief). During a tilt test, the objective is provoke one of these spells by placing the patient in an upright position while constantly monitoring blood pressure and heart rate.
Preparation for the test:
- Nothing to eat or drink overnight or at least six hours prior to the test.
- Make sure to ask your physician about taking your medications, particularly if you are diabetic and are on insulin.
- Wear comfortable clothes and shoes.
You will be placed on a flat comfortable table. A nurse will place electrodes on your chest and a blood pressure cuff on your wrist and/or arm to monitor your heart rate (HR) and blood pressure (BP) continuously throughout the procedure. A recording of your blood
pressure and heart rate will be done at baseline in the lying position, after which the table will be brought upright or tilted to a 70-degree inclination. Blood pressure and heart rate are then monitored continuously and values are recorded every 3 minutes. Unless the test is positive (your BP and/or HR fall and you faint or experience a near-faint), you will remain at 70-degrees for 30 minutes. At 30 minutes, additional maneuvers will be done to try to provoke an abnormal test. The first of these is massaging your upper neck on both the left and right sides (called carotid massage) and the second is giving a small dose of nitroglycerin under the tongue. After nitroglycerin is given, the tilt is continued for another 10-15 minutes. The test is terminated if you have a positive test or did not respond to any of the above.
After the test:
- You will be observed for 10-15 minutes.
- You can eat.
- You can go home on the same day.